糖尿病教育担当看護師による糖尿病外来患者の歯周病管理の実践に関連する要因について日本における全国調査

Factors associated with the practice of periodontal management by diabetes educator nurses for outpatients with diabetes: A nationwide survey in Japan.

抄録

AIMS:

本研究は，日本の医療現場において，糖尿病教育認定看護師が外来糖尿病患者に対して歯周病管理を行う際の要因を特定し，優先順位をつけることを目的とした．

AIMS: This study aimed to identify and prioritize factors contributing to the provision of periodontal care by certified diabetes nurse educators to outpatients with diabetes in medical settings in Japan.

方法:

1277 施設の糖尿病看護認定看護師 321 名に質問紙調査を実施した．歯周病ケアの実践状況について，能力・機会・動機-行動モデルを用いて作成した項目により，歯周病ケアに寄与する要因を評価した．Fisher's exact 検定およびロジスティック回帰を行った．

METHODS: Questionnaires were administered to 321 certified diabetes educator nurses from 1277 institutions. The practice of periodontal care was assessed, with factors contributing to periodontal care through items developed based on the capability, opportunity, and motivation-behavior model. Fisher's exact tests and logistic regression were performed.

結果:

>糖尿病教育認定看護師の 70％以上が糖尿病患者に対する歯周病ケアを行っていなかった．口腔状態のアセスメントを行った者は，行わなかった者に比べ，個別・集団教育や口腔管理専門職への相談に従事する傾向が強かった．その要因として，心理的能力・反射的動機が低いこと，口腔管理への関与が不定期で意思が弱いこと，糖尿病専門外来のない施設に勤務していることが重要であった．

RESULTS: >70% of certified diabetes educator nurses did not provide periodontal care for diabetes patients. The respondents who assessed people's oral conditions were more likely to engage in individual or group education and consult for oral management professionals than those who did not. Significant factors for such assessment were low psychological capability and reflective motivation, irregular and weak intention to engage in oral management, and working at an institution without an outpatient department specializing in diabetes.

結論:

糖尿病専門外来を持たない糖尿病教育認定看護師に対する教育は，優先的に行うべきである．特に，口腔アセスメントに関する知識・技術・自信の向上と歯周病管理の定着を図るための教育が必要である．

CONCLUSIONS: The education for certified diabetes educator nurses who do not work at an institution with an outpatient department specialized in diabetes care should be prioritized. Particularly, education to improve knowledge, skills, and confidence in oral assessments and to make periodontal management regular is needed.