ABSTRACT
Introduction: The purpose of this study was to clarify factors related to recognition of the possibility of end-of-life care at home (hereafter referred to as end-of-life care) among middle-aged and elderly people living in heavy snowfall and depopulated areas.Methods: Residents aged 40~69 years in town B, prefecture A were surveyed by mail using a self-administered, unmarked questionnaire. Analysis methods were: (1) a reliability analysis of survey items, (2) basic statistics, (3) tests for differences in composition ratios, (4) tests of differences between the two groups for each item, and (5) binomial logistic regression analysis. Recognition of the possibility of end-of-life care was used as the objective variable, and sex, age, and 18 indicators significant in (3) and (4) were used as explanatory variables.Results: There were 63 in the positive group for end-of-life care, 239 in the negative group, and 120 in the unknown group (Response rate: 44.1%). Factors related to perception of the possibility of end-of-life care were positively related to "existence of a community hospital, " "positive image of end-of-life care, " and "trust in people in the community. "Conclusion: In depopulated areas, it is necessary to consider specific measures to promote the three factors that raise awareness of the possibility of end-of-life care.
ABSTRACT
Introduction: The purpose of this study was to clarify the issues for nurses in neurology departments of medical clinics in building a comprehensive community care system based on the implementation status of regional cooperation and individual support for hospitalized patients. We selected neurology as the subject of our study because patients who visit the neurology department are in the medical clinic for an extended period, and we believe that regional cooperation and individual support are implemented more than in other departments.Methods: A self-administered questionnaire survey was conducted by mail in February 2020 among nurses at 1,052 clinics, which were randomly selected from 2,104 clinics with neurology departments among medical institutions designated for intractable diseases.Results: We collected 174 responses (16.5% collection rate), 164 of which were valid (15.5% valid response rate). The regional cooperation rate was 71.3% and individual support by nurses was implemented at 29.9% of the clinics in the past year. Clinical physicians often sought "patient support in collaboration with related parties" and "patient guidance". Free descriptions included five categories such as [strengthening the awareness and abilities of nurses who are responsible for community healthcare] and [training nurses who can promote comprehensive community care].Conclusion: Regional cooperation and individual support are necessary as nursing activities linked to the functions of family physicians.