青森県の保健医療福祉職のニーズを踏まえた研修の検討(キャリア開発センターニーズ調査結果報告III)

〔目的〕　青森県内の保健医療福祉関係職の生涯教育及びキャリア開発に資するため，青森県立保健大学キャリア開発センターで開催した研修等について，過去5 年間（2017－2021年）の受講状況，研修ニーズについて整理し，今後の専門職キャリア開発科のよりよい研修事業等見直しの検討を行うことを目的とする。〔方法〕　1 ．調査期間：2021年2 月3 日～26日， 2 ．調査対象者：青森県内の保健医療福祉施設で，本学の事業に参加したことのある1,399施設， 3 ．調査方法：郵送による自記式無記名アンケート調査， 4 ．調査内容：独自に作成したキャリア開発の課題に関する質問紙， 5 ．分析方法：量的データについては単純集計及び所属施設の属性によるクロス集計，質的データについては自由記載内容を類似する内容ごとにまとめ，整理した。〔結果〕　調査の結果，回答施設は371（26.5％）であった。本学センターで開催する研修等の受講状況は， 5割以上が研修等を受講していた。研修等の情報の入手経路は，大学からの開催案内通知がもっとも多く，開催側からの情報発信の重要性が高い。職員に受講させたい研修として自由記載された内容は，具体的な援助技術などの研修が多く挙げられ，対象者の段階別の研修ニーズもあった。〔結論〕　研修等の受講ニーズは高く，今後も現場に求められる研修企画を検討していく必要がある。［Objective］The Career Development Center of Aomori University of Health and Welfare has training programs for the continuing education and career development of health and social welfare workers in the Aomori Prefecture. The objective is to improve the training program based on training attendance and needs assessment over the past 5 years （2017-2021）.［Methods］1. Survey period: February 2021; 2. Survey subjects: A total of 1,399 facilities from the Aomori Prefecture, which have experience of participating in our university’s projects; 3. Survey method: Self-administered anonymous questionnaire by mail; 4. Survey contents: Questionnaire on career development issues; 5. Analysis method: Simple tabulation of quantitative data and qualitative inductive method for qualitative data.［Results］Out of the participating facilities, 371（26.5％） responded to the survey. It was observed that more than 50％ of the respondents had attended trainings held by the center. The most common method of obtaining information about the training was from the center, and the most important mode was the organizer. The types of training that respondents would like their staff to attend were most often related to specific assistive technology, indicating that training for different levels of the target population is also needed.［Conclusions］Demand for the Center’s training programs is high. We need to continue planning more training programs for health and social welfare workers

Prognostic significance of the HFA‐PEFF score in patients with heart failure with preserved ejection fraction

Abstract Aims The HFA‐PEFF score is a part of the stepwise diagnostic algorithm of heart failure with preserved ejection fraction (HFpEF). We aimed to evaluate the prognostic significance of the HFA‐PEFF score on the clinical outcomes in patients with HFpEF. Methods and results The Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with preserved Ejection Fraction (PURSUIT‐HFpEF) study is a prospective, multicentre, observational study in which collaborating hospitals in Osaka record clinical, echocardiographic, and outcome data of patients with acute decompensated heart failure with preserved left ventricular ejection fraction (≥50%) [UMIN‐CTR ID: UMIN000021831]. Acute decompensated heart failure was diagnosed on the basis of the following criteria: (i) clinical symptoms and signs according to the Framingham Heart Study criteria; and (ii) serum N‐terminal pro‐B‐type natriuretic peptide level of ≥400 pg/mL or brain natriuretic peptide level of ≥100 pg/mL. The HFA‐PEFF score has functional, morphological, and biomarker domains. We evaluated the prognostic significance of the HFA‐PEFF score (calculated based on the data at hospital discharge) on post‐discharge clinical outcomes in this cohort. The primary endpoint of the present study was a composite of all‐cause death and heart failure readmission. Between June 2016 and December 2019, 871 patients were enrolled from 26 hospitals (mean follow‐up duration 399 ± 349 days). A total of 804 patients were finally analysed after excluding patients with scores of 0 (N = 5) and 1 (N = 15) from 824 patients with available HFA‐PEFF score based on the echocardiographic and laboratory data at discharge. According to the laboratory and echocardiographic data at the time of discharge, 487 patients (59.1%) were diagnosed as HFpEF (HFA‐PEFF score ≥ 5) while 317 patients (38.5%) had intermediate score. Kaplan–Meier analysis divided by the HFA‐PEFF score [low, score 2–5 (N = 494) vs. high, score 6 (N = 310)] indicated that the HFA‐PEFF score successfully stratified the patients for the primary endpoint (log‐rank test P < 0.001). Cox proportional hazard model showed that the HFA‐PEFF score was significantly associated with the primary endpoint (high score with reference to low score, adjusted hazard ratio 1.446, 95% confidence interval [1.099–1.902], P = 0.008). Conclusion The HFA‐PEFF score at discharge was significantly associated with the post‐discharge clinical outcomes in acute decompensated heart failure patients with preserved ejection fraction. This study suggested clinical usefulness of the HFA‐PEFF score not only as a diagnostic tool but also a practical prognostic tool