| 基本情報/Basic information |
| 一般向け試験名/Public title |
佐賀市三瀬村における在宅療養、在宅死に関する意識調査 |
Survey on Attitudes toward Home Care and Dying at Home in Mitsuse Village, Saga City |
| 一般向け試験名略称/Acronym |
在宅療養意識調査 |
Preference for home care and dying at home among older people. |
| 科学的試験名/Scientific Title |
高齢者における在宅介護、在宅死の希望に影響を与える要因：日本の高齢化率の高い過疎地での横断研究調査 |
Factors influencing preference for receiving care and dying at home among older people: a cross-sectional study in a rural, depopulated, and super-aged area of Japan. |
| 科学的試験名略称/Scientific Title:Acronym |
日本の高齢者の在宅死についての調査 |
Preference for receiving care and dying at home among older people in a rural area of Japan |
| 試験実施地域/Region |
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| 目的/Objectives |
| 目的1/Narrative objectives1 |
住民の希望する療養場所（自宅、施設、病院） |
The place where residents wish to spend a period of recuperation; At home, facilities or hospital. |
| 目的2/Basic objectives2 |
その他/Others |
| 目的2 -その他詳細/Basic objectives -Others |
住民の希望を叶えるために地域に何が必要かの示唆を得る |
Get a hint of what the community or residents need to meet the wishes of residents. |
| 試験の性質1/Trial characteristics_1 |
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| 試験の性質2/Trial characteristics_2 |
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| 試験のフェーズ/Developmental phase |
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| 介入/Intervention |
| 群数/No. of arms |
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| 介入の目的/Purpose of intervention |
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| 介入の種類/Type of intervention |
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| 介入1/Interventions/Control_1 |
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| 介入2/Interventions/Control_2 |
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| 介入3/Interventions/Control_3 |
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| 介入8/Interventions/Control_8 |
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| 介入9/Interventions/Control_9 |
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| 結果/Result |
| 結果掲載URL/URL related to results and publications |
http://www.zaitakuiryo-yuumizaidan.com/data/file/data1_20220412121034.pdf |
| 組み入れ参加者数/Number of participants that the trial has enrolled |
211 |
| 主な結果/Results |
在宅死を希望する住民は46.9%であった。
単変量解析では、在宅死希望群(Group H)で、年齢が有意に高く (75 vs, 78歳, p = 0.010)、交通手段が公共交通機関、もしくはないもの割合が有意に多かった (20% vs. 8%, p = 0.036)。多変量解析では、男性、かかりつけ医なしが在宅死の希望と関連していた (p = 0.031, 0.041)。
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46.9% of residents preferred to die at home. Univariate analysis showed that Group H was significantly older (78 vs. 75 years, p=0.010) and included a higher proportion who used public transportation or did not use any transportation (20% vs. 8%, p=0.036). Multivariate analysis showed that male sex and not having a primary care physician were significantly associated with a preference to die at home (p=0.031 and 0.041) |
| 主な結果入力日/Results date posted |
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| 結果掲載遅延/Results Delayed |
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| 最初の試験結果の出版日/Date of the first journal publication of results |
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| 参加者背景/Baseline Characteristics |
解析対象者の年齢中央値は77歳 (四分位71-84歳)、44%が男性であった。
健康状態のVASの中央値は32 (19-52)点、社会的孤立スケールは8 (6-10)/15点であり、普段使用する交通手段は自ら運転する自家用車、自動二輪車、高齢者向けの電動四輪車が87%であった。独居は13%、同居者数は2 (1-4)人、64%が村内の診療所に通院していた。かかりつけ医がない者は5%で、公的医療保険は後期高齢者制度自己負担2割が最も多く56%であった。入院もしくは施設への入所経験者は54%で、自分の最期の過ごし方について家族と話したことがある者は32%であった。介護保険制度を利用している者は13%、知っている者は61%、地域包括支援センターを利用している者は18%、知っている者は49%であった。 |
The median age of included participants was 77 years (interquartile range: 71-84), and 44% were men. The median VAS score for health status was 32 (interquartile range: 19-52), and that of the LSNS-6 was 8 (interquartile range: 6-10) out of maximum score of 15.In total, 87% of participants reported that they used a vehicle that they drove themselves, such as a private car, motorcycle, or an electric cart. Thirteen percent of participants lived alone; the mean number of people in participants' household was 2 (interquartile range: 1-4). Sixty-four percent of participants regularly visited the clinic in the village. Five percent of participants did not have a primary care physician. The most popular type of public medical insurance was Insurance of Medical Care System for Senior Citizens aged 75 years or older requiring the policyholder to pay only 10% or 20% of the medical fee, accounting for 56%. A total of 54% of respondents had previously been hospitalized or institutionalized in a long-term care facility. Additionally, 32% had discussed with their family members how they would like to spend their final years of life. Concerning participants' involvement in the public long-term care insurance system of Japan, 13% were currently certified for long-term care, and 61% had knowledge about the system but were not certified. Concerning participants' involvement with the community comprehensive support center, 18% had used it, and 49% had knowledge about the center but had never used it. |
| 参加者の流れ/Participant flow |
2020年1月現在、三瀬村に在住する65才以上の住民は360名であった。2020年2月の集団調査では55名から回答を得た。新型コロナ感染症のパンデミックのために集団調査が不可能となった後には、除外基準を満たした43名を除いた234名に個別記入調査を行い、168名から回答を得た (回答率72％)。集団調査と個別記入調査を合わせた回答者223名中、無効回答の12名を除外して、211名の回答を解析対象とした。全体の回答率は62％であった。 |
A total of 360 individuals aged 65 or older were living in Mitsuse Village in January 2020. In the group surveys conducted in February 2020, we received responses from 55 people. Once we were prevented from attending meetings and conducting group surveys at the community center because of the COVID-19 pandemic, we changed to administering self-report surveys. We targeted 234 village residents, after excluding 43 who met the exclusion criteria; 168 people completed the surveys (response rate 72%). A total of 211 participants were finally included, after excluding 12 who gave invalid answers. The total study population from both the group and individual self-report surveys was 223 older village residents, with an overall response rate of 62%. |
| 有害事象/Adverse events |
なし |
Nothing |
| 評価項目/Outcome measures |
すでに自宅で介護されている、もしくは今自分が自宅で介護を受けることが必要な状態になったと仮定してそれが実現可能な者は14%であった。療養期(自力で排泄動作ができなくなったとき)に自宅で過ごしたいかのVASは65 (44－87)点、終末期(半年以内の余命であると判明しているときは77 (22－85)点であった。死をどこで迎えたいかは、自宅46.9%、施設16.6%、病院28.9%であった。 |
The proportion of participants currently receiving long-term care at home and being in an environment where such care was available if currently required was 14%. The median VAS score regarding the wish to remain at home in later life even without the ability to use the toilet independently was 65 (interquartile range: 44-87); the VAS score was 77 (interquartile range: 22-85) for the wish to remain at home with life expectancy less than 6 months. As for the preferred place to die, 46.9%, 16.6%, and 28.9% of participants reported that their preference was at home, a long-term care facility, and a hospital, respectively. |
| 個別症例データ共有計画/Plan to share IPD |
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| 個別症例データ共有計画の詳細/IPD sharing Plan description |
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UMIN-CTR 臨床試験登録情報の閲覧