{"id":2227,"date":"2022-01-04T11:32:49","date_gmt":"2022-01-04T02:32:49","guid":{"rendered":"https:\/\/www.hcfm.jp\/journal\/?p=2227"},"modified":"2022-01-04T11:32:49","modified_gmt":"2022-01-04T02:32:49","slug":"inappropriate-treatments-for-nursing-home-patients-at-the-end-of-life-may-2021","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=2227","title":{"rendered":"Inappropriate treatments for nursing home patients at the end of life \/ May 2021"},"content":{"rendered":"

\u203b\u3053\u306e\u6642\u671f\u306eUpToDate\u306b\u3042\u308b\u201dWhat\u2019s new in family medicine\u201d\u306eTopic\u3067\u53c2\u8003\u306b\u3055\u308c\u3066\u3044\u308b\u6587\u732e\u3067\u3059\u3002<\/p>\n

\u2015\u6587\u732e\u540d\u2015
\nHoninx E, Van den Block L, Piers R, et al. Potentially Inappropriate Treatments at the End of Life in Nursing Home Residents: Findings From the PACE Cross-Sectional Study in Six European Countries.J Pain Symptom Manage. 2021;61(4):732-742.e1. doi:10.1016\/j.jpainsymman.2020.09.001<\/p>\n

\u2015\u8981\u7d04\u2015
\nIntroduction<\/strong>
\n\u30e8\u30fc\u30ed\u30c3\u30d1\u3067\u306f\u300165\u6b73\u4ee5\u4e0a\u306e\u9ad8\u9f62\u8005\u306e\u6700\u592738%\u304c\u8001\u4eba\u30db\u30fc\u30e0\u3067\u4ea1\u304f\u306a\u3063\u3066\u3044\u308b\u3002\u30d9\u30eb\u30ae\u30fc\u3001\u30a4\u30ae\u30ea\u30b9\u3001\u30d5\u30a3\u30f3\u30e9\u30f3\u30c9\u3001\u30a4\u30bf\u30ea\u30a2\u3001\u30aa\u30e9\u30f3\u30c0\u3001\u30dd\u30fc\u30e9\u30f3\u30c9\u306e\u8001\u4eba\u30db\u30fc\u30e0\u3067PACE\uff08Palliative Care for Older\u3001\u9ad8\u9f62\u8005\u306e\u305f\u3081\u306e\u7de9\u548c\u30b1\u30a2\uff09\u306e\u6a2a\u65ad\u7684\u7814\u7a76\u3092\u884c\u3063\u305f\u3002<\/p>\n

\u76ee\u7684
\n \u8001\u4eba\u30db\u30fc\u30e0\u5165\u5c45\u8005\u306e\u4eba\u751f\u6700\u5f8c\u306e1\u9031\u9593\u306b\u304a\u3051\u308b\u6f5c\u5728\u7684\u306b\u4e0d\u9069\u5207\u306a\u6cbb\u7642\u306e\u5272\u5408\u3092\u63a8\u5b9a\u3057\u3001\u56fd\u306b\u3088\u308b\u9055\u3044\u3092\u5206\u6790\u3059\u308b\u3053\u3068\u3002<\/p>\n

