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Aspects of Nursing Support for Decision-making about Consent for Surgery in
Elderly Patients with Dementia: A Text Mining Analysis

2
1
3
S. Matsui, Y. Sakurai, M. Yamamoto, and Y. Kuwahara 3
1 Faculty of Medicine, School of Nursing, Kagawa University, Osaka-Shin-Ai Gakuin University, Japan,
2
Faculty of Nursing, Osaka-Shin-Ai Gakuin University, Japan, and 3Faculty of Medicine, School of
Nursing, Kagawa University, Japan

Background: When elderly patients with dementia require highly invasive treatment or surgery that can
affect their lives, informed consent (IC) is obtained only from family members based on a judgment that
the patients lack decision-making ability.

Objective: This study aimed to clarify aspects of nursing support for decision-making about consent
for surgery in elderly patients with dementia.

Methods: We conducted an anonymous self-administered questionnaire survey of nurses with ≥3 years of
experience working in orthopedics wards of secondary emergency hospitals in the Kinki area. Data from 32
nurses who provided free descriptions of nursing practice related to decision-making support were
subjected to co-occurrence analysis using the text mining tool “Trend Search 2015” (Fujitsu, Tokyo).

Ethical Considerations: This study was approved by an ethics committee. The authors have no conflicts of
interest related to this manuscript.

Results: Mean age (±SD) of the 32 female nurses was 41.3 (±11.5) years (range, 24–65 years); 24 (75.0%)
had ≥9 years of experience. In the analysis, a concept map of 344 related keywords and 57 frequent words
was obtained. The strength of association between keywords is represented by the thickness and distance
of the line that connects them. Among important keywords, “elderly patients with dementia,” “family,”
“surgery,” and “nurse” were extracted as the main groups. The mapping revealed strong associations
Poster Presentation Abstracts
between “elderly patients with dementia” and <family>, <relationship>, <understanding>, and <absent>.
“Family” was strongly associated with <doctors>, <elderly patients with dementia>, <final>, <decision-making>,
“surgery” was strongly associated with <hope>, <confirmation>, <absent>, <pain>, and <take>, and “nurse” was
strongly associated with <IC>, <doctor>, <difference in attitude>, and <present>.

Conclusion: The present text mining analysis clarified aspects of decision-making support for elderly
patients with dementia regarding consent for surgery by nurses working in orthopedic wards of
secondary emergency hospitals in the Kinki area of Japan.

Keywords: elderly patients with dementia, family, surgery, nurse

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Correspondence: Sachiko Matsui, Faculty of Medicine, School of Nursing, Kagawa University,
Osaka-Shin-Ai Gakuin University, Japan
E-mail: smatsui@osaka-shinai.ac.jp

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