患者の達人に学ぶ　ブログ加藤眞三　医療の維新をより良い方向に　　/ウェブリブログ

患者の達人に学ぶ　

<< 作成日時： 2006/02/23 15:15 >>

昨日、NHK　生活ほっとモーニングの番組で　「患者の達人に学ぶ」　というテーマがとりあげられた。

「達人」という言葉に　メリットの執筆者の一人で番組にも出た　sin　さんは抵抗を持つようだが、私は達人も大衆化されて良い時代だろうと思う。そして、慢性病には、色々なレベルの達人がいて良いだろう。

病気の初心者は、色々なレベルの患者の達人を見て、学び教わることができる。
あるいは、患者さん同士でしか得られない情報もあろう。

喘息患者　Aさんは病気の知識に関する試験を受け、喘息の熟練患者の認定をもらい、自分の生活を自分自身でコントロールされ、他の患者さんの指導にもあたっている。まさに、理想の患者の達人であった。

しかし、初心者にとってそんな達人は高すぎる存在かもしれない。
そんな時は自分よりちょっと上の先輩の方が良いお手本になることもある。

NHKの担当者が最初に来られてからもう半年になる。
患者さんどうしの情報交換がこれからの医療に必要になるというと、それを元にして、色々な角度から勉強されていた。

喘息の熟練患者もその一つであるし、スタンフォード大学の患者教育プログラムを導入した日本での活動もその一つだ。私にとっても初めて知ることであり、大変参考になった。
肝臓病教室でやっているグループワークとそっくりのことが、スタンフォード大学でも行われていたのだ。

これも「患者が主役」という医療に訪れた一つの大きな時代の流れの変化であろう。同じようなことが、色々な場所で同時多発的に起こっている。これから、もっと拡がっていくに違いない。