Method<\/strong>
\n\u7814\u7a76\u30c7\u30b6\u30a4\u30f3\u3068\u30b5\u30f3\u30d7\u30ea\u30f3\u30b0
\n \u8001\u4eba\u30db\u30fc\u30e0\u306e\u6b7b\u4ea1\u3057\u305f\u5165\u5c45\u8005\u3092\u5bfe\u8c61\u3068\u3057\u305f\u6a2a\u65ad\u7684\u306a\u8abf\u67fb\u3092\u30012015\u5e74\u306b6\u3064\u306e\u30e8\u30fc\u30ed\u30c3\u30d1\u306e\u56fd\uff08\u30d9\u30eb\u30ae\u30fc\u3001\u30a4\u30ae\u30ea\u30b9\u3001\u30d5\u30a3\u30f3\u30e9\u30f3\u30c9\u3001\u30a4\u30bf\u30ea\u30a2\u3001\u30aa\u30e9\u30f3\u30c0\u3001\u30dd\u30fc\u30e9\u30f3\u30c9)\u3067\u3001\u6bd4\u4f8b\u5c64\u5316\u7121\u4f5c\u70ba\u62bd\u51fa\u6cd5\u3092\u7528\u3044\u3066\u5b9f\u65bd\u3057\u305f\u3002\u5404\u56fd\u306e\u8001\u4eba\u30db\u30fc\u30e0\u306f\u3001\u5730\u57df\uff08\u5dde\u3084\u305d\u306e\u4ed6\u306e\u5927\u304d\u306a\u5730\u57df\uff09\u3001\u7a2e\u985e\u3001\u30d9\u30c3\u30c9\u6570\uff08\u56fd\u306e\u4e2d\u592e\u5024\u4ee5\u4e0a\uff0f\u4ee5\u4e0b\uff09\u3067\u5c64\u5225\u3055\u308c\u3001\u56fd\u5168\u4f53\u3092\u30ab\u30d0\u30fc\u3059\u308b\u3088\u3046\u306b\u7121\u4f5c\u70ba\u306b\u30b5\u30f3\u30d7\u30ea\u30f3\u30b0\u3055\u308c\u307e\u3057\u305f\u3002<\/p>\n

\u30c7\u30fc\u30bf\u53ce\u96c6
\n \u904e\u53bb3\u30ab\u6708\u9593\u306b\u6b7b\u4ea1\u3057\u305f\u5165\u5c45\u8005\u306e\u6982\u8981\u3068\u3001\u305d\u308c\u305e\u308c\u306e\u4e3b\u8981\u306a\u56de\u7b54\u8005\uff08\u30b9\u30bf\u30c3\u30d5\u3001\u3059\u306a\u308f\u3061\u3001\u30b1\u30a2\u306b\u6700\u3082\u95a2\u4e0e\u3057\u3066\u3044\u308b\u770b\u8b77\u5e2b\uff0f\u30b1\u30a2\u30a2\u30b7\u30b9\u30bf\u30f3\u30c8\u3001\u7ba1\u7406\u8005\uff0f\u904b\u55b6\u8005\u3001GP\uff09\u306e\u30ea\u30b9\u30c8\u3092\u5404\u65bd\u8a2d\u304c\u63d0\u4f9b\u3057\u305f\u3002\u3053\u308c\u3089\u306e\u4eba\u3005\u306b\u306f\u3001\u533f\u540d\u30b3\u30fc\u30c9\u3068\u3001\u5b8c\u5168\u306a\u533f\u540d\u6027\u3068\u5b88\u79d8\u6027\u3092\u4fdd\u8a3c\u3059\u308b\u6dfb\u4ed8\u6587\u66f8\u304c\u4ed8\u3044\u305f\u7d19\u306e\u30a2\u30f3\u30b1\u30fc\u30c8\u7528\u7d19\u304c\u9001\u3089\u308c\u3001\u30a2\u30f3\u30b1\u30fc\u30c8\u7528\u7d19\u306f\u30a8\u30af\u30bb\u30eb\u30d5\u30a1\u30a4\u30eb\u3092\u4f7f\u3063\u3066\u30e2\u30cb\u30bf\u30fc\u3059\u308b\u7814\u7a76\u8005\u306b\u76f4\u63a5\u8fd4\u5374\u3055\u308c\u305f\u3002\u81ea\u5206\u304c\u77e5\u3063\u3066\u3044\u308b\u9650\u308a\u3067\u3001\u3053\u308c\u3089\u306e\u6cbb\u7642\u304c\u4eba\u751f\u306e\u6700\u5f8c\u306e\u9031\u306b\u884c\u308f\u308c\u305f\u304b\u3069\u3046\u304b\u3092\u5c0b\u306d\u3089\u308c\u307e\u3057\u305f\u3002<\/p>\n

