{"created":"2021-03-01T06:30:58.167806+00:00","id":25493,"links":{},"metadata":{"_buckets":{"deposit":"4b9c0f3e-c947-480a-9011-28dd42a28771"},"_deposit":{"id":"25493","owners":[],"pid":{"revision_id":0,"type":"depid","value":"25493"},"status":"published"},"_oai":{"id":"oai:niigata-u.repo.nii.ac.jp:00025493","sets":["432:1291:1292:1301","453:456"]},"item_7_alternative_title_1":{"attribute_name":"その他のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Study of perioperative nursing for patients undergoing dental extraction without interruption of antithrombotic medication : about perioperative concerns based on interviews and a questionnaire survey"}]},"item_7_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2008-12","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"76","bibliographicPageStart":"71","bibliographicVolumeNumber":"38","bibliographic_titles":[{"bibliographic_title":"新潟歯学会雑誌"},{"bibliographic_title":"新潟歯学会雑誌","bibliographic_titleLang":"en"}]}]},"item_7_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"血栓塞栓症の既往や循環器系に障害のある有病者において, 歯科観血処置を行う場合の注意事項の一つに, 抗血栓療法中の周術期管理が挙げられる｡以前は術中や術後の出血を危倶し, 術前休薬が慣習的に行われていたが, 最近は休薬による血栓塞栓性合併症の発症リスクを考慮し, 抗血栓療法継続下で処置を行う施設が増えている｡当院口腔外科･顎顔面外科診療室でも,2005年12月から抗血栓療法中の有病者に対する歯科観血処置を原則非休薬下で行っている｡ただし, 術後の出血が各症例の全身状態, 手術部位の状態および手術侵襲の程度や創の管理方法などによって異なるため, より安心して手術が受けられるように現時点では短期入院下での周術期管理を推奨している｡このような入院体制が効果的に機能するためには, 歯科医師だけではなく, 全ての医療スタッフの理解と協力が必要であり,周術期看護に直接携わる病棟看護師の果たす役割は大きい｡特に抗血栓療法中の有病者における抜歯では,通常の外科的処置に対する不安に加え, 止血しにくいことに対する不安, 再出血の可能性に対する不安など様々な不安要因が推測され, 心理的サポートを適切に行う上で, それらを正確に理解することは大切と思われる｡今回, 抗血栓療法中であっても安心して歯科観血処置を受けられるよう, 看護師としてどのような対応が必要なのかを検討する目的で, 入院前と入院後に面接質問を行い, 周術期の心理変化を中心に検討した｡その結果, 非休薬および短期入院下で対応する当診療室の方針に賛同的な意見が多かった｡また,脳梗塞既往症例で休薬による血栓症再発の不安が強い傾向が示された｡術中や術後の出血については,全症例で｢不安がある｣と回答していたが, 入院下での施術が総じて安心感につながり, 結果的に出血性合併症の不安要因を解消していた｡一方で看護師に対する｢遠慮｣から我慢や不安を抱える傾向も伺え, 勤務形態などの現行の看護システムから生じる問題点が明らかになった｡今後はより多くの意見を参考に, 看護師間でもその情報を共有して適切な心理的サポートや短期入院における効率的な周術期看護システムの検討が必要と思われた｡","subitem_description_type":"Abstract"},{"subitem_description":"Dental extraction for patients with antithrombotic therapy had conventionally been performed after withdrawal of antithrombotic medication, but patients have treated without interruption of medication since interruption of antithrombotic therapy may lead to an increased thrombotic risk lately. Since December, 2005, We have treated such patients without cessation of medication in our department. We have performed perioperative management under short-term admission, even if sudden unexpected bleeding occurs, but we have suspected that the patients feel insecure while under antithrombotic therapy in the perioperative period. Firstly, the patients are concerned about complications caused by oral surgery including pain. Ⅰn addition, mixed feelings of security caused by the decreased risk of brain stroke and unease due to the increased risk of bleeding may cause confusion. Given these feelings, psychological support by nurses is essential to manage the patients with antithrombotic therapy during the perioperative term. To understand these mental conditions of patients in detail, we examined the perioperative concerns of 5 cases with antithrombotic therapy using a medical interview and questionnaire survey performed at pre- and post-admission, respectively. All 5 cases had agreed to dental extraction while continuing antithrombotic therapy under short-term admission. One of the patients previously suffered a brain stroke had complained strongly of a concern regarding possible re-thrombotic complications that might occur with interruption of medication. All 5 cases were concerned about sudden unexpected bleeding, but oral surgery during hospitalization resulted in a change of psychology that reduced their unease regarding hemorrhagic complications. However, it was also clear that the patients became impatient and anxious due to a restraint for calling in nurses. These results suggest that the opinions of patients should be taken into account more positively and that