Difficulties in Home-Visit Rehabilitation for Elderly Foreign Residents: Interviews with Physical Therapists

Introduction  With the increase in the number of foreign residents in Japan and the aging of the population, it is expected that there will be more opportunities to provide home-visit rehabilitation to foreign residents are increasing. The purpose of this study was to clarify the difficulties that p...

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Published inKokusai Hoken Iryo (Journal of International Health) Vol. 38; no. 2; pp. 53 - 64
Main Authors Uesugi, Yuko, Saito, Midori
Format Journal Article
LanguageJapanese
Published JAPAN ASSOCIATION FOR INTERNATIONAL HEALTH 2023
日本国際保健医療学会
Subjects
Online AccessGet full text
ISSN0917-6543
2436-7559
DOI10.11197/jaih.38.53

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Abstract Introduction  With the increase in the number of foreign residents in Japan and the aging of the population, it is expected that there will be more opportunities to provide home-visit rehabilitation to foreign residents are increasing. The purpose of this study was to clarify the difficulties that physical therapists (PTs) face when providing home-visit rehabilitation to elderly foreign residents.Methods  A qualitative descriptive study using semi-structured interviews was conducted with PTs who have experience in providing home-visit rehabilitation to elderly foreign residents.Results  The subjects were 11 PTs (9 males and 2 females), with an average age of 39.3 years and the average years of PT experience 13.7 years. The analysis revealed that the difficulties faced by PTs included 10 categories; [Differences in rehabilitation concepts with foreign elderly], [Difficulty in goal setting], [Lack of multilingual support and access to information on support], [Burden of dealing with non-rehabilitation work], [Building trust through daily communication], [Detailed communication in different languages], [Dealing with cultural differences], [Differences in religion and sensitivity to this topic], [Dealing with elderly foreign residents who are hesitant to contact with Japanese people] and [Anxiety about conducting home-visit rehabilitation due to PT’s preconceived notions about foreigners].Conclusions  Differences in the rehabilitation concepts between Japan and some foreign countries were found as a difficulty faced by PTs. Difficulties due to language differences were significant, and institutional difficulties also existed, such as lack of multilingual support and access to information on support. In addition, by visiting private homes and providing individualized services, PTs sometimes had to deal with problems faced by elderly foreign people other than rehabilitation work. These were considered to make it difficult to implement goal-oriented rehabilitation.
AbstractList Introduction  With the increase in the number of foreign residents in Japan and the aging of the population, it is expected that there will be more opportunities to provide home-visit rehabilitation to foreign residents are increasing. The purpose of this study was to clarify the difficulties that physical therapists (PTs) face when providing home-visit rehabilitation to elderly foreign residents.Methods  A qualitative descriptive study using semi-structured interviews was conducted with PTs who have experience in providing home-visit rehabilitation to elderly foreign residents.Results  The subjects were 11 PTs (9 males and 2 females), with an average age of 39.3 years and the average years of PT experience 13.7 years. The analysis revealed that the difficulties faced by PTs included 10 categories; [Differences in rehabilitation concepts with foreign elderly], [Difficulty in goal setting], [Lack of multilingual support and access to information on support], [Burden of dealing with non-rehabilitation work], [Building trust through daily communication], [Detailed communication in different languages], [Dealing with cultural differences], [Differences in religion and sensitivity to this topic], [Dealing with elderly foreign residents who are hesitant to contact with Japanese people] and [Anxiety about conducting home-visit rehabilitation due to PT’s preconceived notions about foreigners].Conclusions  Differences in the rehabilitation concepts between Japan and some foreign countries were found as a difficulty faced by PTs. Difficulties due to language differences were significant, and institutional difficulties also existed, such as lack of multilingual support and access to information on support. In addition, by visiting private homes and providing individualized services, PTs sometimes had to deal with problems faced by elderly foreign people other than rehabilitation work. These were considered to make it difficult to implement goal-oriented rehabilitation. 