14年前に私が都立広尾病院で開始した肝臓病教室は、そのような時代の予兆であったのだろう。

医療者の間でも関心を持つ人は増えている。患者さんの意識も確実に変わってきている。そんな時代の動きにもう一押しをする。そんな番組に仕上がっていたような気がする。

NHKの担当者には、このような話題を取り上げていただいたことにあらためて感謝したい。

http://www.nhk.or.jp/hot/onair_old/index.html

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私の母にも番組を見せました。もと内科外来の看護師で、現在も健診などの場で働いています。 MELITの主旨やしんぞう先生のおっしゃっていた言葉にとても感銘を受けたようでした。「私も患者の達人を目指すぞ」と伝えておきました。先生にはまだ一度しかお会いしたことがないので、本当はもっとお話が聞きたかったのですが、また番組出演の機会はあるでしょうから、それを楽しみにしてます。もちろん、体調が戻ればオフ会にも参加させて頂きたく思います。とりあえず、番組出演お疲れ様でした。	GORO 2006/02/23 17:20
こちらの友人と拝見させていただきました。早速５か条をメモしていました！特に３、治すことだけでなく楽しむ　　４、体調を意識して整える意志　　５、話し合える仲間を持つについては、医療者任せにしてしまいすっかり患者の気分になりきってしまい、ひとり塞ぎがちだったことから、目が覚めるようだと話していました。 MELITでの取り組みについて、確かな情報を得られ、多くの仲間を知ることで支えあえる希望がもてると言っていました。輪が広がりそうです。西村さん、眞三さんは勿論ですが、竹下景子さんがゲストでいらしたのもよかった！とのことでした。	水井パセリ 2006/02/23 22:10
おはようございます。　皆様御苦労様でした。　sinさんが御心配なさっていた「患者の達人」という言葉の意味合いがどうだろうと思いながらも見ますと、ＧＯＲＯさんや藤居さんのデータなどはまさに達人なのでプロっという言葉より、今を反映して良いと思いました。　喘息のかたの認定書はすばらしい取り組みと思いました。担当医のお墨付きでしかもきちんとテストを受けられているので安心して相談ができます。　ただ少し心配なのは、達人が御自分の身体を張ってボランティアでされているので無理されなければいいな…とも思いました。　ＴＶ．でもインターネットでもこのような情報を得られる時代になり、生きるための光の方向が見えるので頑張れそうですね。　遠いイギリスにいらっしゃるにのせんせに御見せしたかった。録画しなくて後悔してます（＞＜）	ひる行灯 2006/02/24 06:22
NHKの番組拝見させて頂きました。私は生後半年から甲状腺疾患で３０半ばの今でも・・・多分一生薬を飲まなければならないのですが、他にも次から次へと体調を崩し病院ばかりの生活でした。実は３年前から慶応病院にお世話になっているのですが、一時あまりに自分の体調に神経質になりすぎていた頃、内科のとある先生に「薬にばかり頼ってはいけないですよ」と諭された事がありました。それ以来少しの症状でも自分で管理できるようになってきたと思います。重いときはお世話になりますけれど。病院の先生は心のよりどころ。でもそれに甘えず、自分で自分を管理する大事さを改めて思う番組でした。先生も毎日お忙しい事と思いますが、どうかお身体ご自愛くださいませ。	ひろみ 2006/02/24 13:26
GOROさん。また、良い時期が訪れて、お会いできることができると思います。焦らずボチボチとやってください。水井さん。　竹下景子さんはさすがですね。リハーサルなしのぶっつけ本番でもその場の雰囲気をチャンと読んでコメントされます。昼行灯さん。　ボランティア活動も余り無理をしないようにすることでしょうね。にのちかさんには、私からビデオを送りましょう。まだ、ダビングの仕方が良くわからないのですが。	加藤眞三 2006/02/24 22:30
ひろみさん。　ご自分の状態をよく把握して、上手くコントロールしてください。悪い時もあれば、よい時もあるのだと思います。今までは、薬に頼る医療を医療者の側も患者の側も育ててきてしまったのだと思います。そこから少し軌道を修正すべき時代を迎えていると思います。	加藤眞三 2006/02/24 22:34
こんにちは。　しんぞう先生、私の単なるぼやきに反応して下さり、とても恐縮しています。きっとにのせんせ、フィギアで優勝した荒川選手のような笑顔で大喜びされることでしょう。	ひる行灯 2006/02/25 09:10
しんぞう先生には、昨年５月、キッペス先生のパストラルケアの講習会で初めてお会いしたものです。私自身、母が膵臓がんにかかり、死というものをどう考えてよいかのかわからず、そして末期がん患者に対する医療の格差を目の辺りにし、キッペス先生にすがった形で、講習会に参加させてもらいました。先生に相談したいのですが、実は、私の高校の友人（３５歳）が、慢性膵炎と診断されました。放置すれば、最悪の事態もあるとのことで、生活習慣も含め、慢性膵炎のケアをお願いできる信頼できる先生をご紹介いただけないものでしょうか。母の膵臓がんで、いろいろな医師と向き合って感じたのは、やはり患者のことを考えてくれている医師に出会えるかどうかが重要だと実感しました。同時に、患者側もいろいろと知識を得ることで、相乗効果も得られると思いました。同じ内容を、 http://melit.jp/voices/katos/2010/01/01/post.html にも書込みました。（詳細も書きました）よろしくお願いします。	こてつ 2006/02/26 12:03
しんぞう先生へ。ご返事ありがとうございます。診断そのものが難しい面があるという点を踏まえて、再度、友人に伝えます。ありがとうございます。	こてつ 2006/02/28 01:29
こてつさま。　先ずは、ご友人のよき相談役になって下さい。	しんぞう 2006/03/02 06:00
しんぞう先生へ。温かい励ましありがとうございます。友人もしんぞう先生のコメントで、少しほっとしています。膵臓はストレスに弱い臓器だと聞きます。ストレスの回避には、まずは、話せる友の存在も大きいと思います。自分のできることを精一杯援助しようと思います。ありがとうございます。	こてつ 2006/03/08 03:05
Ｃ型肝炎の無症候キャリアです。以前愚問に丁寧なご解答を戴いき、その節はありがとうございました。血液検査は全てクリアーしてもう十数年以上で先日の検査でも肝機能が全て正常で安心して血圧を測ったとたん２３４－１１０の数値にビックリし、降圧剤デェオバン４０ｍｇを一錠夕食後処方され現在服用しています。現在は平均１５０－８０台になりました。この降圧剤は肝臓に影響ないか尋ねたら、肝臓で薬は分解するから当然あるが仕方ないと肝臓病の副作用に熱心ではないように見受けがっかりしました。折角注意し抑えてきた肝機能が上がらないか心配です。長く服用すればいい薬に出会いたいのですが、それば我儘な希望でしょうか。新薬とのことで血圧には確かに効いても肝臓がもつか心配です。ほかに影響の少ない薬は無いものでしょうか。肥満体なので減量する積もりですが無呼吸症候群もあるようで、これも肥満の原因で高血圧との悪循環のようです。他の病気を併発したら、その対応が肝炎悪化の岐路のように想います。ご多忙中恐縮ですが後悔しない為敢えて教えを請う次第です。	kohituji 2006/07/29 20:21