\u6e2c\u5b9a\u65b9\u6cd5
\n \u672c\u7814\u7a76\u3067\u3001\u4e0d\u9069\u5207\u306a\u6cbb\u7642\u3068\u306f\u3001\u671f\u5f85\u3055\u308c\u308b\u5065\u5eb7\u4e0a\u306e\u5229\u76ca\uff08\u5bff\u547d\u306e\u5ef6\u9577\u3084\u75db\u307f\u306e\u8efd\u6e1b\u306a\u3069\uff09\u3088\u308a\u3082\u3001\u8ca0\u306e\u5f71\u97ff\uff08\u6b7b\u4ea1\u7387\u3084\u75c7\u72b6\u306e\u91cd\u3055\u306a\u3069\uff09\u304c\u5927\u304d\u3044\u300d\u6cbb\u7642\u3084\u6295\u85ac\u3092\u6307\u3059\u3002
\n\u4eba\u5de5\u7d4c\u8178\u6804\u990a\uff08\u7d4c\u8178\u6804\u990a\u3001\u7d4c\u7ba1\u6804\u990aTPN\uff09\u3001\u8f38\u6db2\u3001\u8607\u751f\u3001\u4eba\u5de5\u547c\u5438\u3001\u8f38\u8840\u3001\u5316\u5b66\u7642\u6cd5\u30fb\u653e\u5c04\u7dda\u7642\u6cd5\u3001\u900f\u6790\u3001\u624b\u8853\u3001\u6297\u751f\u7269\u8cea\u3001\u30b9\u30bf\u30c1\u30f3\u3001\u6297\u7cd6\u5c3f\u75c5\u85ac\u3001\u65b0\u898f\u7d4c\u53e3\u6297\u51dd\u56fa\u85ac\u3092\u5bfe\u8c61\u3068\u3057\u305f\u3002<\/p>\n

Results<\/strong>
\n\u8abf\u67fb\u5bfe\u8c61\u8005\u306e\u7279\u5fb4
\n \u6b7b\u4ea1\u6642\u306e\u5e73\u5747\u5e74\u9f62\u306f\u3001\u30dd\u30fc\u30e9\u30f3\u30c9\u306781\u6b73\u3001\u30d9\u30eb\u30ae\u30fc\u3068\u30a4\u30ae\u30ea\u30b9\u306787\u6b73\u3068\u306a\u3063\u3066\u3044\u305f\uff08\u88681\uff09\u3002\u5165\u9662\u8005\u306f\u307b\u3068\u3093\u3069\u304c\u5973\u6027\u3067\u3001\u30dd\u30fc\u30e9\u30f3\u30c9\u306e63.5%\u304b\u3089\u30a4\u30f3\u30b0\u30e9\u30f3\u30c9\u306e75%\u307e\u3067\u306e\u7bc4\u56f2\u3067\u3042\u3063\u305f\u3002\u5165\u6240\u8005\u306f\u4e3b\u306b\u8001\u4eba\u30db\u30fc\u30e0\u3067\u6b7b\u4ea1\u3057\u305f\uff08\u30dd\u30fc\u30e9\u30f3\u30c9\u3067\u306f80\uff05\u3001\u30aa\u30e9\u30f3\u30c0\u3067\u306f89.3\uff05\uff09\u3002\u8a8d\u77e5\u75c7\u306f\u3001\u30d5\u30a3\u30f3\u30e9\u30f3\u30c9\u3067\u6700\u3082\u591a\u304f\uff0882.5\uff05\uff09\u3001\u30a4\u30f3\u30b0\u30e9\u30f3\u30c9\u3067\u6700\u3082\u5c11\u306a\u304b\u3063\u305f\uff0860.2\uff05\uff09\u3002\u6b7b\u4ea1\u6642\u306e\u75be\u60a3\u3068\u3057\u3066\u306f\u3001\u60aa\u6027\u304c\u3093\uff0842.9\uff05\uff09\u3067\u3042\u3063\u305f\u30a4\u30f3\u30b0\u30e9\u30f3\u30c9\u3092\u9664\u304d\u3001\u3059\u3079\u3066\u306e\u56fd\u3067\u91cd\u5ea6\u306e\u5fc3\u8840\u7ba1\u75be\u60a3\u304c\u6700\u3082\u591a\u304f\u5831\u544a\u3055\u308c\u307e\u3057\u305f\uff08\u30d9\u30eb\u30ae\u30fc34.7\uff05\uff5e\u30dd\u30fc\u30e9\u30f3\u30c955.7\uff05\uff09\u3002\u6a5f\u80fd\u7684\u304a\u3088\u3073\u8a8d\u77e5\u7684\u72b6\u614b\u304c\u6700\u3082\u60aa\u304b\u3063\u305f\u306e\u306f\u30dd\u30fc\u30e9\u30f3\u30c9\uff08BANS-S\u5e73\u5747\u30b9\u30b3\u30a221.9\uff09\u3067\u3001\u6700\u3082\u826f\u304b\u3063\u305f\u306e\u306f\u30a4\u30f3\u30b0\u30e9\u30f3\u30c9\uff08BANS-S\u5e73\u5747\u30b9\u30b3\u30a217.5\uff09\u3067\u3042\u3063\u305f\u3002<\/p>\n

