{"created":"2021-12-13T01:54:55.388324+00:00","id":2000154,"links":{},"metadata":{"_buckets":{"deposit":"5db60fe3-dffd-4e0c-8560-d3a2e468ae52"},"_deposit":{"id":"2000154","owners":[1],"pid":{"revision_id":0,"type":"depid","value":"2000154"},"status":"published"},"_oai":{"id":"oai:niigata-u.repo.nii.ac.jp:02000154","sets":["453:456","471:537:538:1639117359883"]},"author_link":[],"item_1627361970403":{"attribute_name":"出版タイプ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_7_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2020-12","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"8-12","bibliographicPageEnd":"252","bibliographicPageStart":"247","bibliographicVolumeNumber":"134","bibliographic_titles":[{"bibliographic_title":"新潟医学会雑誌","bibliographic_titleLang":"ja"}]}]},"item_7_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"【背景と目的】寝返りは，寝たきりにならないため，更に，就眠中，血液の鬱滞ひいては褥瘡を形成しないために，無意識に行う動作であり，乳児期に獲得される，生存に不可欠ないわば本能的な，動作である．この動作は，認知機能の低下，さらに，筋力の低下およびこれに伴ういわゆる廃用性症候群によって，障害されるものと考えられる．しかし，現時点で渉猟しうる限り，寝返りが打てなくなった患者において，この動作の障害と知的水準および介助の有無と一見，無関係と考えられる摂食の可否，他者とのコミュニケーションの可否，尿，便失禁の有無，着替えの可否，褥瘡の有無，歩行の可否，MMSE(mini-mental state examination test)やHDS-R(長谷川式簡易知能評価スケール改訂版)における知的水準の評価の可否について，検討された報告は，ほとんど見られていない．我々は当初より，自力で寝返りを打てない患者は，自力での摂食，会話は困難であり，また，尿，便失禁を来たし，褥瘡を併発したり，MMSEやHDS-Rを用いた知的水準の評価は困難であると予想した．【対象と方法】今回，対象群を寝返り動作不可能群(A群)と動作可能群(B群)とに分類し，この予想が，事実か否かの検証を試みた．【結果】A群(166例44.6%の内)，自力で経口摂取可能であったのは，20例12.0%，介助により経口摂取可能であったのは，70例42.1%，高カロリー輸液および胃瘻の症例は，61例36.7%，他者とのコミュニケーションが取れた症例は52例31.3%，尿，便失禁の見られたケースは，161例97.0%，褥瘡のみられた症例は，12例7%，歩行が可能であった症例は，3例1.8%，着替えのできた症例は1例0.06%，褥瘡のある例は，3例1.8%，MMSE，HDS-Rによる知的水準の評価が可能であったのは，46例27.7%あった．前，後者の平均得点はそれぞれ前者9.63±5.79点，後者7.33±5.65点であった．一方，B群では，172例83.5%，介助により経口摂収可能であったのは，34例16.5%，高カロリー輸液，経管栄養の症例はなかった．他者とのコミュニケーションが取れた症例は，180例87.4%，尿，便失禁の見られたケースは125例61.2%，歩行が可能であった症例は，179例86.9%，着替えのできた症例は79例38.3%，褥瘡のある例は，1例0.49%，MMSE，HDS-Rによる知的水準の評価が可能であったのは，130例63.1%あった．前，後者の平均得点はそれぞれ前者14.78±7.24点，後者12.94±8.01点であった．【結論】A群の中でも，主として介助により，摂食できる例，他者とのコミュニケーションが取れる例，MMSE，HDS-Rにより知的水準を評価できる例は，わずかであるが認められた．しかし，ほとんどの症例に，尿，便失禁が認められ，着替えのできる症例は，1例しかなかった．一方，B群では，摂食できる例，他者とのコミュニケーションが取れる例，MMSE，HDS-Rにより知的水準を評価できる例はA群と比較すると遥かに，多かった．大多数は，尿，便失禁を呈していたが，予想外に多くの(38.8%)，失禁を認めない症例も見られた．歩行の可能な症例は，86.9%におよび，運動能力，知的水準の高さが寝返り動作と密接に関連していることが示唆された．いずれにしても，寝返りのできない症例は，自力での摂食も困難であり，褥瘡およびこれに伴う敗血症，誤嚥性肺炎など全身的な合併症を併発し，予後不良であることが推測された．","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"The analysis of the ADL (activities of daily living) and mental activities by MMSE and HDS-R of the patients those can not turn over in the bed. 【Background and purposes】Turning over is an indispensable action to prevent the state of being bed-ridden and retention of blood flow resulting in decubitus. This action is a kind of the involuntary movement which is acquired in babyhood and it may be called an instinct. This action may be induced by deterioration of cognition and decrease of the brawn of body and extremities in addition to disuse syndrome. However, up to date, we could not find the reports that analyzed the relations between the impossibilities or possibilities of turning over as the instinct and evaluation of mental activities by mini-mental state examination test (MMSE) or HDS-R (Hasegawa dementia rating scale-revised) eating, communication with others, urinary or fecal incontinence, the change of clothes, walking, decubitus in this objective patients. Initially, we expected that those patients who could not turn over in bed also were not able to eat independently, communicate others, manifest urinary or fecal incontinence and suffer from decubitus. Therefore, we tried to identify those relations. 【Clinical materials and methods】The objective group is consisted of the patients admitted to the Rakuzankai Mishima Hospital on January in 2020. They were males and females. Their ages ranged from 37 years to 101 years (average 84.18士8.33 years, male 172 cases female 200 ones). At this time we divided this object group into two ones as group A and B. Group A is consisted of the patients those who cannot turn over in the bed. Group B is consisted of patients those who can turn over in the bed. Then, in this two group, we analyzed the relations between the impossibilities or possibilities of turning over as the instinct and evaluation of mental activities by MMSE or HDS-R eating, communication with others, urinary or fecal incontinence, the change of clothes, walking bathing by him-or herself and decubitus in these two groups. 