This study aimed to elucidate the relationship between home visiting care workers’ professional identity, their intention to continue working, and their collaboration with home visiting nurses. A questionnaire survey was conducted with 847 home visiting care workers who had less than three years of experience in home care. The relationship between care workers’ professional identity, their intention to continue working, and their collaboration with home visiting nurses was examined as a causal model using structural equation modeling. The factors that influenced the intention to continue working included “relationship-building behavior intended to facilitate system construction,” a factor of collaboration with home visiting nurses, and the employment patterns of home visiting care workers. Building a relationship where home visiting nurses and care workers can freely communicate and discuss care provided to patients at home is important. Such a relationship supports an employment environment that enables home visiting care workers to work effectively.

Focusing on differences by gender and age, we utilized the Japanese National Database and public data to elucidate the actual state of home deaths among cancer patients and the medical resources and activities influencing the home death rate. The highest percentage of home deaths occurred among females under the age of 65, with variations observed across prefectures for those under 65. It was determined that the factors associated with home deaths include an increase in the number of doctor’s home visits, and a decrease in the number of acute care hospital beds, regardless of gender and age. It is crucial to improve the home care support system, taking into account differences in gender and age, to further train physicians responsible for home visits, and to optimize the allocation of hospital beds by function within the region.

The objective of this study was to evaluate the impact of KYT (Kiken Yochi Training) on the prevention of violence in home care by implementing KYT with staff at home nursing offices.

Methods : KYT focused on violence was implemented in five home nursing offices, followed by an individual mail survey dispatched to participants from each office three to four weeks after the KYT session.

Results : The survey included 80 respondents, with a response rate of 72%. Of these, 78 respondents (97.5%) acknowledged that they “recognized the importance of violence prevention for staff safety” and "felt an increased need to discuss countermeasures as a team. “In their free responses, they listed specific preventive measures such as “maintaining a safe distance from individuals” and “checking and securing escape routes.”

Discussion : The KYT on violence potentially contributes to heightened awareness of the importance of preventive measures and facilitates the contemplation of specific strategies to avoid violence in various situations.

Therapeutic drug monitoring (TDM) is used to evaluate blood concentrations of drugs whose therapeutic and side effect ranges are close to each other, and it is common to use blood concentrations immediately before administration (trough).

However, trough blood sampling is difficult in home medical care, and blood may be sampled after taking the drug. Therefore, this time, we used non-trough blood samples from patients taking sodium valproate levetiracetam, and digoxin to examine whether blood concentrations could be evaluated using predicted trough values calculated using analysis software.

As a result, it was considered useful to use the predicted trough value to evaluate side effects and compliance if blood was collected during the elimination phase, which was determined from drug characteristics, time elapsed after administration, and blood collection time.

【Purpose】This study was conducted to clarify the abilities required for practitioners who coordinate medical treatment and care at home care support clinics.

【Methods】Interviews were conducted with 23 practitioners involved in coordination and collaboration at home care support clinics, and verbatim transcripts were made and examined using co-occurrence network analysis with KH Coder.

【Results】From the advanced coded analysis, the following abilities were extracted : “understanding, respecting, and supporting the wishes and needs of the patient and family,” “predicting sustainable care,” “coordinating as a team (home and medical institution),” “having opportunities for discussion and building relationships,” “sharing and collaborating,” “gathering information and organizing issues,” and “understanding ideas of others.

【Conclusion】We clarified the necessary competencies for collaborative practitioners.

When infection arises as a complication linked to the placement of a totally implantable central venous catheter port (CV port), its prompt management, including potential removal, is crucial. However, a patient’s background may complicate CV port removal. Our patient was a 73-year-old man who received outpatient chemotherapy for gastric cancer but could not travel to the hospital due to decreased activities of daily living. Home visits were initiated to provide palliative care. On the twentieth day of home visits, a fever and signs of a pocket infection were noted. Although hospital - based CV port removal was recommended, the patient declined, citing the pain and distress of travel. Consequently, the CV port was removed under local anesthesia at the patient’s home. The wound healed without infection, and the patient passed away 41 days after the removal procedure. When CV port removal is required in cases in which hospital transport is challenging, performing the procedure during a home visit represents an effective treatment option.

Introduction : We report the effectiveness of our information-sharing system to support an elderly handicapped woman living alone undergoing home care medicine.

Case : An 85-year-old woman undergoing home medical care lived alone after her husband was hospitalized. Although she suffered from loss of eyesight and presbycusis, she wished to continue living in her home. To support her daily life and reinforce interdisciplinary collaboration related to home care medicine, we used the information-sharing system (e-Renraku Notebook) we originally developed. Using this system in conjunction with doctors, nurses, care workers, and pharmacists, the patient’s condition and clinical data could be effectively shared.

Discussion : Interdisciplinary collaboration is indispensable to support an elderly patient receiving home care medicine. In the present case, if she must continue insulin self-injection with many handicaps, such as total blindness and presbycusis, members of the home-visiting service should frequently monitor the patient. Our home-visiting staff shared the patient’s health status, comments, and photos from other professionals before visiting. Our system can effectively support a home care medicine patient with many handicaps.

This study investigated the effects of symptom relief and dietary modification for anorexia in terminally ill cancer patients undergoing home care. A retrospective survey was conducted involving patients with anorexia showing decreased oral intake. The subjects were 112 patients (male/female, 59/53), with average age of 74 years and average treatment period of 47 days. The primary lesions were in the pancreas, lung, and gastrointestinal tract. Pain, nausea and vomiting, abdominal bloating, and dyspnea were associated with anorexia.

Oral intake increased in 54 cases after sufficient symptom relief and dietary modification, and patients who were able to maintain oral intake showed significantly longer survival.