Tomioka Kimiko, Kumagai Shinji, Higuchi Yumi, Tsujimura Hiroji, Arai Yastomo, Yoshida Jin
Life and Hygiene Division, Osaka Prefectural Institute of Public Health, Japan.
Sangyo Eiseigaku Zasshi. 2007 Mar;49(2):54-8. doi: 10.1539/sangyoeisei.49.54.
Since the public nursing care insurance system was enacted by the Japanese government, a transition from conventional group treatment to the individual care is required. In Japanese nursing homes for the elderly, bathing assistance methods have shifted from use of traditional mechanical bathtubs or a big bathtub to methods using small homestyle bathtubs, known as "individual bathing assistance". A study on the work load of caregivers with individual bathing assistance has never been conducted. Therefore, in a nursing home for the elderly practicing the individual bathing assistance method, we explored low back load using surface electromyography and trunk inclination angle measurement. Moreover, subjective evaluations by not only the caregivers but also the care receivers were investigated. The individual bathing assistance time per person was about 35 min. When caregiver used the mechanical lift equipment to assist getting into and out of the bathtub, trunk inclination angle and muscle load were lower than with manual handling. Mechanical lift equipment had the advantage of reducing low back load. When caregivers gave assistance with dressing and ablution of the lower limbs, and in setting wheelchair footrests, trunk inclination angle and muscle load showed high values. The satisfaction rating of using the mechanical lift equipment showed the best score, and ratings of perceived exertion were about the same. Thus, the importance of safe and comfortable care for both caregivers and care receivers should be stressed to make effective use of assistance products and care equipment.
自从日本政府颁布公共护理保险制度以来,护理模式需要从传统的集体护理向个性化护理转变。在日本的养老院中,洗澡辅助方式已经从使用传统的机械浴缸或大浴缸转变为使用小型家庭式浴缸,即所谓的“个性化洗澡辅助”。目前尚未对采用个性化洗澡辅助方式的护理人员的工作量进行过研究。因此,在一家采用个性化洗澡辅助方式的养老院中,我们通过表面肌电图和躯干倾斜角度测量来探究腰部负荷情况。此外,我们还调查了护理人员和受护理者的主观评价。每人的个性化洗澡辅助时间约为35分钟。当护理人员使用机械升降设备辅助进出浴缸时,躯干倾斜角度和肌肉负荷低于手动操作时的情况。机械升降设备具有降低腰部负荷的优势。当护理人员协助进行下肢穿衣和洗漱以及设置轮椅脚凳时,躯干倾斜角度和肌肉负荷较高。使用机械升降设备的满意度评分最高,而自觉用力程度评分大致相同。因此,应强调为护理人员和受护理者提供安全舒适护理的重要性,以便有效利用辅助产品和护理设备。