大日方　裕紀 (オオヒナタ　ヒロノリ)

保健科学研究院　保健科学部門　基盤看護学分野助教
Last Updated :2024/12/10

■研究者基本情報

学位

  • 修士（看護学）, 慶應大学, 2020年03月
  • 博士（看護学）, 東北大学, 2023年03月

Researchmap個人ページ

ホームページURL

ORCID ID

J-Global ID

研究分野

  • ライフサイエンス, 臨床看護学, フレイル, 緩和ケア, Phase of Illness

■経歴

学歴

  • 2020年04月 - 2023年03月, 東北大学, 大学院医学系研究科保健学専攻, 緩和ケア看護学分野
  • 2018年04月 - 2020年03月, 慶應義塾大学, 健康マネジメント研究科, 修士（看護学）, 日本国

■研究活動情報

論文

  • Association between dynapenia and multimorbidity: A systematic review
    Hironori Ohinata, Shan Yun, Naoko Miyajima, Michiko Yuki
    Annals of Geriatric Medicine and Research, 2024年04月24日
    研究論文（学術雑誌）
  • Phase of Illness at the time of being referred to the hospital palliative care team and changes after the intervention
    Hironori Ohinata, Hideyuki Hirayama, Maho Aoyama, Eriko Satomi, Yoshiyuki Kizawa, Mayuko Miyazaki, Keita Tagami, Ryuichi Sekine, Kozue Suzuki, Nobuyuki Yotani, Koji Sugano, Hirofumi Abo, Akihiro Sakashita, Kazuki Sato, Sari Nakagawa, Yoko Nakazawa, Jun Hamano, Mitsunori Miyashita
    Progress in Palliative Care, 2024年03月03日
    研究論文（学術雑誌）
  • 看護実習前知識確認試験問題の正答率と識別指数を用いた問題の適切性の検討 Computer Based Testing導入に向けた取り組み　　　　　　　　　　　　　　　
    稲岡 希実子, 大日方 裕紀, 古山 陽一, 武田 彩子, 中川 陽子, 二瓶 映美, 菱谷 純子, 安田 真美, 岡田 佳詠
    国際医療福祉大学学会誌, 29, 1, 146, 155, 国際医療福祉大学学会, 2024年03月
    日本語, 目的:A大学看護学部において,2019年度に対面で実施した実習前知識確認試験結果の正答率と識別指数の中から基準値を逸脱する問題を抽出後に修正し,2020年度にその修正した問題を含めたオンライン試験結果の正答率と識別指数を分析して問題の適切性を検討することを主たる目的とした.方法:研究参加に同意が得られた学生の試験結果を分析対象とした.識別指数と正答率の計算は,株式会社教育ソフトウェアの国家試験まるごと合格対策自動採点・成績管理ソフトウェアカスタマイズ版for Windowsを用いて行った.さらに,年度ごとの識別指数と正答率の平均点と標準偏差などの基本統計量を求めて分析を行った.結果:2019年度から2021年度までの3年間で2年生202名,3年生291名から研究参加の同意を得た.2019年度の問題を修正した結果,2020年度では2年生および3年生の試験の難易度と問題の適切性は改善が認められた.結論:2019年度と2020年度の試験結果との比較によって,問題の質の改善が一定程度図られていることが示された.今後は,正答率と識別指数に加えて,問題間の内的整合性の観点から推定される信頼性係数(α係数)を測定することが必要である.(著者抄録)
  • Polypharmacy, potentially inappropriate medication, and dysphagia in older inpatients; A multi-center cohort study.
    Shintaro Togashi, Hironori Ohinata, Taiji Noguchi, Hidetaka Wakabayashi, Mariko Nakamichi, Akio Shimizu, Shinta Nishioka, Ryo Momosaki
    Annals of geriatric medicine and research, 2024年01月17日, ［国際誌］
    英語, 研究論文（学術雑誌）, BACKGROUND: Although the relationship between medication status, symptomatology, and outcomes has been evaluated, data on the prevalence of polypharmacy and potentially inappropriate medications (PIMs) and the association of polypharmacy and PIMs with swallowing function during follow-up are limited among hospitalized patients aged ≥65 years with dysphagia. METHODS: In this 19-center cohort study, we registered 467 inpatients aged ≥65 years and evaluated those with the Food Intake LEVEL Scale (FILS) scores ≤8 between November 2019 and March 2021. Polypharmacy was defined as prescribing ≥5 medications and PIMs were identified based on the 2023 Updated Beers criteria®. We applied a generalized linear regression model to examine the association of polypharmacy and PIMs with FILS score at discharge. RESULTS: We analyzed 399 participants (median age, 83.0 years; males, 49.8%). The median follow-up was 51.0 days interquartile range, 22.0-84.0 days]. Polypharmacy and PIMs were present in 67.7% of and 56.1% of patients, respectively. After adjusting for covariates, neither polypharmacy (β = 0.05 [95% confidence interval (CI), -0.04-0.13], p = 0.30) nor non-steroidal anti-inflammatory medications (β = 0.09 [95%CI, -0.02-0.19], p = 0.10) were significantly associated with FILS score at discharge. CONCLUSIONS: The results of this study indicated a high proportion of polypharmacy and PIMs among inpatients aged ≥65 years with dysphagia. Although these prescribed conditions were not significantly associated with swallowing function at discharge, our findings suggest the importance of regularly reviewing medications to ensure the appropriateness of prescriptions when managing older inpatients.
