Fusama Mie, Nakahara Hideko, Urata Yukitomo, Kawahata Kimito, Kawahito Yutaka, Kojima Masayo, Sugihara Takahiko, Hashimoto Motomu, Miyamae Takako, Murashima Atsuko, Mori Masaaki, Yajima Nobuyuki, Matsui Toshihiro
Health Sciences Department of Nursing, Kansai University of International Studies, Miki, Japan.
Faculty of Health Science, Osaka Yukioka College of Health Science, Ibaraki, Japan.
Mod Rheumatol. 2025 Feb 21;35(2):256-264. doi: 10.1093/mr/roae087.
This study aims to identify challenges nurses face in providing care to older patients with rheumatoid arthritis (RA) in Japan.
Nurses certified by the Japan Rheumatism Foundation were requested via mail to describe challenges in providing care to older RA patients. Qualitative content analysis was used.
One hundred and eighty-two issues were identified from 152 responses. Twenty categories were grouped into seven components, five of which focused on patients: (1) lack of patient understanding, (2) lack of understanding and support from surrounding people, (3) numerous comorbidities and complications, (4) challenges related to physical strength, and (5) financial issues. Two focused on nurses: (6) lack of knowledge of nurses and (7) inadequate systems and environment in the workplace. Various difficulties, such as polypharmacy due to multimorbidity, lifestyle issues due to aged couples or those living alone, and inadequate decision-making and informed consent due to cognitive decline, were also identified.
Nurses experienced numerous medical and nonmedical difficulties in providing care to older RA patients. Assessing patients' comprehension and self-management and grasping their situations at home are necessary. Along with the improvement of nurses' knowledge and skills, support from their workplace and multidisciplinary team care, including families, are crucial.
本研究旨在确定日本护士在为老年类风湿关节炎（RA）患者提供护理时所面临的挑战。
通过邮件向日本风湿病基金会认证的护士询问为老年RA患者提供护理时面临的挑战。采用定性内容分析法。
从152份回复中识别出182个问题。20个类别被归为7个组成部分，其中5个侧重于患者：（1）患者理解不足，（2）周围人群缺乏理解与支持，（3）多种合并症和并发症，（4）与体力相关的挑战，以及（5）财务问题。2个侧重于护士：（6）护士知识不足，以及（7）工作场所的系统和环境不完善。还发现了各种困难，如因多种疾病导致的多药联用、老年夫妇或独居者的生活方式问题，以及因认知能力下降导致的决策和知情同意不足。
护士在为老年RA患者提供护理时遇到了众多医疗和非医疗方面的困难。评估患者的理解能力和自我管理能力并了解其家庭情况很有必要。除了提高护士的知识和技能外，工作场所的支持以及包括家庭在内的多学科团队护理至关重要。