6\u30ab\u56fd\u306b\u304a\u3051\u308b\u3001\u4eba\u751f\u306e\u6700\u5f8c\u306e1\u9031\u9593\u306b\u304a\u3051\u308b\u6f5c\u5728\u7684\u306b\u4e0d\u9069\u5207\u306a\u6cbb\u7642\u306e\u5272\u5408\u306e\u9055\u3044
\n \u6700\u5f8c\u306e1\u9031\u9593\u306b\u5c11\u306a\u304f\u3068\u30821\u3064\u306e\u4e0d\u9069\u5207\u306a\u6cbb\u7642\u3092\u884c\u3063\u305f\u5272\u5408\u306f\u3001\u30d9\u30eb\u30ae\u30fc\u306e19.9\uff05\u304b\u3089\u30dd\u30fc\u30e9\u30f3\u30c9\u306e68.2\uff05\u307e\u3067\u5dee\u304c\u3042\u3063\u305f\uff08p<0.001\uff09\u3002\u4eba\u5de5\u7684\u306a\u6804\u990a\u88dc\u7d66\u3084\u6c34\u5206\u88dc\u7d66\u306f\u3001\u30dd\u30fc\u30e9\u30f3\u30c9\u3067\u6700\u3082\u591a\u304f\uff0854.3\uff05\uff09\u3001\u30aa\u30e9\u30f3\u30c0\u3067\u306f\u6700\u3082\u5c11\u306a\u304b\u3063\u305f\uff082.7\uff05\u3001p<0.001\uff09\u3002\u30dd\u30fc\u30e9\u30f3\u30c9\uff0848.6\uff05\uff09\u3068\u30a4\u30bf\u30ea\u30a2\uff0824.5\uff05\uff09\u3067\u306f\u8f38\u6db2\u304c\u6700\u3082\u591a\u304f\u4f7f\u7528\u3055\u308c\u3066\u3044\u305f\uff08p<0.001\uff09\u3002\u7d4c\u8178\u6804\u990a\u5264\u306f\u4e3b\u306b\u30dd\u30fc\u30e9\u30f3\u30c9\uff0817\uff05\uff1bp>0.001\uff09\u3067\u6295\u4e0e\u3055\u308c\u3066\u3044\u305f\u306e\u306b\u5bfe\u3057\u3001\u7d4c\u7ba1\u6804\u990a\u306f\u30a4\u30bf\u30ea\u30a2\uff0821.5\uff05\uff1bp>0.001\uff09\u3067\u591a\u304f\u4f7f\u7528\u3055\u308c\u3066\u3044\u307e\u3057\u305f\u3002\u3059\u3079\u3066\u306e\u6cbb\u7642\u6cd5\u306e\u3046\u3061\u3001\u6297\u751f\u7269\u8cea\u306e\u4f7f\u7528\u304c\u6700\u3082\u591a\u304f\u3001\u30d9\u30eb\u30ae\u30fc\u306e11.3\uff05\u304b\u3089\u30dd\u30fc\u30e9\u30f3\u30c9\u306e45\uff05\u307e\u3067\u3001\u3059\u3079\u3066\u306e\u56fd\u3067\u4f7f\u7528\u3055\u308c\u307e\u3057\u305f\uff08p<0.001\uff09\u3002
\n\u30ea\u30b9\u30af\u56e0\u5b50\u8abf\u6574\u306e\u7d50\u679c\u3001\u3053\u308c\u3089\u306e\u5dee\u306f\u4f4f\u6c11\u306e\u7279\u6027\u306b\u3088\u308b\u3082\u306e\u3067\u306f\u306a\u304f\u3001\u5404\u56fd\u306e\u9069\u5207\u306a\u30b1\u30a2\u306e\u9055\u3044\u3092\u53cd\u6620\u3057\u305f\u3082\u306e\u3067\u3042\u308b\u3068\u8003\u3048\u3089\u308c\u305f\u3002<\/p>\n

