@article{oai:air.repo.nii.ac.jp:00000588,
 author = {高橋, 紀子 and 岡田, ミヨ子 and 長谷川, 由紀子 and 佐藤, 紀子 and 成田, 琢磨 and 神谷, 千鶴 and 浅沼, 義博 and TAKAHASHI, Noriko and OKADA, Miyoko and HASEGAWA, Yukiko and SATO, Noriko and NARITA, Takuma and KAMIYA, Chizuru and ASANUMA, Yoshihiro},
 issue = {1},
 journal = {秋田大学医学部 保健学科紀要},
 month = {Mar},
 note = {糖尿病患者に対し,教育入院用クリニカルパスを作成し,7例に適用した.このパスの中での栄養士の果たす役割は,アウトカムを「食事療法の必要性が理解でき,ご飯などの秤量ができ,退院後も継続できる」とした.入院期間は平均24日であり,この間に全例において, 3回栄養指導を行うことができた.入院時に調査した患者の食事状況については,7例中6例が間食をしていた.また,食事傾向は7例中5例が基本量よりも多く食べていた.また,7例中2例では食事療法に対する家族の協力は得られず,問題を抱えていた.教育入院前後のBody Mass Index (BMI)は,入院時27.4±4.8,退院時26.7±4.6であった.また,収縮期血圧は,各140±26mmHg,117±18mmHgであった.BMI,収縮期血圧ともに入院により有意に改善した.血液検査成績として,空腹時血糖, HbAlcを測定した.空腹時血糖は,入院時182±40mg/dl,退院時132±52mg/dlであった.また,HbA1cは,各10.0±1.8%, 8.0±0.9%であった.空腹時血糖,HbA1cともに入院により有意に改善した.退院時に,食事療法の理解度を調査した.摂取エネルギー量や主食・主菜・副菜の組み合わせの理解は7例ともあった.また,食品交換表の理解は,「ある」が3例,「1部ある」が3例であり,「ない」は1例のみであった.糖尿病教育入院用クリニカルパスを用いて管理栄養士が食事療法に介入することは,計画的に栄養指導を行うことができる,栄養士がチーム医療のなかに積極的に入ることができる等の理由により有意義であると考える., The clinical path was adopted for 7 diabetes patients who were admitted in our hospital for the purpose of diabetes education. The outcome of nutrition guidance following the clinical path is that the patient can understand the necessity of a meal plan, measure rice and other foods, and maintain the diet program after discharge. Nutrition intervention was performed 3 times for each patient during hospitalization (mean 24 days). Through interviews on admission, it became clear that 6 out of 7 snack between meals, 5 out of 7 eat more calories than the base quantity, and 2 out of 7 are not able to expect the cooperation of their family on their meal plan. Body mass index (BMI) (mean±S. D) was 27.4±4.8 on admission, and 26.7±4.6 on discharge. Systolic blood pressure was 140±26mmHg and 117±18mmHg respectively. Both parameters improved significantly through admission. Fasting blood sugar was 182±40mg/dl on admission, and 132±52mg/dl on discharge. Glycated hemoglobin was 10.0±1.8% and 8.0±0.9%, respectively. Both parameters improved significantly through admission. On discharge, the level of comprehension of the meal plan was assessed. All patients understood energy intake and the combination of main dishes and side dishes. Three patients understood the food substitution table well, three understood to some extent, and only 1 did not understand it. It is meaningful for the dietitian to intervene in diabetes education using the clinical path, since nutritional intervention can be planned and the dietitian can participate actively as part of the medical team.},
 pages = {58--67},
 title = {糖尿病クリニカルパス適用において食事指導を行った7症例の検討},
 volume = {12},
 year = {2004}
}