This study aimed to help develop collaborative care models for care service staff working in homes and residential facilities to implement measures for the improvement of undernutrition in terms of nursing care. The survey is care service staff 's awareness of undernutrition including required information. Although nursing care providers were aware of the overall care-related needs of their care recipients, they were in somewhat knowledgeable level about the nutritional health/functioning status that can be assessed by the nutritional condition indices such as the BMI(body mass index) and serum albumin level. The results of this study suggest that the level of nursing care service providers' awareness of the improvement of undernutrition of the elderly in need of nursing care was not high; although in-home nursing care providers understood the overall picture of services or their tasks including the levels of nursing care required by elderly patients and their levels of independence in ADL(activities of daily living) according to their degrees of disabilities or dementia, they did not comprehend the nutritional status of their patients such as the styles of diet and intake of meals; and nursing care service providers in residential facilities were aware of the nutritional status of their patients, although they were not unable to understand the overall picture of services. There were significant differences in the levels of the awareness of the improvement of undernutrition by the types of nursing care-related professions ; for example, while consultants were only aware of the basics of services like the level of nursing care required by patients, nursing care providers understood the styles of diet as well as dental and choke-related conditions and health care professionals comprehended the intake of meals, BMI, and serum albumin level. The study results suggest that it is necessary to develop tools for the collection of care service-related information and assessment to be shared by care service staff to improve undernutrition to prevent the elderly from becoming to require higher levels of nursing care. <Key-words> the elderly in need of nursing care, the prevention of the elderly from becoming to require higher levels of nursing care, improvement of undernutrition, the level of nursing care
The present study aimed to clarify information-gathering during the process of designing care plans regarding nutrition improvement in nursing care insurance services. A total of 2,000 nursing care insurance service providers were randomly selected from the nursing care insurance service networks throughout Japan, and an anonymous selfcompleted questionnaire survey was conducted care managers. This study identified a low rate of including nutrition indices as information-gathering items during the process of designing care plans regarding nutrition improvement. This was suggested to be attributable to the type of service, fundamental qualifications, and education. To design care plans aimed at nutrition improvement for older people requiring care, it is necessary to provide care managers with standardized education on nutrition indices and older people's independence. In addition, the need for education in basic professional education courses was suggested.
The purpose of this study was to clarify the implementation contents of independent excretion care of elderly pneumonia patients, including nurses' thoughts, by acute care hospital nurses. Semi-structured interviews were conducted with 17 nurses working on a respiratory ward, and the obtained data were qualitatively and inductively analyzed. The acute hospital nurses approached to independent excretion care included: performing such care through multi-professional liaison and learning from senior nurses. On the other hand, they faced dilemmas when performing excretion care that did not meet patients' requirements due to insufficient manpower and the prioritization of treatment in the clinical setting. To perform independent excretion care for elderly patients with pneumonia, the following nursing support approaches may be necessary: continuously providing education focusing on excretion care, and tool development for independent excretion care.
Undernutrition is a factor associated with care dependency in the elderly. Undernutrition means the state that a nutrient necessary to live healthfully can't take in. This study examined the nutritional status and mental/physical functions of the care-dependent elderly living in facilities and home covered by long-term care insurance to clarify factors influencing their nutritional status, as well as indices for the early identification of undernutrition among them. I analyzed it about the Alb level and BMI to become indices of undernutrition in this study. Data regarding the actual status of 529 care-dependent elderly individuals, 369 (69.8%) residents of Long-term Care Insurance-covered facilities (facility group), and 160 (30.2%) living at home (home group), were obtained in 9 arbitrarily selected areas. Care dependency was frequently marked in the facility group, while it was generally mild in the home group. Regarding the nutritional status, there were no differences in the BMI between the groups, but the Alb level was lower in the former. The Alb level was also significantly correlated with 4 factors: BMI, mode of feeding, dietary intake, and ability to walk. On detailed analysis, decreases in the Alb level were associated with altered modes of feeding and a reduced ability to walk in the facility group, and a decreased dietary intake in the home group. These results support the feasibility of predicting decreases in the Alb level by clarifying altered modes of feeding and a reduced ability to walk among those with marked care dependency, and by detecting decreases in the dietary intake among those with mild care dependency even when the Alb level is unclear. The factors identified in this study may be new indices for the identification of undernutrition in the care-dependent elderly.<Key-words> undernutrition, mode of feeding, dietary intake, ability to walk, Alb yfujio@juntendo.ac.jp(Yuko FUJIO) Asian J Human Services, 2016, 10:16-24.
To promote care planning that prevents the progression of care dependency among care service users by improving their nutritional conditions, we examined the status of ICT use for such planning and contents of care plans, involving 714 care managers throughout Japan. Based on the results, we propose an ICT program to prevent the progression of care dependency among care service users by improving their nutritional conditions through interprofessional collaboration, adopting the following approaches: 1) standardizing assessment to create care plans that facilitate nutrition improvement, and organically reflecting challenges of such improvement on care plans, actively and effectively using ICT; 2) encouraging communities to share their care planning systems to promote the sharing of care plans for nutritional improvement with service providers; and 3) promoting interprofessional collaboration by sharing the systems. <Key-words> interprofessional collaboration, ICT program, nutrition improvement, prevention of the progression of care dependency
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