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アブストラクト（47巻1号：神奈川歯学）
Japanese
| Title ： | 遷延性意識障害者への看護介入に対する生体反応に関する研究 |
|---|---|
| Subtitle ： | 原著 |
| Authors ： | 佐藤光栄*1,*2, 山口和郎*3, 近藤昊*4, 川口毅*4 |
| Authors（kana） ： | |
| Organization ： | *1人間総合科学大学大学院人間総合科学研究科心身健康科学専攻, *2横浜創英短期大学看護学科, *3湘南病院, *4人間総合科学大学大学院 |
| Journal ： | 神奈川歯学 |
| Volume ： | 47 |
| Number ： | 1 |
| Page ： | 15-23 |
| Year/Month ： | 2012 / 6 |
| Article ： | 原著 |
| Publisher ： | 神奈川歯科大学学会 |
| Abstract ： | 「緒言」医療の高度化によって生命を救われたが, 意識レベルが回復しない遷延性意識障害者や, 寝たきり状態で日々刺激が少ない状態で過ごし, 感情表現することも少なくなり意識レベルが低下したように見えている患者なども多くみられている. 遷延性意識障害者(1944年に米国神経学会のThe Multi-Society Task Force on PVS (MSTF)から出された定義を満たすものとしている)に関する全国レベルで実態調査もまだなく, 人口比換算による推定を行っている現状である. 藤原ら1)の報告によると2010年の調査では遷延性意識障害者は, 全国で約55,000人と推定され, その70%以上が70歳以上の高齢者であり, 60%以上が女性で占められている. 原因疾患は, 脳血管疾患が64%で最も多かったとの報告している2, 3). これらの患者は, 不動状態から廃用性変化を起こし独特の姿勢や胃瘻や経管により直接胃に栄養を補給されている状況にある. |
| Practice ： | 歯科学 |
| Keywords ： | 遷延性意識障害者, 口腔ケア, コルチゾール, ノルアドレナリン |
English
| Title ： | Research on the reaction of the living body to nursing to bedridden elderly people and the patients with persistent unconsciousness |
|---|---|
| Subtitle ： | |
| Authors ： | Mitsue SATO*1,*2, Kazuo YAMAGUCHI*3, Hiroshi KONDO*4, Takeshi KAWAGUCHI*4 |
| Authors（kana） ： | |
| Organization ： | *1Health Sciences of Mind and Body Studies Department of Human Arts and Sciences, Graduate school of University of Human Arts and Sciences, *2Yokohama Soei Junior College, *3Shonan Hospital, *4Graduate school of University of Human Arts and Sciences |
| Journal ： | Kanagawa Shigaku |
| Volume ： | 47 |
| Number ： | 1 |
| Page ： | 15-23 |
| Year/Month ： | 2012 / 6 |
| Article ： | Original article |
| Publisher ： | Kanagawa Odontological Society |
| Abstract ： | [Abstract] The present study aimed to investigate indices for evaluating nursing for patients in a persistent vegetative state (PVS). Extra nursing intervention was conducted for patients in a PVS and for conscious, bedridden elderly controls, and potential objective indices for assessing the stress status of patients in a PVS were investigated based on changes in levels of stress. Dependent factors were a third-party evaluation and subjective evaluations by the conscious, bedridden elderly subjects. Nursing intervention comprising assistance for sitting, foot bathing and oral care was conducted 5 times a week for 3 weeks for 15 patients in a PVS and 6 conscious, bedridden elderly subjects. Changes in pre- and post-intervention saliva and blood cortisol levels and blood catecholamine levels were investigated along with a third-party evaluation. A subjective General Well-Being survey was also conducted on the conscious, bedridden elderly subjects and both subject groups were compared. Results revealed a slight improvement in consciousness level in patients in a PVS post-intervention. With regard to vital reactions, although no marked change in cortisol levels was observed, noradrenaline levels tended to increase. Furthermore, subjective evaluations by conscious, bedridden elderly subjects revealed a tendency for improved sense of general well-being due to nursing intervention and third-party evaluations showed a trend toward slight improvements in the patient's condition in both groups. Interpreting these results to be in line with vital reactions indicated residual responses demonstrating some kind of intention based on minute endocrine changes, autonomic nervous system responses and changes in consciousness level. The present findings suggest that these vital reactions could be evaluated as reflecting the intentions of patients in a PVS. These results also suggest that changes in cortisol and catecholamine levels should be monitored as part of nursing intervention for patients in a PVS as an indicator of biological changes. |
| Practice ： | Dentistry |
| Keywords ： |