目的  在留外国人の増加、高齢化に伴い、今後訪問リハビリテーションで外国人対応を行う機会が増えることが予想される。本研究は、理学療法士(以下PT)が在留外国人高齢者に対して訪問リハビリテーション(以下訪問リハビリ)を実施する際に直面する困難を明らかにすることを目的とした。方法  在留外国人高齢者への訪問リハビリを経験したPTを対象に、半構造化面接法を用いた質的記述的研究を実施した。結果  研究対象者11名(男性9名、女性2名)、平均年齢39.3歳、平均PT経験年数13.7年であった。対応した在留外国人高齢者の出身国は、中国、韓国、台湾、インド、ベトナム、タイ、オーストラリア、アメリカ、イギリス、ドイツであった。分析の結果、PTが直面する困難として、10のカテゴリー【外国人高齢者とのリハビリ概念の違い】【ゴール設定の難しさ】【多言語支援の不足や支援に関する情報の入手】【リハビリ業務以外の対応の負担】【日常的なコミュニケーションによる信頼関係の構築】【言語の違いによる詳細な意思疎通】【文化の違いへの対応】【宗教に対する関わりにくさ】【日本人と接することに抵抗感をもつ外国人高齢者への対応】【PTがもつ外国人への先入観による訪問リハビリ実施の不安】が抽出された。結論  PTが直面する困難として、日本と一部外国人高齢者との間に「リハビリ概念」の違いが見出された。言語の壁による困難も大きく、多言語支援の不足や支援に関する情報を入手しにくい制度上の困難も存在した。また、個人宅へ訪問し個別対応を行う中で、リハビリ業務以外の外国人高齢者が抱える問題に対応しなければならないことがあった。これらは「ゴールを見据えたリハビリの実施」を難しくしていると考えられた。
Introduction  With the increase in the number of foreign residents in Japan and the aging of the population, it is expected that there will be more opportunities to provide home-visit rehabilitation to foreign residents are increasing. The purpose of this study was to clarify the difficulties that physical therapists (PTs) face when providing home-visit rehabilitation to elderly foreign residents.Methods  A qualitative descriptive study using semi-structured interviews was conducted with PTs who have experience in providing home-visit rehabilitation to elderly foreign residents.Results  The subjects were 11 PTs (9 males and 2 females), with an average age of 39.3 years and the average years of PT experience 13.7 years. The analysis revealed that the difficulties faced by PTs included 10 categories; [Differences in rehabilitation concepts with foreign elderly], [Difficulty in goal setting], [Lack of multilingual support and access to information on support], [Burden of dealing with non-rehabilitation work], [Building trust through daily communication], [Detailed communication in different languages], [Dealing with cultural differences], [Differences in religion and sensitivity to this topic], [Dealing with elderly foreign residents who are hesitant to contact with Japanese people] and [Anxiety about conducting home-visit rehabilitation due to PT’s preconceived notions about foreigners].Conclusions  Differences in the rehabilitation concepts between Japan and some foreign countries were found as a difficulty faced by PTs. Difficulties due to language differences were significant, and institutional difficulties also existed, such as lack of multilingual support and access to information on support. In addition, by visiting private homes and providing individualized services, PTs sometimes had to deal with problems faced by elderly foreign people other than rehabilitation work. These were considered to make it difficult to implement goal-oriented rehabilitation.
Author Uesugi, Yuko
Saito, Midori
Author_FL Uesugi Yuko
齊藤 翠
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  organization: Department of Nursing, Kinjo Gakuin University
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  organization: Graduate School of Health Sciences, Kobe University
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国際保健医療
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19) 厚生労働省.令和3年社会医療診療行為別統計の概況 医科診療[Web page].厚生労働省Web site. https://www.mhlw.go.jp/toukei/saikin/hw/sinryo/tyosa21/dl/ika.pdf. Accessed April 11, 2023.
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References_xml – reference: 20) 出入国在留管理庁,文化庁.在留支援のためのやさしい日本語ガイドライン.文化庁Web site. Available at https://www.bunka.go.jp/seisaku/kokugo_nihongo/kyoiku/pdf/92484001_01.pdf Accessed October 21, 2022.
– reference: 1) 出入国在留管理庁.在留外国人統計(旧登録外国人統計)統計表[Web page].出入国在留管理庁Web site. Available at https://www.moj.go.jp/isa/policies/statistics/toukei_ichiran_touroku.html. Accessed October 05, 2022.
– reference: 3) 瀧尻明子,植本雅治.在日ベトナム人高齢者の生活と健康状態に関する研究.大阪市立大学看護学雑誌 2015; 11: 11-20.
– reference: 15) 湯瑛,若山佐一,八板麻衣子.中国(中華人民共和国)における脳卒中リハビリテーションの現状一理学療法の実際について一.理学療法学2007; 34(2): 643.
– reference: 12) 公益社団法人日本理学療法士協会.理学療法士とは[Web page].日本理学療法士協会 Web site. Available at https://www.japanpt.or.jp/about_pt/therapist/. Accessed October 21, 2022.
– reference: 2) 呉珠響,斉藤恵美子.無年金または低年金の定住コリアン高齢者が経験した健康に関連する生活上の困難さ.日本看護科学会誌 2017; 37: 105-113.