sharing of information among nurses is needed for adequate psychological support. And prospective discussions are important for the patients to develop strategies for an effective nursing system under short-term admission.","subitem_description_type":"Abstract"}]},"item_7_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"150298","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Chiba, Kaori"}]},{"nameIdentifiers":[{"nameIdentifier":"150299","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Kodama, Yasumitsu"}]},{"nameIdentifiers":[{"nameIdentifier":"150300","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Okumura, Yuki"}]},{"nameIdentifiers":[{"nameIdentifier":"150301","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Tsubokawa, Akiko"}]},{"nameIdentifiers":[{"nameIdentifier":"150302","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Chino, Yuko"}]},{"nameIdentifiers":[{"nameIdentifier":"150303","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Koyama, Takahiro"}]},{"nameIdentifiers":[{"nameIdentifier":"150304","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Yamada, Yushi"}]},{"nameIdentifiers":[{"nameIdentifier":"150305","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Takagi, Ritsuo"}]}]},"item_7_publisher_7":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"新潟歯学会"}]},"item_7_select_19":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_select_item":"publisher"}]},"item_7_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN0018300X","subitem_source_identifier_type":"NCID"}]},"item_7_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"03850153","subitem_source_identifier_type":"ISSN"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"千葉, 香"}],"nameIdentifiers":[{"nameIdentifier":"150290","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"児玉, 泰光"}],"nameIdentifiers":[{"nameIdentifier":"150291","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"奥村, 友希"}],"nameIdentifiers":[{"nameIdentifier":"150292","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"坪川, 晶子"}],"nameIdentifiers":[{"nameIdentifier":"150293","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"知野, 優子"}],"nameIdentifiers":[{"nameIdentifier":"150294","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"小山, 貴寛"}],"nameIdentifiers":[{"nameIdentifier":"150295","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"山田, 裕士"}],"nameIdentifiers":[{"nameIdentifier":"150296","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"高木, 律男"}],"nameIdentifiers":[{"nameIdentifier":"150297","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-08-19"}],"displaytype":"detail","filename":"NS_38(2)_71-76.pdf","filesize":[{"value":"826.0 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"NS_38(2)_71-76.pdf","url":"https://niigata-u.repo.nii.ac.jp/record/25493/files/NS_38(2)_71-76.pdf"},"version_id":"e0f851b7-10d8-436b-81c4-ee01a00830eb"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"抗血栓療法antithrombotic therapy","subitem_subject_scheme":"Other"},{"subitem_subject":"抜歯dental extraction","subitem_subject_scheme":"Other"},{"subitem_subject":"短期入院short-term admission","subitem_subject_scheme":"Other"},{"subitem_subject":"面接質問medical interview and questionnaire survey","subitem_subject_scheme":"Other"},{"subitem_subject":"患者心理mental condition of patients","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":"抗血栓療法中の有病者における非休薬下抜歯周術期看護の検討 : 面接質問から考察する周術期心理について","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"抗血栓療法中の有病者における非休薬下抜歯周術期看護の検討 : 面接質問から考察する周術期心理について"},{"subitem_title":"抗血栓療法中の有病者における非休薬下抜歯周術期看護の検討 : 面接質問から考察する周術期心理について","subitem_title_language":"en"}]},"item_type_id":"7","owner":"1","path":["456","1301"],"pubdate":{"attribute_name":"公開日","attribute_value":"2014-02-04"},"publish_date":"2014-02-04","publish_status":"0","recid":"25493","relation_version_is_last":true,"title":["抗血栓療法中の有病者における非休薬下抜歯周術期看護の検討 : 面接質問から考察する周術期心理について"],"weko_creator_id":"1","weko_shared_id":null},"updated":"2022-12-15T03:55:25.440975+00:00"}