Factors Related to End-of-life Care Provision by Home-visit Nursing Agencies not Calculating the Medical Expenses for Function-enhanced Home Nursing Management: Focus on Educational Factors

Abstract

Objective: To clarify the education and training-related factors associated with provision of endof-life care by home-visit nursing agencies that did not calculate the medical expenses for functionenhanced home nursing management.Methods: An anonymous questionnaire was administered to 2,000 randomly selected home-visit nursing agencies throughout Japan. It asked about the facility structure, training/education factors among nurses and managers, regional and cultural difficulties in implementing end-of-life care at home, and provision of end-of-life care at home.Results: A total of 242 responses were analyzed. Logistic regression analysis was carried out, adjusting for the number of full-time equivalent nurses, the presence of an additional 24-hour response system and regional and cultural difficulties in implementing end-of-life care at home. It showed that the provision of end-of-life care at home was associated with end-of-life care training for managers (odds ratio: 4.17, 95% confidence intervals: 1.76-9.90), and support to increase the frequency of accompanied visits for nurses practicing end-of-life care at home for the first time (3.12, 1.33-7.29).Conclusion: End-of-life care at home may be promoted by providing specific training for managers and ensuring that nurses who are practicing end-of-life care at home for the first time are accompanied.受付日：2022 年 4 月 22 日 受理日：2022 年 9 月 5 日 1) 公益財団法人日本訪問看護財団 Japan Visiting Nursing Foundation 2) 東京大学大学院医学系研究科健康科学・看護学専攻高齢者在宅長期ケ