在宅酸素療法患者への全人的アプローチ(内科領域における全人的医療)(第31回日本心身医学会総会)

抄録

Home Oxygen Therapy (HOT) is an indispensable therapeutic means to the patients with chronic respiratory failure, such as chronic pulmonary emphysema, post tuberculosis, lung fibrosis, etc. Recently, home care has been regarded so important that HOT has been applied to the patients with chronic respiratory failure for the purpose improving QOL for them. Now in Japan (1990), HOT is practiced for about 15,000 patients with chronic respiratory failures. These patients are getting considerable benefit, not only in improving shortness of breath, but also in developing ADL. Inspite of introducing this therapy, however, the majority of HOT patients have many handicaps as respiratory cripple and are exposed against much stress in both psychological and somatic respects. As a part of holistic approach to the HOT patients, we have performed the following trials. I) The survey of psychosocial respects of the HOT patients, using : (1) comprehensive psychosomatic questionnaire for the patients with long term oxygen therapy (Egashira, Agoo 1986), (2) self rating questionnaire of depression, (3) questionnaire C of the research team of Japanese Ministry of Health and Welfare, (4) and others. The results of this survey revealed that the patients have many problems in psychosomatic respects which consist of dependency, pessimism for prognosis, frustration, in another, a trend of depression, and decrease of social role functioning in reinstatement and human relationship. II) Reginal approach including (1) staff meeting for HOT practice (Kyushu Respiratory Care Conference) (2) formation of a club for HOT patients and its communication program in our hospital.