脳卒中の再発予防に関する医療施設の患者教育の実態調査 <資料>

脳卒中の再発予防に関する患者教育の実態を明らかにするために,広島県と大阪府豊能医療圏における病院及び診療所の医療スタッフに対して質問紙による郵送調査を行った.調査期間は2010年1月～3月,質問紙配布数は病院157施設,診療所395施設,病院の有効回答数は47部(有効回答率29.9%),診療所は168部(有効回答率42.5%)であった.

患者教育実施割合は急性期病棟70.8%,回復期病棟57.1%,病院外来43.5%,診療所61.3%,教育時間は急性期病棟と慢性期病棟では「1～2時間」がそれぞれ52.9%,37.5%であった.病院外来と診療所では「10分未満」がそれぞれ60.0%,84.4%と高く,医師による患者教育が多かった.地域連携パスの使用は病院24施設(51.1%),診療所は32施設(19.0%)であった.

再発率の高い脳卒中の再発予防のためには,回復期病棟と病院外来において高血圧や高脂血症,糖尿病管理等を踏まえた専門スタッフによる教育の必要性が示唆された.

In order to examine the current state of patient education on the prevention of cerebral apoplexy recurrence, a questionnaire survey was conducted. The participants were medical staffers at 157 hospitals and 395 clinics in Hiroshima Prefecture and Toyono Medical Bloc, Osaka Prefecture. The survey form was sent by mail and the study was conducted between January and March, 2010. Forty-seven valid forms were received from the hospitals (a valid response rate of 29.9%) and 168 from the clinics (42.5%).

Patient education was practiced at 70.8% of the acute-stage wards, 57.1% of the recovery-stage wards, 43.5% of the outpatient units, and 61.3% of the clinics. The average time spent on patient education was "1-2 hours" at 52.9% of the acute-stage wards and 37.5% of the chronic-stage wards. Only "less than 10 minutes" was spent at 60.0% of the outpatient units and 84.4% of the clinics, respectively; it was provided mostly by the doctors. Community collaboration paths were used by 24 hospitals (51.1%) and 32 clinics (19.0%).

It was inferred that, in order to prevent recurrence of cerebral apoplexy, which has a high rate of recurrence, education by specialists is called for at recovery-stage wards and outpatient units with a focus on management of high blood pressure, hyperlipemia and diabetes.