Departmental Bulletin Paper 外来がん化学療法部門における患者・家族への曝露防止指導
The education of outpatients and their families on the prevention of exposure to antineoplastic drugs

杉山, 令子  ,  石井, 範子  ,  工藤, 由紀子  ,  佐々木, 真紀子  ,  長谷部, 真木子  ,  長岡, 真希子  ,  菊地, 由紀子  ,  SUGIYAMA, Reiko  ,  ISHII, Noriko  ,  KUDO, Yukiko  ,  SASAKI, Makiko  ,  HASEBE, Makiko  ,  NAGAOKA, Makiko  ,  KIKUCHI, Yukiko

23 ( 2 )  , pp.83 - 92 , 2015-10-31 , 秋田大学大学院医学系研究科保健学専攻
外来がん化学療法における患者と家族への曝露防止指導の状況を明らかにするため, 郵送法にて質問紙調査を行った. 全国の大学病院, がん専門病院, 一般病院の合計899施設の外来がん化学療法担当看護師各1名を対象とした.552施設の回答があり, 514施設を分析した.看護師の97%が抗がん剤の医療従事者への健康影響を認知していた. 抗がん剤による曝露防止についての患者への指導は58%, 家族への指導は51%, 患者・家族のための曝露防止ガイドラインやパンフレットを用いているのは17%であった. 指導内容は患者・家族の何れに対しても, 点滴終了方法, 点滴バッグの処理方法は約80%であったが, 排泄物や洗濯物の取扱いは20%未満であった. 指導しない理由は「曝露防止方法がわからない」「患者の動揺を考慮」が多かった. 患者・家族への指導は, 施設の種類, 治療件数と関係がみられ, 指導の割合は実施件数の多い施設で高く, 一般病院が大学病院やがん専門病院より低かった. 誤抜針, 液漏れ等の持続注入中の在宅トラブルを53%が経験していた. どの施設でも患者・家族に適切な指導が行えるようにマニュアル設置の必要性が示唆された.
The purpose of the present study was to clarify the effects of educating outpatients and their familieson exposure prevention. Questionnaires were administered to 899 nurses in charge of outpatient cancerchemotherapy. Responses were received from 552 institutes; a total of 514 responses were analyzed.Ninety-seven percent of nurses are aware of the health effects of antineoplastic drugs. Patienteducation was carried out at 58% of institutions, family education was performed at 51% of institutions,and guidelines explaining exposure prevention to patients and their family members were used at 17% ofinstitutes. Eighty percent of the education involved methods of drip termination. In contrast, less than20% of the education focused on methods relating to the handling of excreta and laundry. Reasons for notproviding education on these topics included the following responses: I do not know the method forpreventing exposure, and I wished to avoid disturbing patients and their families. The education thatwas provided was correlated with the type of institute and the number of patients who were treated; therate of education was higher in institutes that implemented more treatment and institutes in whichpreventive measures were taken, and was lower in general hospitals than in university hospitals andhospitals that specialized in cancer treatment. The results suggested the need to establish a manual thatwould allow any institute to be able to appropriately educate patients and their family members.

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