日本老年护理与生活质量研究——来自老年人的调查结果

Mami Takahashi, Makoto Oe, H. Sanada
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摘要

医疗技术和系统部署的显著进步为日本带来了前所未有的预期寿命和老龄化速度。因此,日本政府在出生率下降和超老龄化的社会中,一直在寻求实现一个健康长寿的社会。它一直在制定战略,以实现延长“健康预期寿命”的目标,并一直在执行这些战略。日本的大多数患者年龄在65岁或以上。不仅支持完全治愈,而且保持他们的健康对他们的日常生活质量至关重要。因此,当存在不健康的情况时,有必要减少他们的不便和痛苦,并给予关注。努力实现这些目标既是老年护理的乐趣,也是老年护理的责任。当我们关注生命的最后阶段时,我们发现80%的公民在医疗机构死亡,尽管他们希望呆在家里。普遍调查显示,人们希望把时间花在家里。他们不希望在没有正当理由的情况下被迫接受延长生命的药物,而且家庭在做出延长生命的决定时使用的要点似乎与自己使用的要点不同。虽然大约70%的公民支持为他们的临终关怀提供指导,但只有3%的人最终这样做了。这表明家庭的意见可能无法反映老年人的意见。医院之所以成为大多数人死亡的地方,主要原因是缺乏基础设施。此后,在日本,从生活质量的角度来看,老年护理不仅要发展硬的基础设施,还要加强反映一个人在最后几天愿望的软措施,这将是至关重要的。
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A Study of Gerontological Nursing and Quality of Life in Japan - From Survey Results on the Elderly
Remarkable improvements in medical technology and system deployment have brought to Japan a level of life expectancy and a speed of aging unlike any mankind has experienced. As a result, the Japanese government has been seeking to realize a healthy society of longevity amidst its declining birthrate and super aging society. It has been developing strategies for achieving the target of extending a ‘healthy life expectancy’ and has been executing on those. The majority of patients in Japan are 65 or older. Supporting not only a complete cure but also maintaining their health are crucial to their daily Quality of Life. It will therefore be necessary to reduce their inconvenience and pain when unhealthy conditions exist and to offer concern. Working to achieve these goals is both the pleasure and responsibility of Gerontological Nursing. When focused on the last stage of life, we find that eighty per-cent of citizens die in medical institutes despite their wish to be at home. Consensus surveys report that people hope instead to spend their time at home. They do not wish to be forced to accept life-prolonging agents without justifiable cause, and the points used by the family to make the decisions regarding the prolonging of life seem to be different from those used by oneself. While around seventy percent of citizens support the idea of giving instructions for their terminal care, only three percent of them end up doing so. This indicates that the family’s opinion might not reflect that of the elderly. The major reason for why the hospital has become the place where most people die is the lack of infrastructure. Hereafter in Japan, it will be critical for Gerontological Nursing to not only develop a hard infrastructure but also to enhance the soft measures that reflect a person’s wish during the final days from the viewpoint of the Quality of Life.
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