{"created":"2023-05-15T13:16:09.932442+00:00","id":741,"links":{},"metadata":{"_buckets":{"deposit":"2c6d5ed3-fcf6-4195-957d-03219d9790b1"},"_deposit":{"created_by":13,"id":"741","owners":[13],"pid":{"revision_id":0,"type":"depid","value":"741"},"status":"published"},"_oai":{"id":"oai:ncu.repo.nii.ac.jp:00000741","sets":[]},"author_link":["1446","1001","1055","1564","1563"],"item_10_alternative_title_2":{"attribute_name":"タイトルヨミ","attribute_value_mlt":[{"subitem_alternative_title":"イリョウ シセツ カイゴ シセツナイ デノ ケッカク ハッセイ ボウシ ニ カンスル ブンケンテキ コウサツ : ハイケッカク ノ ジュシン ノ オクレ シンダン ノ オクレ オ チュウシンニ"}]},"item_10_biblio_info_10":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2014-03","bibliographicIssueDateType":"Issued"},"bibliographicPageEnd":"17","bibliographicPageStart":"7","bibliographicVolumeNumber":"13","bibliographic_titles":[{"bibliographic_title":"名古屋市立大学看護学部紀要"},{"bibliographic_title":"Bulletin of Nagoya City University School of Nursing","bibliographic_titleLang":"en"}]}]},"item_10_description_22":{"attribute_name":"フォーマット","attribute_value_mlt":[{"subitem_description":"application/pdf","subitem_description_type":"Other"}]},"item_10_description_7":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"1999年に結核緊急事態宣言(旧厚生省)が出された。保健医療機関が結核対策に取り組んでいるが、未だ2万人以上の結核患者が新規登録されている。医療・介護施設内で活動性結核患者が発見されると、保健所と相談しながら多大な労力をかけて接触者健診が繰り返されており、結核感染対策は重要な課題である。そこで、結核患者の発見の遅れ及び医療・介護施設内での結核発生に関する文献の検討を行い、感染対策について考察した。結核患者の\"発見の遅れ\"には、患者が受診行動を起こさずに長期間を過ごしてしまう\"受診の遅れ\"と医療者側が結核を疑わず見過ごしてしまう\"診断の遅れ\"がある。受診の遅れ、診断の遅れそれぞれは、患者個々の状況によって数日から数年と遅れの日数に幅があった。施設内感染を引き起こした初発患者は、受診の遅れが長かった。受診の遅れにより病状が悪化し、他者への感染の危険性が増すと考えられた。デインジャーグループである看護師や医師など医療従事者が結核を発症したまま勤務を継続し、感染拡大を引き起こしていた。診断の遅れの要因としては,医師の結核を診療する機会の減少による経験不足や呼吸器内科医でも診断が難しい症例の増加があげられた。医療・介護施設内での肺結核感染を減らすために、以下のことが重要と考えた。受診の遅れに対しては1.国民、医療・介護施設利用者及び職員に対し結核感染についての啓発を行い、意識を向上する、2.医療・介護施設職員の健康管理システムを構築する、3.保健所・病院・診療所・介護施設で、協働できる地域連携システムを構築する。診断の遅れに対しては、1.結核を疑った場合に、適切な結核診断につながる院内のシステムの整備を行う、2.医師・看護師など医療従事者に対して、結核について教育を継続して実施する。","subitem_description_type":"Abstract"}]},"item_10_description_8":{"attribute_name":"抄録(英)","attribute_value_mlt":[{"subitem_description":"Since Tuberculosis Emergency Declaration was issued in 1999 (by the former Ministry of Welfare), healthcare institutions have engaged in measures against tuberculosis (TB). However, new cases of TB exceeded twenty thousand in 2011. Once a patient is diagnosed with active TB in medical and care facilities, extensive efforts are made to conduct investigation of TB contacts repeatedly in consultation with public health centers. Measures against TB infection are important issues. Therefore, we reviewed literatures on delays in the detection of TB cases and development of TB in medical and care facilities, and discussed related measures against TB infection. \"Total delay\" of TB cases consists of \"patient's delay\", which the patient does not seek medical attention for a long period of time, and \"doctor's delay\", which health-care professionals do not suspect and therefore overlook TB infection. For both types of delays, the duration of delay varied from a few days to a few years depending on the patients' individual situations. New-onset patients who caused infacilities infection had long patient's delay. \"Patient's delay\" was thought to develop the disease and to increase the infection risk to others. Nurses, doctors and other health-care professionals were considered as high risk group because they transmitted TB while continuing working in the facility without recognizing that they have been infected. The lack of clinical experience in TB and the increase of atypical cases to diagnosis even for doctors in respiratory medicine were regarded as \"Doctor's Delay\". Recommended measures against \"Patient's Delay\" were to promote TB infection prevention to people, users and staff of medical and care facilities, to build the health-care system for the staff of medical and care facilities and to build the regional alliance