Takezako Yayoi, Kajii Eiji
Center for Community Medicine, Jichi Medical University, Japan.
Nihon Ronen Igakkai Zasshi. 2010;47(4):302-7. doi: 10.3143/geriatrics.47.302.
This study describes the acceptance of patients with feeding tubes in nursing homes for the elderly.
We sent questionnaires to 1,438 nursing homes in 2006-7 asking how many patients with feeding tubes the nursing homes had and how many new patients with feeding tubes they would accept in the future.
The response rate was 63.6%. We analyzed the data of 735 nursing homes. The median range (25-75%) of the number of patients, patients accepted, and total number of patients currently resident was determined. The percentage of tube feedings to total beds in those categories was 8.0% (range 4.0-13.3), 5.0% (0-10.0), and 13.3% (8.0-23.8), respectively. Whereas 6% of the nursing homes had no limits on acceptance of patients with feeding tubes, 27.2% of the nursing homes replied that they would no longer accept such patients. Factors associated with restricted acceptance included nurse responses (odds ratio (OR) 0.54, 95% confidence interval (CI) 0.30-0.95), a facility with over 100 beds (OR 2.14, 95% CI 1.10-4.17), and no current patients with feeding tubes (OR 4.19, 95% CI 2.36-7.43).
One quarter of nursing homes for the elderly in Japan replied that they would no longer accept patients with feeding tubes. More nurses than other professionals replied that they would accept patients with feeding tubes. Larger nursing homes were less likely to accept tube-feeing patients. Furthermore, nursing homes with no tube-feeding patients were unwilling to accept such patients.
本研究描述了养老院中老年人对鼻饲管患者的接纳情况。
我们在2006年至2007年向1438家养老院发放问卷，询问各养老院有多少鼻饲管患者以及未来将接纳多少新的鼻饲管患者。
回复率为63.6%。我们分析了735家养老院的数据。确定了患者数量、接纳患者数量以及当前居住患者总数的中位数范围（25%-75%）。这些类别中鼻饲患者占总床位的百分比分别为8.0%（范围4.0%-13.3%）、5.0%（0-10.0%）和13.3%（8.0%-23.8%）。6%的养老院对接纳鼻饲管患者没有限制，27.2%的养老院回复称他们将不再接纳此类患者。与接纳受限相关的因素包括护士的回复（比值比（OR）0.54，95%置信区间（CI）0.30-0.95）、床位超过100张的机构（OR 2.14，95% CI 1.10-4.17）以及当前没有鼻饲管患者（OR 4.19，95% CI 2.36-7.43）。
日本四分之一的养老院回复称他们将不再接纳鼻饲管患者。回复愿意接纳鼻饲管患者的护士比其他专业人员更多。规模较大的养老院接纳鼻饲管患者的可能性较小。此外，没有鼻饲管患者的养老院不愿意接纳此类患者。