Discussion<\/strong>
\n\u307b\u3068\u3093\u3069\u306e\u6cbb\u7642\u6cd5\u306e\u5b58\u5728\u5272\u5408\u306f\u3001\u56fd\u306b\u3088\u3063\u3066\u7d71\u8a08\u7684\u306b\u6709\u610f\u306b\u7570\u306a\u3063\u3066\u3044\u305f\u3002<\/p>\n

\u7814\u7a76\u306e\u5f37\u307f
\n \u533b\u7642\u5236\u5ea6\u3084\u7de9\u548c\u30b1\u30a2\u306e\u6587\u5316\u304c\u7570\u306a\u308b\u6b27\u5dde6\u30ab\u56fd\u306e322\u306e\u8001\u4eba\u30db\u30fc\u30e0\u306e1,384\u4eba\u306e\u5165\u5c45\u8005\u306e\u30c7\u30fc\u30bf\u3092\u542b\u3081\u308b\u3053\u3068\u304c\u3067\u304d\u305f\u3002\u30ea\u30b9\u30af\u8abf\u6574\u3092\u884c\u3046\u3053\u3068\u3067\u3001\u672c\u7814\u7a76\u306e\u7d50\u679c\u304c\u56fd\u3054\u3068\u306e\u5b58\u5728\u5272\u5408\u306e\u9055\u3044\u3092\u53cd\u6620\u3057\u3066\u304a\u308a\u3001\u5165\u5c45\u8005\u306e\u7279\u6027\u306e\u9055\u3044\u306b\u5f71\u97ff\u3055\u308c\u3066\u3044\u306a\u3044\u3053\u3068\u304c\u78ba\u8a8d\u3055\u308c\u307e\u3057\u305f\u3002<\/p>\n

\u7814\u7a76\u306e\u9650\u754c
\n\u2460\u8abf\u67fb\u30c7\u30fc\u30bf\u304b\u3089\u3001\u7279\u5b9a\u306e\u6cbb\u7642\u6cd5\u304c\u300c\u4e0d\u9069\u5207\u300d\u306a\u5834\u5408\u3092\u63a8\u6e2c\u3059\u308b\u3053\u3068\u306f\u3067\u304d\u305a\u3001\u6cbb\u7642\u304c\u884c\u308f\u308c\u305f\u6642\u70b9\u3067\u306f\u3001\u3042\u308b\u6cbb\u7642\u304c\u4e0d\u9069\u5207\u3067\u3042\u308b\u3068\u306f\u8003\u3048\u3089\u308c\u306a\u304b\u3063\u305f\u304b\u3082\u3057\u308c\u306a\u3044\u3002
\n\u2461\u30c7\u30fc\u30bf\u306f\u770b\u8b77\u5e2b\u500b\u4eba\u304b\u3089\u53ce\u96c6\u3057\u305f\u305f\u3081\u3001\u30ea\u30b3\u30fc\u30eb\u30d0\u30a4\u30a2\u30b9\u306e\u53ef\u80fd\u6027\u304c\u3042\u308a\u307e\u3059\u3002
\n\u2462\u6cbb\u7642\u306e\u958b\u59cb\u6642\u671f\u3084\u81e8\u5e8a\u7684\u306a\u9069\u5fdc\u306b\u3064\u3044\u3066\u306e\u60c5\u5831\u3092\u53ce\u96c6\u3057\u3066\u3044\u306a\u3044\u3002
\n\u2463\u6cbb\u7642\u6cd5\u306b\u3088\u3063\u3066\u306f\u5927\u91cf\u306e\u6b20\u640d\u30c7\u30fc\u30bf\uff08\u6700\u5927\u306724\uff05\uff09\u304c\u3042\u3063\u305f\u3002 \u2192 \u4e0d\u5b8c\u5168\u306a\u75c7\u4f8b\u3068\u5b8c\u5168\u306a\u75c7\u4f8b\u306e\u56de\u5e30\u5e30\u7d0d\u6cd5\u306b\u3088\u308b\u611f\u5ea6\u5206\u6790\u3092\u884c\u3044\u307e\u3057\u305f\u3002\u305d\u306e\u7d50\u679c\u3001\u4e3b\u306b\u540c\u69d8\u306e\u7d50\u679c\u304c\u5f97\u3089\u308c\u3001\u6b20\u640d\u30c7\u30fc\u30bf\u306e\u5f71\u97ff\u306f\u5c0f\u3055\u3044\u3053\u3068\u304c\u308f\u304b\u308a\u307e\u3057\u305f\u3002
\n\u2464\u5165\u5c45\u8005\u304c\u75c5\u9662\u3067\u6b7b\u4ea1\u3057\u305f\u5834\u5408\u3001\u8001\u4eba\u30db\u30fc\u30e0\u306f\u4eba\u751f\u6700\u5f8c\u306e1\u9031\u9593\u306e\u75c5\u9662\u3067\u306e\u6cbb\u7642\u306b\u95a2\u3059\u308b\u60c5\u5831\u3092\u6301\u3063\u3066\u3044\u306a\u3044\u53ef\u80fd\u6027\u304c\u3042\u308a\u3001\u3053\u308c\u304c\u904e\u5c0f\u8a55\u4fa1\u306b\u3064\u306a\u304c\u308b\u53ef\u80fd\u6027\u304c\u3042\u308a\u307e\u3059\u3002\u2192 \u75c5\u9662\u3067\u6b7b\u4ea1\u3057\u305f\u5165\u5c45\u8005\u306f\u5168\u4f53\u306e15\uff05\u306b\u904e\u304e\u306a\u3044\u3053\u3068\u304b\u3089\u3001\u3053\u308c\u306b\u3088\u308b\u30d0\u30a4\u30a2\u30b9\u306e\u53ef\u80fd\u6027\u306f\u5c0f\u3055\u3044\u3068\u601d\u308f\u308c\u307e\u3059\u3002<\/p>\n

