訪問看護師と医師の協働による在宅療養者への白癬症ケア―治療の介入とその効果

The aim of this study was to assess the effects of cooperation by visiting nurses and physicians experienced in general patient care, dermatology, and podiatry for the treatment of ringworm. Questionnaires were delivered to 1184 patients receiving home-based care by one of 14 participating visiting nursing establishments with a combined capacity of 3273 patients throughout five wards of the Tokyo metropolitan area. Responses were obtained from 691 patients (participation rate, 60.2％; average age, 80.2 years). The onychomycosis morbidity rate among home care patients was 22.7％. The results showed a significant reduction in the incidence of ringworm in the intervention group, from 79.5％ to 54.5％(p＝0.022), and in the incidence of "foot skin infection", from 100.0％ to 31.6％ (p＜0.001). Although the level of care deteriorated in the control group (p＝0.008), there was no significant change in the intervention group. The incidence of leg pain also remained unchanged in the control group (p＝0.285) but decreased in the intervention group (p＝0.003). While the "degree of satisfaction with foot cleanliness" did not change significantly in the control group (p＝0.260), patients in the intervention group were generally satisfied with foot cleanliness. It is necessary to take into account foot care and the effect of onychomycosis treatment vearsusu no treatment and to ensure that visiting nurses and caregivers master foot care-related treatment regimens. We suggest the need to improve the maintenance of foot care and ringworm intervention/treatment performed by physicians, nurses, and caregivers.