糖尿病患者のセルフケア継続のための効果的な介入時期と方法の検討 : 糖尿病教育入院に関する文献的研究

糖尿病教育入院での教育的支援が、退院後のセルフケアにどのように影響しているのか、長期にわたるセルフケア継続のための効果的な介入方法と、その時期を明らかにすることを目的に文献調査を行なった。2003～2008年に発表された日本での会議録、総説をのぞく原著論文を、医学中央雑誌から「成人」「糖尿病」「教育」「自己管理」をキーワードに検索し、66件の文献を対象にした。その結果以下の4点が示された。 ①糖尿病教育入院による教育効果は、6ヶ月を境に減少していた。②糖尿病教育入院の追跡調査では、退院後1年までがプログラム化されていた。③糖尿病教育入院プログラムは、入院中は具体的に示されていたが、退院後については、受診と検査、看護師の面接であった。④糖尿病教育入院の近年の傾向として、自己効力感を高める取り組みがされていた。このことから、退院後に現実の生活に適応させ、継続させる困難さが明らかになり、そのための長期介入の必要性が示唆された。We conducted bibliographical research on educational support for diabetic patients who have been hospitalized to receive education and training, in order to clarify effective intervention methods and their timing for long-term self-care. We performed a search of original articles from medical magazines, excluding conference minutes, published in Japan between 2003 and 2008 using the keywords, “Adult,” “diabetes,” “education” and “self-management”. 66 pieces of literature were eventually subject to our research, and as a result, the following 4 issues were noted.1.Educational effectiveness through educational hospitalization for diabetes would start to decrease around 6 months after hospitalization. 2. In follow-up research of diabetic patient educational hospitalization, the record up to 1 year after discharge from the hospital was programmed. 3. Educational hospitalization programs for diabetic patients were proposed in detail during their hospitalization, but after their release from the hospital, only outpatient checkups, medical examinations and interviews with nurses were held. 4. A recent movement has begun that tries to increase the self-efficacy feeling for diabetic patients’ educational hospitalization.By examining these points, it seems clear that the adaptation and continuation of educated matters to real life after hospitalization are difficult to maintain, and therefore, the necessity of longer period intervention is indicated