著者

佐藤 紀子 雨宮 有子 細谷 紀子 飯野 理恵 丸谷 美紀 井出 成美

出版者

千葉看護学会

雑誌

千葉看護学会会誌 (ISSN:13448846)

巻号頁・発行日

vol.24, no.1, pp.1-11, 2018-09

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[抄録] 本研究の目的は,介護予防事業従事者(以下従事者とする)が活用できる「高齢者のエンパワメントに着目した介護予防支援ガイド」(以下ガイドとする)を作成し,ガイドを活用した従事者間の振り返りの内容からガイドの有効性を検討することである。まず,先行研究で明らかにした高齢者のエンパワメントに影響を及ぼす支援内容を精錬化させ,7項目21の支援内容からなる支援指針を作成した。ガイドは,この支援指針を含む6つの項目で構成した。作成したガイドを活用して,3施設で3か月間介護予防事業を実施してもらった。開始から1か月,2か月,3か月の時点において,従事者間でガイドを用いて支援の振り返りを行ってもらい,その内容をデータとした。振り返りの内容と変化から,1.従事者が高齢者のエンパワメントの視点から有効な支援ができたか,2.ガイドを活用した従事者間の振り返りによって,改善点を見出すことができたかの観点から有効性を検討した。その結果,「高齢者の理解」,「従事者と参加高齢者との関係性」,「他者との相互作用の場の提供」,「高齢者が継続的に介護予防に取り組める環境整備」というエンパワメント支援に求められる視点から実践の質を高められることが確認できた。また,本ガイドは「支援の方針の共有」「できている,あるいは不十分な支援を確認」「支援の必要性や重要性への気づき」「課題と今後の方向性の明確化」という振り返りを促進するものであり,実践の改善点を見出すことに有効であったといえる。[ABSTRACT] The purpose of this study was to create a "long-term care prevention support guide focused on the empowerment of elderly people"( hereinafter, "care guide") that can be used by long-term care prevention practitioners, and to investigate the efficacy of this care guide based on the reflections of practitioners who used the care guide. The first step involved refining the details of support that influence the empowerment of elderly people revealed in earlier research and subsequently creating a support guideline based on 21 types of support organized into 7 items. The care guide was formed of six of the items included in this support guideline. The created care guide was then used in the long-term care prevention activities of practitioners at three different facilities for three months. At one, two and three months after introducing the care guide, practitioners working at the three facilities were asked to reflect on support using the care guide. The details of these reflections were then rendered as data. The details of and changes in reflections were used to examine the efficacy of the care guide in terms of the success of(1) the care guide in effectively motivating practitioners to act from the perspective of empowering elderly people, and(2) reflections in improving the practices of practitioners who used the care guide. The results confirmed that the care guide was able to enhance the quality of practices required to support empowerment, such as "understanding elderly people," "relationships between practitioners and participating elderly people," "providing a place for interaction with others," and "providing an environment where elderly people can continuously work on long-term care prevention." Further, the care guide was also able to enhance the reflections, such as "sharing support strategies," "verifying feasible or inadequate support," "recognizing the necessity and importance of support," and "clarifying challenges and future objectives." This confirmed the efficacy of the care guide since practitioners were able to reflect on support in a way that enabled them to improve their practices.