28 巻 (2017) 4 号 p. 279-287
Questionnaire survey regarding the home-visiting nutritional guidance was conducted to clarify the future way of home-visiting nutritional guidance for registered dieticians who work in local hospitals/clinics and patients with intractable neurological diseases and elderly users who are supported by visiting nursing stations/community general support center.
① Registered dieticians （RD） who work in national hospital and local hospitals/clinics in Omuta city recognized the importance of home-visiting nutritional guidance, however, they had little work experience of the guidance. ② Some hospitals/clinics had the policy of non-acceptance of the guidance and the setting for implementation was generally undeveloped, affecting the dissemination of home-visiting nutritional guidance. ③ Low recognition of the guidance among physicians, health professionals and users was one of the factors of low implementation. ④ The patients with intractable neurological diseases and the elderly users generally satisfied with the diet although they knew the guidance less than 20%. ⑤ About a half of the subjects who had anxiety and problems about the dietary life were not good at cooking and/or did not know cookery method appropriate for themselves. ⑥ The subjects who did not want to have the guidance cited the reasons of the answer such as "unnecessity", "troublesome" and "do not want others to enter my house." ⑦ About 40% of the RD as reason why hospitals/clinics do not introduce the guidance responded "Patients do not know or need the guidance". On the other hand, about a half of the elderly users living in the same area of the RD answered, "I do not feel the guidance is necessary."
These results suggest that active and diverse approaches to introduce the home-visiting nutritional guidance are required not only by the public administration but also by RD in addition to the solving problems regarding the guidance considering QoL of the patients/elderly users.