Japanese

Title	経口摂取要介護高齢者の発熱発生と口腔ケアアセスメント項目との関連性
Subtitle	原著
Authors	吉岡昌美1), 中江弘美1), 篠原千尋1), 十川悠香1), 福井誠2), 日野出大輔2), 中野雅徳1)
Authors (kana)
Organization	1)徳島文理大学保健福祉学部口腔保健学科, 2)徳島大学大学院医歯薬学研究部口腔保健衛生学分野
Journal	日本摂食嚥下リハビリテーション学会雑誌
Volume	27
Number	1
Page	16-24
Year/Month	2023 / 4
Article	原著
Publisher	日本摂食嚥下リハビリテーション学会
Abstract	「要旨」要介護高齢者の口腔機能低下やそれに伴う食形態の制限は, 低栄養や免疫機能低下を通じて発熱や肺炎の発症リスクを上昇させると考えられる. 本研究では, 経口摂取が可能な施設入所要介護高齢者を対象に, 「口腔ケア支援簡易版アセスメントシート」を用いた約1年半のコホート調査を行い, その間の37.5℃以上の発熱とベースラインの口腔アセスメント結果との関連性について調べ, 発熱発生に関連する要因を明らかにすることを目的とした. 1年間の発熱の有無が確定できた259名を対象に分析した結果, 1年間の発熱有無と主食形態, 開口困難, 舌の前突困難, 飲み込みにくさ, 口腔ケア自発性なし, 開口保持困難, 水分保持困難との間に有意な関連を認めた. さらに, 観察期間を限定せずデータが得られた279名を対象にこれらの項目と発熱発生との関連性について分析した結果, 年齢, 性別, BMI, 認知症自立度で調整しても開口困難, 舌の前突困難, 飲み込みにくさ, 口腔ケア自発性なし, 開口保持困難, 水分保持困難との間に有意な関連性が認められた. また, 年齢が高いほど, BMIが低いほど発熱リスクは高く, 女性に比べて男性で発熱リスクが高いことも明らかとなった. 以上のことから, 開口, 舌の前突, 飲み込み, 水分保持などに関する口腔機能の低下が, 発熱リスクの予測因子となりうる可能性が示唆された.
Practice	医療技術
Keywords	口腔アセスメントシート, 要介護高齢者, 発熱, リスク因子, コホート研究, oral assessment sheet, dependent elderly, fever, risk factor, cohort study

English

Title	Association between Onset of Fever and Oral Care Assessment Items in Older Adults Requiring Nursing Care Who Are Capable of Oral Ingestion
Subtitle
Authors	Masami YOSHIOKA1), Hiromi NAKAE1), Chihiro SHINOHARA1), Yuka SOGAWA1), Makoto FUKUI2), Daisuke HINODE2), Masanori NAKANO1)
Authors (kana)
Organization	1)Department of Oral Health Sciences, Faculty of Health and Welfare, Tokushima Bunri University, 2)Department of Hygiene and Oral Health Science, Tokushima University Graduate School of Biomedical Sciences
Journal	The Japanese Journal of Dysphagia Rehabilitation
Volume	27
Number	1
Page	16-24
Year/Month	2023 / 4
Article	Original article
Publisher	The Japanese Society of Dysphagia Rehabilitation
Abstract	[Abstract] Decreased oral function in older adults requiring long-term care and associated dietary restrictions are thought to increase the risk of developing fever and pneumonia through malnutrition and decreased immune function. We conducted a cohort survey for approximately 1.5 years using oral care assessment sheets for older adults who were capable of oral ingestion and who required nursing care in a facility. The purpose of this study was to clarify the factors related to the onset of fever. A statistical analysis was performed on 259 subjects for whom the presence or absence of fever could be confirmed for 1 year. Significant associations were found between the onset of fever and the staple food form, difficulty in mouth-opening, difficulty in protruding the tongue, difficulty in swallowing, lack of spontaneity in oral care, difficulty in keeping the mouth open, and difficulty in holding water in the mouth. Furthermore, without limiting the observation period, Cox hazard analysis was performed on the relationship between these items and the onset of fever in 279 subjects for whom data were available. It was found that there was a significant relationship between difficulty in mouth-opening, difficulty in protruding the tongue, difficulty in swallowing, lack of spontaneity in oral care, difficulty in keeping the mouth open, and difficulty in holding water in the mouth. Older age and lower body mass index were associated with a higher risk of the onset of fever, and the risk of the onset of fever was higher in men than in women. These results suggest that a marked decline in oral functions such as mouth-opening, tongue protrusion, swallowing, and holding water in the mouth could predict the onset of fever.
Practice	Medical technology
Keywords	oral assessment sheet, dependent elderly, fever, risk factor, cohort study

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