Permalink : http://hdl.handle.net/2115/42801

JaLCDOI : 10.14943/43511

KEYWORDS : diabetes;nurse;unexpected difficulty;telephone consultation;nighttime and holidays;糖尿病;看護師;予期せぬトラブル;電話相談;夜間休日

背景：薬物治療を継続的している在宅糖尿病患者には，低血糠や機器不良などのトラブルが診療時間外にも発生する。目的：診療時間外における在宅糖尿病患者の電話相談ニーズの実態を明らかにする。方法：A糖尿病専門病院（月平均外来受診約3,300件）の病棟管理日誌から，2005年4月以降16ヵ月間の記録を，患者の年齢，性別，相談内容等について調査した。調査は，同病院の倫理審査委員会の承認を受けた。結果：相談総数は823件，丹平均51.4件で，患者の平均年齢は63.8歳，男性40.6%，女性59.4%であった。相談内容は，低・高血糖，高血圧，嘱吐などの症状トラブルが55.6%，インスリン投与の判断や誤投与，機器不良などの治疫に関するものが27%，その他17.4%であった。結論：患者にとって予期せぬトラブルが起きた場面では，看護師などの専門職者によるタイムリーで利便性の高い電話相談等を利用した対処指導が必要であることが明らかになった。
Background: Problems such as low blood sugar, defective equipment, and other unexpected difficulty occur on outpatients with diabetes who need constant medication even outside office hours. Objective: This report aims to clarify the actual conditions of patient's telephone consultations by nurses during nighttime and holidays. Methods: Using the nursing management diary of a diabetes-specialized hospital (average number of outpatients per month: about 3,300), we investigated the 16-month period from 2005 April onward, analyzing the age, gender, and consultation records of the patients. Prior to the investigation, we received approval from the hospital's ethical review board. Results: The total number of consultations was 823, the monthly average was 51.4, the patients' average age was 63.8, and the ratio of men to women was 40.6% to 59.4%. Regarding the content of the consultations, concerns related to symptomatic troubles such as low/high blood sugar, high blood pressure and vomiting accounted for 55.6%, concerns related to treatment, such as the administration or misadministration of insulin, or the defective equipment, accounted for 27%, while other concerns accounted for 17.4 %. Conclusions: This study revealed that in cases where patients face unexpected difficulty they need guidance and assistance using timely and accessible telephone consultation by nurses even during nighttime and holidays.