松江赤十字病院では高齢者の治療選択・終末期医療について、エビデンスに基づく実践や治療方針を多職種で考える機会は限られている。 そのような中、症例を通じた多職種デスカンファレンスについて、今後の高齢者の治療選択・終末期医療における多職種協働の普遍的な実践の示唆に有用と思われたため報告する。当該症例の担当であった5職種に対し、カンファレンスの目的、進行予定、協議ポイント等を記した紙、国内外の高齢者医療に関する文献を事前配布してからカンファレンスに参加してもらった。カンファレンス後、自由記述式のアンケートを実施し、学習効果の検討材料とした。アンケート結果からは、少なくとも治療方針決定における多職種協議の重要性を参加者全員が認識し、高齢者医療における今後の実践への示唆や発展性が得られたことがうかがえた。多職種での協議機会は、倫理的感受性および高齢者医療における各職種の実践の質向上に寄与できる可能性がある。
Despite the rapidly aging Japanese society, opportunities available for experts from different fields to discuss evidence-based practices and a treatment strategy for each case regarding treatment options and end-of-life care for the elderly are still limited in our hospital. In this context, the author organized an interprofessional death conference among care providers involved in a case which the author proposed. Since such conference may be useful to suggest universal implementation of interprofessional collaboration on treatment options and end-of-life care for the elderly in the future, its benefits are reported in this study. A handout with description of purpose, agenda, and discussion points of the conference, as well as hard copy of medical articles relevant to geriatric care in Japan and overseas had been distributed beforehand among care providers which complied of five occupations involved in this particular case, were then asked to check these materials before attending the conference. After the conference, a survey using self-description questionnaire was carried out to evaluate the learning effect of the conference. From results of the questionnaire, it was shown that all the participants were at least aware of importance of interprofessional collaboration on determining the treatment policy of geriatric care, and that each of the individual participants gained insights and possibilities regarding future practices in geriatric care. Providing opportunities of collaboration across different fields will potentially contribute to improve ethical sensitivity among medical practitioners and quality of professional practices in individual fields engaging in care for the elderly.
