{"created":"2023-06-19T10:30:46.072032+00:00","id":2908,"links":{},"metadata":{"_buckets":{"deposit":"91e76197-86df-4d98-9b37-5a9ee73abd35"},"_deposit":{"created_by":31,"id":"2908","owners":[31],"pid":{"revision_id":0,"type":"depid","value":"2908"},"status":"published"},"_oai":{"id":"oai:kwmed.repo.nii.ac.jp:00002908","sets":["1709617079800:35:791"]},"author_link":["109935","109936","109937","109938"],"item_10001_alternative_title_1":{"attribute_name":"その他(別言語等)のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"A Proposal for an Early Response to Delirium in Terminal Cancer Patients with the Aim of Preventing Extreme Grief","subitem_alternative_title_language":"en"}]},"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2020","bibliographicIssueDateType":"Issued"},"bibliographicPageEnd":"20","bibliographicPageStart":"15","bibliographicVolumeNumber":"46","bibliographic_titles":[{"bibliographic_title":"川崎医学会誌","bibliographic_titleLang":"ja"},{"bibliographic_title":"Kawasaki medical journal","bibliographic_titleLang":"en"}]}]},"item_10001_description_33":{"attribute_name":"記事種別(日)","attribute_value_mlt":[{"subitem_description":"症例報告","subitem_description_language":"ja","subitem_description_type":"Other"}]},"item_10001_description_34":{"attribute_name":"記事種別(英)","attribute_value_mlt":[{"subitem_description":"Case Report","subitem_description_language":"en","subitem_description_type":"Other"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"川崎医学会","subitem_publisher_language":"ja"}]},"item_10001_relation_14":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"https://doi.org/10.11482/KMJ-J202046015","subitem_relation_type_select":"DOI"}}]},"item_10001_relation_17":{"attribute_name":"関連サイト","attribute_value_mlt":[{"subitem_relation_type_id":{"subitem_relation_type_id_text":"https://igakkai.kms-igakkai.com/wp/wp-content/uploads/2020/KMJ-J202046015.pdf","subitem_relation_type_select":"URI"}}]},"item_10001_relation_35":{"attribute_name":"医中誌ID","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"2021178665","subitem_relation_type_select":"ICHUSHI"}}]},"item_10001_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00045593","subitem_source_identifier_type":"NCID"},{"subitem_source_identifier":"AA12940574","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"03865924","subitem_source_identifier_type":"PISSN"},{"subitem_source_identifier":"2758089X","subitem_source_identifier_type":"EISSN"}]},"item_10001_text_31":{"attribute_name":"著者所属(日)","attribute_value_mlt":[{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学臨床腫瘍学"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学臨床腫瘍学"}]},"item_10001_text_32":{"attribute_name":"著者所属(英)","attribute_value_mlt":[{"subitem_text_language":"en","subitem_text_value":"Department of Clinical Oncology Kawasaki Medical School, Kurashiki, Japan"},{"subitem_text_language":"en","subitem_text_value":"Department of Clinical Oncology Kawasaki Medical School, Kurashiki, Japan"}]},"item_10001_textarea_5":{"attribute_name":"抄録(英)","attribute_value_mlt":[{"subitem_textarea_language":"en","subitem_textarea_value":"　A terminally ill patient with a life expectancy of two weeks was labeled as“a patient who is violent toward medical professionals.”The cause was his violent behavior toward the nurses, which was triggered by delirium that is prevalent in such end-of-life patients. Unable to overcome this unfortunate reputation, he passed away in the presence of his parents. It is thought that this would not have occurred if the support staff had taken some measures against delirium with the terminal cancer patient at an earlier stage. Through the example provided in this case, this paper proposes an early response to delirium. The patient, in this case, was an adult man in his 30s, who received chemotherapy for cancer of the central nervous system four years earlier and achieved remission. However, because of the difficulty he faced in returning to society, both of his parents quit their jobs to help support him. During an outpatient followup in March of the previous year, another cancer was detected. Due to his mental state caused by sequelae and his poor PS (performance status), chemotherapy was deemed impractical. In February 20XX, the patient was admitted to the hospital because of an aggravated respiratory condition. After his hospitalization, delirium symptoms associated with his aggravated condition developed. Because of his delirium, unfortunately, the nurses became victims of his violence. The patient's parents were given the explanation that their son needed to be transferred to another hospital due to his violent behavior. However, before the transfer took place, just one week from the time the transfer was explained to the family, the patient passed away. It is believed the lack of early prevention and countermeasures against delirium and the associated violence had created this situation. It is thought that recognizing the appearance of delirium symptoms in their early stages, taking preventative measures with an understanding of the risk of violence, and providing medical care to end-stage cancer patients to prevent extreme grief for their families is important. "}]},"item_10001_textarea_6":{"attribute_name":"抄録(日)","attribute_value_mlt":[{"subitem_textarea_language":"ja","subitem_textarea_value":"　余命２週間のがん末期の患者が，終末期のせん妄による看護師への暴力をきっかけに，「医療者に暴力をふるうような患者です．」と悪評され，不名誉を拭えないまま，両親に見守られる中，亡くなった．対応するスタッフが，終末期がん患者のせん妄に対し早期に対応できていればこのような事態を招かなかったと考えられる．今回の症例を通して，せん妄への早期対応を提案したく報告する．症例は30歳代男性で，４年前，中枢神経がんに対して化学療法が施行され奏効し寛解に到達した．しかし，社会復帰は困難な状況であったため，両親は共に仕事を辞め，付き添い本人を支えた．外来での経過観察中，１年前の３月に別のがんを発症した．後遺症による精神状態と PS不良を理由に化学療法は不可能と判断された．20XX 年２月になり，呼吸状態が悪化したため入院となった．入院後，状態悪化に伴うせん妄症状が出現し，せん妄のため看護師へ暴力行為を行ってしまった．暴力行為のため，転院せざるを得ない旨を両親に説明することとなったが，転院には間に合うことなく，転院の説明から１週間で永眠された．せん妄と，それに伴う暴力行為に対する早期予防・対策が立案できていないことが，この状況を招いた要因と考えられる．せん妄症状の発生に早い段階で気づき，暴力リスクを理解し対策していくことが，がん終末期患者とその家族の深い悲しみを回避する医療を行うために大切なことと考える．"}]},"item_10001_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"佐野, 史典","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"山口, 佳之","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"SANO, Fuminori","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"YAMAGUCHI, Yoshiyuki","creatorNameLang":"en"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2022-10-18"}],"displaytype":"detail","filename":"KMJ-J202046015.pdf","filesize":[{"value":"976.0 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"PDF","objectType":"fulltext","url":"https://kwmed.repo.nii.ac.jp/record/2908/files/KMJ-J202046015.pdf"},"version_id":"05805b75-fc6c-4303-b3c6-cb6aa65fee58"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"せん妄","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"終末期がん患者","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"緩和ケア","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"Delirium","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"terminal cancer patients","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"palliative care","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":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"深い悲しみを持たせないことを目的とした終末期がん患者のせん妄への早期対応の提案","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"深い悲しみを持たせないことを目的とした終末期がん患者のせん妄への早期対応の提案","subitem_title_language":"ja"}]},"item_type_id":"10001","owner":"31","path":["791"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2022-10-18"},"publish_date":"2022-10-18","publish_status":"0","recid":"2908","relation_version_is_last":true,"title":["深い悲しみを持たせないことを目的とした終末期がん患者のせん妄への早期対応の提案"],"weko_creator_id":"31","weko_shared_id":-1},"updated":"2024-04-12T06:50:10.633969+00:00"}