– reference: 7) 金川仁子,金子さゆり.在宅系リハビリテーションが利用者のADLとQOLに及ぼす影響に関する実証研究.日本医療・病院管理学会誌 2014; 51(1): 9-20.
– reference: 13) 吉良健司.「訪問リハビリテーション」の定義.吉良健司.はじめての訪問リハビリテーション.東京:株式会社医学書院.2007; 12.
– reference: 18) 若林宣之,中井友子,宇田薫,根本玲奈,岩崎義仁,橋本幸典.訪問リハビリテーションにおけるトラブル報告 訪問におけるトラブルと原因.理学療法京都 2003; 32: 106-107
– reference: 14) 丸山仁司,藤沢しげ子,霍明.【理学療法士の国際協力】中国における理学療法学教育への国際協力.理学療法ジャーナル 2004; 38(12): 1013-1019.
– reference: 21) 中川恵実子.当院の外国籍の方へのリハビリテーション~ペルー人の失語症者への言語評価および訓練の工夫、医療通訳との関わりについて~.公立甲賀病院紀要 2016; 19: 13-18.
– reference: 19) 厚生労働省.令和3年社会医療診療行為別統計の概況 医科診療[Web page].厚生労働省Web site. https://www.mhlw.go.jp/toukei/saikin/hw/sinryo/tyosa21/dl/ika.pdf. Accessed April 11, 2023.
– reference: 24) 春本千保子,森憲一.QOL向上を目指した脳卒中片麻痺者の訪問リハビリテーション~COPMにより目標と治療戦略を決定しSF36v2TMで効果判定を行った一症例~.大阪府理学療法士会誌 2014; 42: 38-42.
– reference: 4) 厚生労働省.療養病床の将来像について.[Web page].厚生労働省Web site. Available at https://www.mhlw.go.jp/shingi/2006/01/dl/s0126-9f.pdf. Accessed November 29, 2022.
– reference: 10) 新村出.広辞苑 第七版.東京:岩波書店,2018.
– reference: 23) 高橋美穂,三谷有司,高橋佐季子,奥山昌弘,橋本茂樹,横串算敏.回復期病棟から療養病床に転棟した症例の経過とPTの役割.北海道リハビリテーション学会雑誌 2010; 35: 55-57.
– reference: 6) 伊藤隆夫.訪問医療における理学療法士の役割.理学療法学 2001; 28(8): 399-402.
– reference: 9) 佐藤郁哉.質的データ分析法 原理・方法・実践.東京: 新曜社,2008.
– reference: 11) 厚生労働省.厚生白書(昭和56年版)[Web page].厚生労働省Web site. https://www.mhlw.go.jp/toukei_hakusho/hakusho/kousei/1981/. Accessed November 03, 2022.
– reference: 22) 本間功洋,山田奈緒子,原田智美,野田美保子.医療系訪問サービスにおける対人・信頼関係に関するリスク・マネジメントについて~アンケートによる利用者の意識調査から~.青森県作業療法研究 2001; 19(1): 57-61.
– reference: 5) 厚生労働省.地域包括ケアシステム[Web page].厚生労働省Web site. Available at https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/hukushi_kaigo/kaigo_koureisha/chiiki-houkatsu/. Accessed October 05, 2022.
– reference: 16) 陳金娣,新田静江.中国農村部の高齢者における在宅ケアサービスニーズと関連要因.日本公衆衛生雑誌 2011; 58(3): 176-182.
– reference: 25) 吉良健司.訪問リハビリテーションの実際と今後の展望.理学療法学 2008; 35(4): 174-177.
– reference: 27) 公益財団法人日本理学療法士協会.理学療法学教育モデル・コア・カリキュラム.東京:日本理学療法士協会; 2019.
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Snippet Introduction  With the increase in the number of foreign residents in Japan and the aging of the population, it is expected that there will be more...
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jstage
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StartPage 53
SubjectTerms Aged
Emigrants and Immigrants
Home Care Services
Physical Therapists
Rehabilitation
リハビリテーション
在宅医療
在留外国人
理学療法士
高齢者
Title Difficulties in Home-Visit Rehabilitation for Elderly Foreign Residents: Interviews with Physical Therapists
URI https://www.jstage.jst.go.jp/article/jaih/38/2/38_53/_article/-char/en
https://cir.nii.ac.jp/crid/1390296530911824768
Volume 38
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ispartofPNX Kokusai Hoken Iryo (Journal of International Health), 2023, Vol.38(2), pp.53-64
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