【Results】In the group A, those who can eat were cases by themselves were 20 cases, 12.0%, those who can eat with an assistance were 70 cases, 42.1%, those who were underwent hyperalimentation or tube nutritional support 61 cases 36.7%, who can communicate others were 52 cases 31.3%, who manifest urinary or fecal incontinence 161 cases 97.0%, who can walk were 3 cases 1.8% who can perform a change of clothes were 1case 0.06%, who suffer from decubitus were 12 cases 7% and who can undergo MMSE or HDS-R were 46 cases 27.7%. And the data of the former and the latter were 9.63士5.79, 7.33士5.65 respectively. Concerning the bathing, all cases were washed by nursing staffs or clinical helpers to avoid being drowned. Therefore, we could not discriminate whether the patients can have bathing by themselves or not. On the other hand, in the group B, those who can eat independently were 172 cases 83.5%, can eat with an assistance were 34 cases 16.5%, no one underwent hyper alimentation, or tube nutritional support. Those who can communicate others were 179 cases 86.9%, who manifest urinary or fecal incontinence 125 cases 61.2%, who can walk were 179 cases 86.9%, who can perform a change of clothes were 79 cases 38.3%, who suffer from decubitus were 1case 0.49% and who can undergo MMSE or HDS-R were cases 130 cases 63.1%. And the data of the former and the latter were 14.78士7.24, 7.33士5.65, 12.94土8.01 respectively. 【Conclusion】In group A, only a few people can eat independently, can communicated others, can undergo MMSE or HDS-R. compared with B. Almost all cases manifest urinary or incontinence, and few ones can walk. On the other hand, much more patients of group B can eat independently, can communicate others and undergo MMSE or HDS-R. than group A. Almost all cases manifested urinary or fecal incontinence and some cases can perform a change of clothes in group A. —+Then, it is suggested that the patients those can walk be able to turn over in bed because of the high ability of exercise or preserved mental activity. Anyway, those patients who can not turn over in bed are not able to eat independently or dependently, are apt to suffer from decubitus, resulting in serious systemic disorders such as sepsis or aspiration pneumonia. In conclusion, their prognosis is suspected to be markedly poor.","subitem_description_language":"en","subitem_description_type":"Abstract"}]},"item_7_publisher_7":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"新潟医学会","subitem_publisher_language":"ja"}]},"item_7_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00182415","subitem_source_identifier_type":"NCID"}]},"item_7_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0029-0440","subitem_source_identifier_type":"PISSN"}]},"item_access_right":{"attribute_name":"アクセス権","attribute_value_mlt":[{"subitem_access_right":"open access","subitem_access_right_uri":"http://purl.org/coar/access_right/c_abf2"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"今井, 邦英","creatorNameLang":"ja"},{"creatorName":"Imai, Kunihide","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"田中, 弘","creatorNameLang":"ja"},{"creatorName":"Tanaka, Koh","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"田中, 政春","creatorNameLang":"ja"},{"creatorName":"Tanaka, Masaharu","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"宮本, 忍","creatorNameLang":"ja"},{"creatorName":"Miyamoto, Shinobu","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"杉田, 真浩","creatorNameLang":"ja"},{"creatorName":"Sugita, Masahiro","creatorNameLang":"en"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_access","date":[{"dateType":"Available","dateValue":"2021-12-16"}],"displaytype":"detail","filename":"134(8-12)_247-252.pdf","filesize":[{"value":"3MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"objectType":"fulltext","url":"https://niigata-u.repo.nii.ac.jp/record/2000154/files/134(8-12)_247-252.pdf"},"version_id":"41987871-2967-4d93-979d-74f57c66a393"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"寝返り","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"褥瘡","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"知的水準","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"HDS-R","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"MMSE","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"寝返り不可能の高度認知症症例におけるMMSE,HDS-Rを用いた知的水準および日常動作障害の検討","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"寝返り不可能の高度認知症症例におけるMMSE,HDS-Rを用いた知的水準および日常動作障害の検討","subitem_title_language":"ja"},{"subitem_title":"The Analysis of the ADL (activities of daily living) and Mental Activities by MMSE and HDS-R of the Patients those can not Turn Over in Bed","subitem_title_language":"en"}]},"item_type_id":"7","owner":"1","path":["456","1639117359883"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2021-12-16"},"publish_date":"2021-12-16","publish_status":"0","recid":"2000154","relation_version_is_last":true,"title":["寝返り不可能の高度認知症症例におけるMMSE,HDS-Rを用いた知的水準および日常動作障害の検討"],"weko_creator_id":"1","weko_shared_id":-1},"updated":"2022-12-15T04:35:00.517603+00:00"}