高齢患者の排尿自立について : 退院1年後の予後

Abstract

入院中, 排尿自立を目的とした治療および指導によりカテーテルおよびオムツフリーになった高齢者293例の1年後の排尿状態を生活の場に分けて比較検討した。1)在宅者は訪問看護により排尿自立を目的とする治療を継続したが, 老人ホームや他病院の他施設では治療の継続がえられなかった。2)在宅者では, 老人ホーム入所者および他院入院患者に比較して, ADL良好者が有意に多かった。3)退院1年後に, 192例の在宅者のうち, 151例において排尿自立が維持されていたが, 他施設では, 101例中21例で維持されていたのみであった。4) ADL障害者における排尿自立の維持は, 在宅者(34%)が他施設入所者(18%)に比べて有意に高率であった

We investigated how 293 elderly patients who had been successfully treated to be free of catheters or diapers managed to urinate one year after their discharge from our hospital. Of 192 patients who returned to their own home 154 (80%) had good activities in daily life (ADL), and of 101 who moved to a nursing home or other hospital only 7 (7%) had good ADL. Among the 192 in their own home, 151 (79%) remained free of catheters or diapers thanks to the home care services provided by trained nurses belonging to our hospital. However, among the 101 at other facilities 21 (21%) could avoid these appliances. Furthermore, those who stayed in their own home with poor ADL had a significantly higher rate of being independent of catheters or diapers (34%) compared to those who lived in facilities other than their home with poor ADL (13%). These findings indicate that the elderly patients who reside in their own home or have good ADL possess a better chance of avoiding catheters or diapers compared to those who live in other than their residence or have poor ADL, and that continued urological care coupled with the home-visiting services is effective and important in attaining these aims.