先ずは減量をすることですね。それだけで、服薬する必要がなくなることもあります。ディオバンは特別に肝臓に悪い薬ではありませんので、余り心配する必要はありません。	しんぞう 2006/07/30 01:03
早速の明確なご回答ありがとうございました。判っちゃ居るけどやめられないの甘えで甘いもの取り過ぎを禁断。頑張ります！先生、背中を押して戴き心中の虫に甘えの糖分を発見。払拭する意欲が湧きました。加齢による弊害を華麗な変身でいい結果をご報告しお礼に代えたいと存じます。	kohituji 2006/07/30 07:20
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bestcapsule <a href= http://www.google.com/pagead/iclk?sa=l&ai=viagra&num=123456&adurl=http://www.bestcapsule.com >bestcapsule</a> e	sdrthsrh 2008/07/23 21:56
hochu vodki!x	Kathy 2008/07/24 15:49
Excellent site, added to favorites!!a	lhuv 2008/07/25 01:26
Many interesting information on your site - keep up good work.	jeroen 2008/07/25 09:41
Cool!.. Nice work...M	Ron 2008/07/25 16:14
Nice site! Big thanx to webmaster!	lhuv 2008/07/25 19:03
Dear web-master ! I looked your site and I want to say that yor very well	Rosina 2008/07/26 01:02
huyak	judy 2008/07/26 14:39
This+is+very+interesting+sitet	Robert 2008/07/26 17:03
Hello stupid pendosegi.k	Robert 2008/07/26 18:39
You have built a good websiten	Melissa 2008/07/27 04:07
I can find the prayer I want. I thank God for this website.	Kathy 2008/07/27 05:09
Very cool design! Useful information. Go on!	Willem 2008/07/27 07:31
Nice post. I\'ll return.u	judy 2008/07/27 18:30
i love this site.	Dan 2008/07/29 11:15
I enjoyed your page. Keep up the good work! Feel free to visit my page. It\'s cool too.i	Willem 2008/07/30 18:12
hochu vodki!	john 2008/08/01 01:54
Magnificent collection of prayers - and I haven\'t begun to explore the rest of the website!=	Willem 2008/08/01 11:18
Pretty nice site, wants to see much more on it! :)	Kathy 2008/08/02 07:01
Thank you for your site. I have found here much useful information...	john 2008/08/02 20:11
Greetings!..h	john 2008/08/04 07:54
This website is useful for individuals who are searching prayers and novenas and all.	Hannes 2008/08/06 03:31
Sentimental and nostalgic. Great.u	Ron 2008/08/06 05:36
Thanks so very much for taking your time to create this very useful and informative site. I have learned a lot from your site. Thanks!!	Willem 2008/08/06 10:12
Greetings!..s	judy 2008/08/13 04:50
Magnificent collection of prayers - and I haven\'t begun to explore the rest of the website!	Siber 2008/08/15 10:46
Nice site... Cool guestbook...;	Melissa 2008/08/15 16:00
You have an outstanding good and well structured site. I enjoyed browsing through it.p	jeroen 2008/08/17 20:21
i love this site.D	Albert 2008/08/18 00:54
i+love+this+site.t	jeroen 2008/08/18 19:37
Wonderful+pages%21+Keep+up+the+grat+work.g	judy 2008/08/21 18:28
Excellent site, added to favorites!!e	Willem 2008/08/24 19:59
Oh o ho! very nice site!g	judy 2008/08/25 11:26
This is very interesting site...a	Albert 2008/08/26 08:11