  • 緩和ケアにおけるPhase of Illness(Palliative Care Phase)に関する文献レビュー
    大日方裕紀, 大日方裕紀, 青山真帆, 宮下光令
    日本がん看護学会誌(Web), 37, 2023年
  • Symptoms, performance status and phase of illness in advanced cancer: multicentre cross-sectional study of palliative care unit admissions.
    Hironori Ohinata, Maho Aoyama, Yusuke Hiratsuka, Masanori Mori, Ayako Kikuchi, Hiroaki Tsukuura, Yosuke Matsuda, Kozue Suzuki, Hiroyuki Kohara, Isseki Maeda, Tatsuya Morita, Mitsunori Miyashita
    BMJ supportive & palliative care, 2022年10月27日, ［国際誌］
    英語, 研究論文（学術雑誌）, OBJECTIVES: To clarify the relationship between Phase of Illness at the time of admission to palliative care units and symptoms of patients with advanced cancer. METHODS: This study was a secondary analysis of the East Asian collaborative cross-cultural Study to Elucidate the Dying process. Palliative physicians recorded data, including Phase of Illness, physical function and the Integrated Palliative care Outcome Scale. We used multinomial logistic regression to analyse ORs for factors associated with Phase of Illness. Twenty-three palliative care units in Japan participated from January 2017 to September 2018. RESULTS: In total, 1894 patients were analysed-50.9% were male, mean age was 72.4 (SD±12.3) years, and Phase of Illness at the time of admission to the palliative care unit comprised 177 (8.9%) stable, 579 (29.2%) unstable, 921 (46.4%) deteriorating and 217 (10.9%) terminal phases. Symptoms were most distressing in the terminal phase for all items, followed by deteriorating, unstable and stable (p<0.001). The stable phase had lower association with shortness of breath (OR 0.73, 95% CI 0.57 to 0.94) and felt at peace (OR 0.73, 95% CI 0.56 to 0.90) than the unstable phase. In the deteriorating phase, weakness or lack of energy (OR 1.20, 95% CI 1.02 to 1.40) were higher, while drowsiness (OR 0.82, 95% CI 0.71 to 0.97) and felt at peace (OR 0.81, 95% CI 0.71 to 0.94) were significantly lower. CONCLUSION: Our study is reflective of the situation in palliative care units in Japan. Future studies should consider the differences in patients' medical conditions and routinely investigate patients' Phase of Illness and symptoms. TRIAL REGISTRARION NUMBER: UMIN000025457.
  • Sensitivity and Specificity of Body Mass Index for Sarcopenic Dysphagia Diagnosis among Patients with Dysphagia: A Multi-Center Cross-Sectional Study.
    Shintaro Togashi, Hidetaka Wakabayashi, Hironori Ohinata, Shinta Nishioka, Yoji Kokura, Ryo Momosaki
    Nutrients, 14, 21, 2022年10月26日, ［国際誌］
    英語, 研究論文（学術雑誌）, The accuracy of body mass index (BMI) for sarcopenic dysphagia diagnosis, which remains unknown, was evaluated in this study among patients with dysphagia. We conducted a 19-site cross-sectional study. We registered 467 dysphagic patients aged ≥ 20 years. Sarcopenic dysphagia was assessed using a reliable and validated diagnostic algorithm. BMI was assessed using the area under the curve (AUC) in the receiver operating characteristic analysis to determine diagnostic accuracy for sarcopenic dysphagia. The study included 460 patients (median age, 83.0 years (76.0-88.0); men, 49.8%). The median BMI was 19.9 (17.3-22.6) kg/m2. Two hundred eighty-four (61.7%) patients had sarcopenic dysphagia. The AUC for sarcopenic dysphagia was 0.60-0.62 in the