\u81e8\u5e8a\u7684\u610f\u7fa9
\n \u56fd\u306b\u3088\u308b\u9055\u3044\u304c\u5927\u304d\u3044\u3053\u3068\u304b\u3089\u3001\u6587\u5316\u7684\u306a\u9055\u3044\u3092\u8003\u616e\u3057\u3066\u3001\u4ecb\u8b77\u65bd\u8a2d\u306e\u30b9\u30bf\u30c3\u30d5\u3084GP\u304c\u6cbb\u7642\u306e\u610f\u601d\u6c7a\u5b9a\u3084\u7d42\u672b\u671f\u306e\u8a8d\u8b58\u3092\u884c\u3046\u969b\u306b\u5f79\u7acb\u3064\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3092\u4f5c\u6210\u3059\u308b\u5fc5\u8981\u304c\u3042\u308b\u3002\u4ecb\u8b77\u65bd\u8a2d\u306b\u304a\u3051\u308b\u4e8b\u524d\u306e\u30b1\u30a2\u30d7\u30e9\u30f3\u306f\u3001\u5165\u5c45\u8005\u3001\u89aa\u65cf\u3001\u4ecb\u8b77\u8005\u304c\u5c06\u6765\u306e\u30b1\u30a2\u306e\u76ee\u6a19\u3084\u597d\u307f\u3092\u8a71\u3057\u5408\u3046\u306e\u306b\u5f79\u7acb\u3064\u53ef\u80fd\u6027\u304c\u3042\u308b\u305f\u3081\u3001\u3088\u308a\u5927\u304d\u306a\u6ce8\u610f\u3092\u6255\u3046\u5fc5\u8981\u304c\u3042\u308b\u3002\u6700\u5f8c\u306b\u3001\u7d42\u672b\u671f\u306e\u30b1\u30a2\u306b\u95a2\u3059\u308b\u4f1a\u8a71\u3084\u7d42\u672b\u671f\u306e\u30b1\u30a2\u306e\u8eab\u4f53\u7684\u5074\u9762\u306b\u95a2\u3059\u308b\u30b9\u30bf\u30c3\u30d5\u306e\u30c8\u30ec\u30fc\u30cb\u30f3\u30b0\u304c\u5fc5\u8981\u3067\u3042\u308b\u3002\u4eca\u56de\u306e\u7d50\u679c\u306f\u3001\u653f\u7b56\u7acb\u6848\u8005\u3084\u305d\u306e\u4ed6\u306e\u610f\u601d\u6c7a\u5b9a\u8005\u304c\u3001\u8001\u4eba\u30db\u30fc\u30e0\u306b\u304a\u3051\u308b\u7d42\u672b\u671f\u30b1\u30a2\u306e\u9069\u5207\u6027\u3092\u5411\u4e0a\u3055\u305b\u308b\u305f\u3081\u306e\u516c\u8846\u885b\u751f\u653f\u7b56\u3084\u4ecb\u5165\u7b56\u3092\u7b56\u5b9a\u3059\u308b\u969b\u306b\u5229\u7528\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u3001\u307e\u305f\u3001\u56fd\u5883\u3092\u8d8a\u3048\u3066\u512a\u826f\u4e8b\u4f8b\u3092\u4ea4\u63db\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059\u3002<\/p>\n