Please, do not delete the given message. Money obtained from spam will go to the help hungry to children ugand	john 2008/08/26 15:30
Oh o ho! very nice site!	Dan 2008/08/28 20:35
Just serfed in. Great site, guys!	Robert 2008/09/01 12:48
Cool guestbook, interesting information... Keep it UP. excellent site i really like your stuff.t	jeroen 2008/09/07 16:08
daite na pivo	Kathy 2008/09/07 18:13
Nice post. I\'ll return.g	Dan 2008/09/11 16:16
Very+good+web+site%2C+great+work+and+thank+you+for+your+service.s	Hannes 2008/09/16 10:15
These prayers help me to keep God in my life, especially with the many distractions I encounter.	Timmy 2008/09/16 13:48
Hi! Definitely nice and neat site you got there.g	jammarlibre 2008/09/19 14:25
I you all love!h	Robert 2008/09/20 16:40
made+it+.All+information+on+this+site+is+represented+for+users.+A+site+is+	Rosina 2008/09/26 10:24
Hi, everybodya	Albert 2008/09/26 21:32
This website is Great! I will recommend you to all my friends. I found so much useful things here. Thank you.s	Kathy 2008/09/28 09:54
Thanks%2Bso%2Bvery%2Bmuch%2Bfor%2Btaking%2Byour%2Btime%2Bto%2Bcreate%2Bthis%2Bvery%2Buseful%2Band%2Binformative%2Bsite.%2BI%2Bhave%2Blearned%2Ba%2Blot%2Bfrom%2Byour%2Bsite.%2BThanks%2521%2521E	judy 2008/10/03 04:59
Excellent+site%2C+added+to+favorites%21%21%0A	lhuv 2008/10/11 05:29
Dear+web%2Dmaster+%21+I+looked+your+site+and+I+want+to+say+that+yor+very+well	Albert 2008/10/16 18:50
I enjoyed your page. Keep up the good work! Feel free to visit my page. It\'s cool too.	lhuv 2008/10/19 15:31
s prazdnikov vast	jeroen 2008/10/23 13:11
Hi, all. Nice site...I really like your site ! Good job man.h	Ron 2008/10/23 13:13
Thank for making this valuable information available to the public.	Hannes 2008/10/24 22:56
Nice site! Big thanx to webmaster!u	Timmy 2008/10/29 03:38
made it .All information on this site is represented for users. A site is	Dan 2008/11/01 09:37
Hello admin, nice site ! Good content, eautiful design, thank !	Siber 2008/11/01 22:08
Da nu Nahn	Timmy 2008/11/02 08:24
I praise God for answering my prayers. God, you are so wonderful, majestic. Jesus Christ, I adore Your Sacred Heart.g	Albert 2008/11/03 04:48
hochu vodki!i	Robert 2008/11/03 09:52
Hello stupid pendosegi.	Dan 2008/11/03 18:01
I\'l be back... :)e	Hannes 2008/11/05 20:03
Thank for making this valuable information available to the public.	Siber 2008/11/06 03:12
It\'s a great and valuable site!k	judy 2008/11/06 21:21
Da nu Nahd	john 2008/11/08 00:24
I\'l be back... :)e	jeroen 2008/11/12 17:38
Very good web site, great work and thank you for your service.	Rosina 2008/11/15 04:19
hochu vodki!s	Willem 2008/11/15 07:03
Cool!.. Nice work...r	jammarlibre 2008/11/17 13:28
It\'s a great and valuable site!n	jammarlibre 2008/11/17 20:27
Found your site in google, and it has a lot of usefull information. Thanx.=	Timmy 2008/11/17 23:39
?ⅱ濵 <a href= http://zheleznyakaukek.land.ru/ >?ⅱ濵</a>	Ron 2008/11/18 16:10
?ⅱ濵 <a href= http://zheleznyakaukek.land.ru/ >?ⅱ濵</a> o	Dan 2008/11/18 16:11

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