overall patients, male, female, and patients aged ≥ 65 years The BMI cut-off value for sarcopenic dysphagia diagnosis was 20.1 kg/m2 in the overall patients (sensitivity, 58.1%; specificity, 60.2%) and patients aged ≥ 65 years (sensitivity, 59.8%; specificity, 61.8%). Conclusion: Although the AUC, sensitivity and specificity of BMI for sarcopenic dysphagia diagnosis was approximately 0.6, BMI < 20.0 kg/m2 might be a predictor for sarcopenic dysphagia. In clinical settings, if patients with dysphagia have a BMI < 20.0 kg/m2, then sarcopenic dysphagia should be suspected as early as possible after admission.
  • Complexity in the context of palliative care: a systematic review.
    Hironori Ohinata, Maho Aoyama, Mitsunori Miyashita
    Annals of palliative medicine, 2022年09月30日, ［国際誌］
    英語, 研究論文（学術雑誌）, BACKGROUND: People receiving palliative care have complex, wide-ranging, and changing needs, not just physical distress, but also psychosocial, practical, and spiritual. Influences on complexity in palliative care are different among healthcare providers and may depend on diverse aspects of the patient's condition, time, and environment. Therefore, this study aimed to integrate and describe the perspective of complexity in palliative care. METHODS: We used an integrative review, which is a method of compiling, summarizing, and analyzing existing insights from previous studies. We conducted an electronic literature search in MEDLINE (Ovid), PsycINFO (EBSCOhost), Web of Science Core Collection, and CINAHL (EBSCOhost), examining literature from May 1972 to September 2020 and updated in December 2020. Subsequently, synthesis without meta-analysis of the findings was completed. RESULTS: We identified 32 peer-reviewed articles published in English. The included literature mainly originated in Europe and the United States. The research methods included quantitative studies (n=13), qualitative studies (n=12), case studies (n=3), and reviews (n=4). We identified 29 that influenced complexity in palliative care, 25 perceptions of the patient, including background and physical, psychological, social, and spiritual; two perceptions in the healthcare setting; and two perceptions in the socio-cultural setting. Above all, the perceptions of complexity in palliative care included younger age, prognosis, and spirituality. In addition, we added the identified perceptions of complexity with references to the complexity model in palliative care. DISCUSSION: Although this review was limited in its search strategy and some data sources may have been overlooked, it still provided perceptions that influenced complexity in palliative care. These complex influencing perceptions are necessary for patients to receive appropriate palliative care at the right time and for health care providers to conduct a multi-disciplinary team approach. Furthermore, longitudinal prospective data are needed to examine the changes and relationships among complexity over time.
  • 抗がん剤変更時における高齢消化器がん患者のフレイルとQOLの関連
    大日方 裕紀, 矢ヶ崎 香, 浜本 康夫, 平田 賢郎, 須河 恭敬, 小松 浩子
    日本看護科学会誌, 42, 254, 262, 公益社団法人 日本看護科学学会, 2022年
    日本語, 目的：抗がん剤変更時における高齢消化器がん患者のフレイルの実態とQOL の関連を明らかにすることである．

    方法：抗がん剤変更時の65歳以上の消化器がん患者を対象に横断的観察研究を行った．フレイル及びQOLの測定は，G8とEQ-5D-5Lを用いた．

    結果：51名が研究参加を同意し，データ収集と分析を行った．フレイルに該当する高齢消化器がん患者は，40名（78.4%）であった．フレイルには，BMI（p < .001），下腿三頭筋周囲径（p = .023）が関連していた．また，フレイル群は非フレイル群に比べQOLが低かった（p = .04）．

    結論：抗がん剤変更時における高齢消化器がんのフレイル患者の特徴とフレイルサイクルへ陥りやすい集団が明らかになった．治療変更時における高齢がん患者に対するフレイルの評価は，QOLを考慮した個別的な支援の重要な要素になり得る．

その他活動・業績

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