Conclusion<\/strong>
\n\u8001\u4eba\u30db\u30fc\u30e0\u5165\u5c45\u8005\u306e\u4eba\u751f\u6700\u5f8c\u306e1\u9031\u9593\u306b\u304a\u3051\u308b\u4e0d\u9069\u5207\u3068\u601d\u308f\u308c\u308b\u6cbb\u7642\u306e\u5b58\u5728\u5272\u5408\u306f\u3001\u6297\u751f\u7269\u8cea\u306e\u4f7f\u7528\u304c\u4e00\u822c\u7684\u3067\u3042\u3063\u305f\u3053\u3068\u3092\u9664\u3044\u3066\u3001\u307b\u3068\u3093\u3069\u306e\u8abf\u67fb\u5bfe\u8c61\u56fd\u3067\u4f4e\u304b\u3063\u305f\u3002\u30a4\u30bf\u30ea\u30a2\u3068\u30dd\u30fc\u30e9\u30f3\u30c9\u3067\u306f\uff0c\u3059\u3079\u3066\u306e\u6cbb\u7642\u304c\u3088\u308a\u591a\u304f\u884c\u308f\u308c\u3066\u304a\u308a\uff0c\u7279\u306b\u4eba\u5de5\u6804\u990a\u30fb\u8f38\u6db2\u3068\u6297\u751f\u7269\u8cea\u306e\u6295\u4e0e\u304c\u591a\u304b\u3063\u305f\u3002\u3053\u308c\u3089\u306e\u9055\u3044\u306f\u3001\u6cd5\u5f8b\u3001\u30b1\u30a2\u7d44\u7e54\u3001\u6587\u5316\u3001\u7de9\u548c\u30b1\u30a2\u306b\u95a2\u3059\u308b\u4ecb\u8b77\u65bd\u8a2d\u30b9\u30bf\u30c3\u30d5\u306e\u77e5\u8b58\u3084\u6280\u8853\u306a\u3069\u3001\u56fd\u3054\u3068\u306e\u9055\u3044\u3092\u53cd\u6620\u3057\u3066\u3044\u308b\u3002<\/p>\n

\"\"<\/a><\/p>\n

\"\"<\/a><\/p>\n

\"\"<\/a><\/p>\n

\"\"<\/a><\/p>\n

\u3010\u958b\u50ac\u65e5\u3011
\n2021\u5e7410\u67086\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

\u203b\u3053\u306e\u6642\u671f\u306eUpToDate\u306b\u3042\u308b\u201dWhat\u2019s new in family medicine\u201d\u306eTopic\u3067\u53c2\u8003\u306b\u3055\u308c\u3066\u3044\u308b\u6587\u732e\u3067\u3059\u3002 \u2015\u6587\u732e\u540d\u2015 Honinx E, Van den Block L, Piers R, … \u7d9a\u304d\u3092\u8aad\u3080 Inappropriate treatments for nursing home patients at the end of life \/ May 2021<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[33,12,11],"tags":[],"class_list":["post-2227","post","type-post","status-publish","format-standard","hentry","category-whats-new","category-12","category-11"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2227","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2227"}],"version-history":[{"count":1,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2227\/revisions"}],"predecessor-version":[{"id":2232,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2227\/revisions\/2232"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2227"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2227"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2227"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}