Developing a Model for the Nursing Care of Elderly Dementia Patients In Advanced Treatment Hospitals

本研究的目的是建立一种老年痴呆患者入住高级治疗医院的护理模式。首先，我们搜索了2004年9月1日至2006年3月31日入住高级治疗设施“a”的患者的医疗记录，以澄清老年痴呆患者入院的情况。结果，我们发现该医院全部住院患者中有43.8%是65岁及以上的老年患者，其中1.5%被诊断患有痴呆症。接下来，我们在2006年11月1日至17日期间对242名护士进行了问卷调查，目的是说明护士在高级治疗设施“a”照顾老年痴呆症患者的实际经验和遇到的问题。问卷调查结果显示，77.8%的护士声称曾处理过多名老年痴呆患者。此外，照顾老年痴呆患者的护士中有70%认为任务困难，对实际护理的满意度也很低。2008年1月15日至2月22日，我们与日本22家先进的治疗机构合作，对护士长进行了调查，共收到113份回复。调查结果显示，14.2%的护士已制定并使用护士常备医嘱。在护理过老年痴呆症患者的护士长中，约有50%的人认为，提供这种护理的难度因患者而异。基于上述调查结果，我们认为在高级治疗医院中发展老年痴呆患者的护理模式应考虑以下因素：充足的人员以保证充分的护理和实现个性化护理等。

The aim of this research is to develop a nursing care model for elderly dementia patients admitted to advanced treatment hospitals.First we conducted a search of the medical records of patients admitted to Advanced Treatment Facility `A' from 1 September 2004 to 31 March 2006 to clarify the conditions surrounding admission of elderly dementia patients. As a result, we discovered that 43.8% of the hospital's entire inpatient population were elderly patients aged 65 years or over, among whom 1.5% had been diagnosed with dementia. Next we conducted a paper-based questionnaire on 242 nurses from 1 to 17 November 2006 with the aim of illustrating the actual experiences and issues encountered by nurses in caring for elderly dementia patients at Advanced Treatment Facility `A'. The results of the questionnaire showed that while 77.8% of nurses claimed to have dealt with multiple elderly dementia patients. Furthermore, 70% of those nurses who had cared for elderly dementia patients felt that the task was difficult and the level of satisfaction with the actual care provided was also low.Enlisting the cooperation of 22 advanced treatment facilities in Japan, we also conducted a survey of head nurses from15January to 22 February 2008 and received a total of 113 responses. The survey results indicated that 14.2% had been drawn up and were using nurse standing orders. Around 50% of the head nurses who had experienced caring for elderly dementia patients felt that the level of difficulty in providing such care varied according to the patient.Based on the results of the surveys outlined above, we consider that the development of a model for the nursing care of elderly dementia patients in advanced treatment hospitals should incorporate the following factors: sufficient personnel to ensure ample care and realization of individualized care and so on.