2021 年 254 巻 1 号 p. 25-31
Many cultures are witnessing high-risk births due to the increasing trend of delayed childbearing. This has resulted in a higher proportion of children requiring long-term medical care (CLTM). The number of home-visit nursing stations available for pediatric patients should increase to provide care for CLTM at home. Through a questionnaire-based cross-sectional survey of 338 home-visit nursing station managers, this study aimed to identify the determinants of the acceptance of CLTM by analyzing the characteristics of the stations, managers, staff, and registered children, and the volume of home visits. Chi-squared tests and logistic regressions were applied to determine the independence of the variables of acceptance and analyze their significance, respectively. The response rate was 14.6%, the number of pediatric patients registered in the past was 914, and the average number of registered pediatrics was 2.7. The results indicate a correspondence between the increase in home visits by nursing staff and the number of CLTM accepted for home-visit nursing services after discharge from neonatal intensive care units. Additionally, stations whose managers have three or more years of pediatric care experience accept more CLTM, and their employees are better equipped to facilitate these acceptances. Nonetheless, the number of facilities with pediatric departments has declined; thus, nurses will face increasing difficulty gaining pediatric work experiences. Therefore, enhanced seminars and training on pediatric medical care for managers and nurses, as well as strengthened collaboration/coordination with pediatric wards, clinics, and multidisciplinary occupations should be implemented as countermeasures. Our findings illustrate issues and strategies for acceptance.
