Abstract
Decubitus is a disorder which is not cured easily. However, health professionals who have treated many cases know that the disorder can be prevented. The author has been proposing to medical societies how to prevent decubitus based on a scientific basis from around the middle of the 1960s. The proposition is based on the method of coloring by the ammonium rhodanide and on the KOSIAK method of a balloon pressure measurement; both reported to be giving almost the same result. Many studies on the mechanisms underlying decubitus and/or bedsore development have been performed from a 100 years ago. There are many elucidated facts concerning the pathology and biochemistry of decubitic changes in scientific journals. Nevertheless, the number of patients with decubitus, who would be able to prevent it, has not decreased despite the spread of knowledge. Our study group has been working for years on how to improve the present poor condition regarding the frequency of decubitus and how to find out any possible solution. The evil of the bedsore and the ways of its prevention have been proposed through the author’s academic activity for 40 years. In order to acquire a solution for today's situation, we have striven for prevention of decubitus for many years. Then, the Japanese Ministry of Health, Labour and Welfare introduced the policy that was named “the non-enforcement of bedsore measures” for the prevention of decubitus in inpatient medical institutions, which reduces income for the health insurance companies. By the enforcement of the policy, the medical institution laid emphasis on the prevention. Then, the hospitalization practice for the decubitus prevention measures was renewed for additional two years after its introduction. Our investigation on the preventive effects was conducted with aid of the Grant-in-Aid for Scientific Research (KAKENHI) by MEXT in 2005-2006 and the Association for Technical Aids research grant in 2006-2007. The research grants acquisition and study implementation were done mainly in Takizawa. Nagaoka, Takizawa and Murakami reported the development of a device to use, study methods and contents, and details of the results. We report what kind of influence was caused by the introduction of bedsore measures non-enforcement policy on the basis of a questionnaire survey.
