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		<h1 class="catchCopy">根拠に基づいた心臓リハビリテーションの臨床実践！</h1>
		

		<h1 class="title">実践EBM 心臓リハビリテーション（電子版のみ）<span class="version"></span></h1>
		<h2 class="subTitle">エビデンス診療ギャップとその対応</h2>

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					編集：松尾善美（武庫川女子大学教授）
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					<span class="transparent">編集</span>　上嶋健治（京都大学教授）
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				<ul class="property"><li class="disc">B5判・344頁・2色刷</li><li class="disc">ISBN&nbsp;978-4-8306-4538-9</li><li class="disc">2016年5月14日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">心リハは多くの疫学研究や臨床試験からエビデンスが構築され，論文や成書で公知のものとなるだけでなく，近年では心血管疾患患者への標準治療の一つと認識され，診療ガイドラインも改訂が重ねられている．一方，臨床現場では，様々な理由・事情によりエビデンスに合致した診療が行われない問題，いわゆる「エビデンス診療ギャップ」と呼ばれる現象が生じている．本書では，この溝の橋渡しとなるべく，心リハ現場に従事されたエキスパートの手により具体的なノウハウやちょっとしたコツなどが幅広く解説されている．</section><section class="preface">序　文<br><br>　心臓リハビリテーションは，近年我が国で急速に普及し，循環器内科による治療や心臓血管外科手術とともに標準的治療として認められ，継続して発展している．すなわち，心血管疾患患者に対する治療手段の一つとしての心臓リハビリテーションは，大学病院から市中のクリニックに至るまで臨床実践が行われるようになってきたが，さらなる普及が課題である．その最終目標は，患者の健康関連QOL向上と再発予防であり，その中核は運動療法である．発展の背景には，世界におけるこれまでの臨床研究によるエビデンスの構築とそれに基づく診療ガイドライン作成による介入の標準化が図られ，心血管疾患患者を診療する医療職における共通の理解が進んだことによると考えられる．しかし，一方で診療ガイドラインを運用しても患者個々の抱える問題は多様であり，プログラムの個別化を適切に作成することが困難な場合も経験されるであろう．<br>　プログラムを適切に作成し，かつ実施するには，心臓リハビリテーションに関係するさまざまな知識の習得とそれらに対する十分な理解および豊富な臨床経験に基づいた臨床意思決定Clinical Decision Makingが必要である．この能力は，リーダーシップを発揮する医師だけが有するのではなく，心臓リハビリテーションに関わるすべてのスタッフに不可欠であることはいうまでもない．問題解決能力が向上したスタッフで構成されるチームでは，質の高い心臓リハビリテーションが実践されることは明らかである．<br>　「実践EBM 心臓リハビリテーション」のタイトルを冠した本書は，根拠に基づいた実践的心臓リハビリテーションを医師，理学療法士，看護師，健康運動指導士の先生方に執筆いただいた．第I章ではエビデンスをさらにどのように活用するのか，第II章では臨床実践における諸問題へどのように対応すればよいのか，第III章では心臓リハビリテーション難渋症例をどのように攻略するのかについて具体的に解説されており，読者の実践力が向上し，エビデンスギャップを克服することができる一助となることを編者の一人として信じてやまない．<br><br>平成28年4月<br>武庫川女子大学　松尾善美</section><section class="indexes">第I章　エビデンスのさらなる有効活用<br> 1　心臓リハビリテーションのエビデンスとその活用法<br> 2　運動療法は回復・治療・予防の三冠王 ─なぜ先進的治療法を実施しないのか？─<br> 3　再発予防に対する各種介入の原理と効果<br> 4　心臓リハビリテーションにおけるエビデンスとギャップ<br> 5　診療の質が重要 ─診療の質を担保するには？─<br> 6　エビデンスから普及のための広報へ<br>第II章 	臨床実践における諸問題への対応<br> 1　離床困難な患者への対応<br> 2　リスク層別化で安全管理は十分か？<br> 3　トレーニング法の適応 ─運動様式，運動強度，運動頻度・時間─<br> 4　筋をどのようにトレーニングすればよいのか？ ─レジスタンストレーニングの実際とその効果─<br> 5　運動療法中のモニタリングデータ解読法<br> 6　デバイス装着患者の運動療法<br> 7　脳卒中合併例への対応<br> 8　COPD合併心疾患に対する心臓リハビリテーションの注意点<br> 9　運動器障害を合併する患者のトレーニング法<br>10　チーム医療における多職種の役割発揮<br>11　アドヒアランスを高める方法<br>12　虚弱高齢者の術前心臓リハビリテーション<br>第III章　心臓リハビリテーション難渋症例の攻略法<br> 1　急性冠症候群の壮年患者 ─仕事が忙しく，心リハの継続が難しい症例─<br> 2　入退院を繰り返す心不全患者 ─セルフケアマネジメントが難しい症例─<br> 3　病識が乏しい末梢動脈疾患患者<br> 4　難治性不整脈を有する患者<br> 5　血圧管理に難渋する大動脈解離術後患者 ─血圧管理のために運動強度の調整が必要であった症例─<br> 6　低心機能患者 ─急性心不全治療後，運動療法開始に難渋した症例─<br> 7　合併症の多い高齢患者<br> 8　血液透析中の心疾患患者 ─いつ，どのように介入するか─<br> 9　維持期の外来患者 ─長期フォローアップを行った症例─<br>10　介護老人保健施設利用者<br>11　抑うつを合併する患者<br>索　引</section></article>
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