system with a public health center, hospitals, medical clinics and care facilities. As for measures against \"Doctor's Delay\", putting in place the inhospital system to lead to the appropriate diagnosis for suspicious TB cases and educating health-care professionals about TB infection continuously were considered important to decrease TB infection in medical and care facilities.","subitem_description_type":"Other"}]},"item_10_source_id_12":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"13464132","subitem_source_identifier_type":"ISSN"}]},"item_10_source_id_14":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AA11541529","subitem_source_identifier_type":"NCID"}]},"item_10_version_type_23":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_ab4af688f83e57aa","subitem_version_type":"AM"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorAffiliations":[{"affiliationNameIdentifiers":[{"affiliationNameIdentifier":""}],"affiliationNames":[{"affiliationName":""}]}],"creatorNames":[{"creatorName":"Aoyama, Emi","creatorNameLang":"en"},{"creatorName":"青山, 恵美","creatorNameLang":"ja"}],"familyNames":[{},{}],"givenNames":[{},{}],"nameIdentifiers":[{},{}]},{"creatorAffiliations":[{"affiliationNameIdentifiers":[{"affiliationNameIdentifier":""}],"affiliationNames":[{"affiliationName":""}]}],"creatorNames":[{"creatorName":"矢野, 久子","creatorNameLang":"ja"}],"familyNames":[{}],"givenNames":[{}],"nameIdentifiers":[{},{},{},{}]},{"creatorAffiliations":[{"affiliationNameIdentifiers":[{"affiliationNameIdentifier":""}],"affiliationNames":[{"affiliationName":""}]}],"creatorNames":[{"creatorName":"Wakimoto, Hiroko","creatorNameLang":"en"},{"creatorName":"脇本, 寛子","creatorNameLang":"ja"}],"familyNames":[{},{}],"givenNames":[{},{}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"岩田, 広子"}],"nameIdentifiers":[{}]},{"creatorAffiliations":[{"affiliationNameIdentifiers":[{"affiliationNameIdentifier":""}],"affiliationNames":[{"affiliationName":""}]}],"creatorNames":[{"creatorName":"Suzuki, Kanzo","creatorNameLang":"en"},{"creatorName":"鈴木, 幹三","creatorNameLang":"ja"}],"familyNames":[{},{}],"givenNames":[{},{}],"nameIdentifiers":[{},{},{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2014-04-22"}],"displaytype":"detail","filename":"B12-20140301-7.pdf","filesize":[{"value":"2.3 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"B12-20140301-7","url":"https://ncu.repo.nii.ac.jp/record/741/files/B12-20140301-7.pdf"},"version_id":"c6f18d4f-1ead-46d2-b5f3-56fb629508ec"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"結核","subitem_subject_scheme":"Other"},{"subitem_subject":"受診の遅れ","subitem_subject_scheme":"Other"},{"subitem_subject":"診断の遅れ","subitem_subject_scheme":"Other"},{"subitem_subject":"院内感染","subitem_subject_scheme":"Other"},{"subitem_subject":"集団感染","subitem_subject_scheme":"Other"},{"subitem_subject":"tuberculosis","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"patient's delay","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"doctor's delay","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"nosocomial infection","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"group infection","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":"医療施設・介護施設内での結核発生防止に関する文献的考察 : 肺結核の受診の遅れ、診断の遅れを中心に","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"医療施設・介護施設内での結核発生防止に関する文献的考察 : 肺結核の受診の遅れ、診断の遅れを中心に"},{"subitem_title":"A Literature Review on the Prevention of Tuberculosis within Medical and Care Facilities : Focus on \"Patient's Delay\" and \"Doctor's Delay\" of Pulmonary Tuberculosis","subitem_title_language":"en"}]},"item_type_id":"10","owner":"13","path":["118"],"pubdate":{"attribute_name":"公開日","attribute_value":"2014-04-21"},"publish_date":"2014-04-21","publish_status":"0","recid":"741","relation_version_is_last":true,"title":["医療施設・介護施設内での結核発生防止に関する文献的考察 : 肺結核の受診の遅れ、診断の遅れを中心に"],"weko_creator_id":"13","weko_shared_id":-1},"updated":"2023-07-24T06:40:28.837854+00:00"}