著者

寺尾 洋介 テラオ ヨウスケ TERAO Yosuke 高橋 良幸 タカハシ ヨシユキ TAKAHASHI Yoshiyuki 正木 治恵 マサキ ハルエ MASAKI Harue 谷本 真理子 タニモト マリコ TANIMOTO Mariko

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.20, no.1, pp.47-54, 2014-09-30

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本研究の目的は,特別養護老人ホーム入居高齢者への家族の関わりを支えるものを明らかにすることである。特別養護老人ホーム入居高齢者の家族5名(男性2名,女性3名,看取り介護ケアが導入されている高齢者3名の家族を含む)を対象に,半構造化インタビュー及び,家族-高齢者間の面会場面の参加観察からデータ収集を行い,質的統合法(KJ法)を用いて個別分析と全体分析を行った。全体分析より特別養護老人ホーム入居高齢者への家族の関わりを支えるものとは,【家族の関係:時・場所を超えて変わらない家族の関係性】【ホームでの出来事:関わるから得られる不思議さを伴う発見】【ホームでの出来事:ホームで支えられる双方の平穏】【ホームでの出来事:安楽・希望に繋がる日常の繰り返し】【繋がろうとする欲求:生老病死を受容しながらの愛情の共有】【繋がろうとする欲求:厳しい介護経験を超えての社会発信】の6つのシンボルマークから成る空間配置を示した。結果より,高齢者が衰退する中でも平穏で在り続けることで,家族自身の自己欲求を満たし,社会化をもたらし,家族自身の存在を支え直すものと考察された。家族-高齢者双方を支えるために高齢者が平穏で在り続ける援助の必要性,並びに家族がケア提供者と共に高齢者と関わり,家族の自己肯定感と家族-高齢者双方の安寧をもたらす援助の方向性が示唆された。This research aims to clarify the basis for the relationship between families and elderly people residing in nursing homes. In Japan, nursing homes provide welfare facilities for elderly people requiring long-term care. Data were collected using semi-structured interviews with two male and three female family members and participant observation of five family members and elderly people, three of whom were receiving end-of-life care in nursing homes. Individual and comprehensive analyses were performed using a qualitative synthesis method( the KJ method). The comprehensive analysis focused on the basis of the relationship between family members and elderly people on six parameters:" the family's relationship: the quality of family ties regardless of time and place"; " events at the nursing home: the extent of family member's wondering discovery of the elderly's new aspect obtained from related,""events at the nursing home: the extent of feelings of ease and comfort among family members and nursing home residents";" events at the nursing home: daily routines that engender feelings of calmness and hope";" desire for connection:the extent of affectionate behavior in the face of birth, aging, sickness, and death"; and" desire for connection:the extent of the family's release from challenging, albeit caring, tasks, and experiences." Although elderly people in nursing homes are losing their physical and mental vitality, the calmness they tend to express helps satisfy their family members' individual desires to be part of the family, brings family members together, and supports the family as it rediscovers the very core of its existence. It is important that caregivers assist in the maintenance of elderly people's tranquility to facilitate family members' self-affirmation and to ensure that elderly people and their family members are both at peace.

著者

清水 安子 黒田 久美子 内海 香子 正木 治恵 Shimizu Yasuko Kuroda Kumiko Uchiumi Kyoko Masaki Harue シミズ ヤスコ クロダ クミコ ウチウミ キョウコ マサキ ハルエ

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.11, no.2, pp.23-30, 2005-12-30

被引用文献数

1

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本研究の目的は,糖尿病患者の看護効果測定ツールの開発に向けて,糖尿病患者のセルフケア能力の要素を抽出することである。1990年以降,千葉大学大学院看護学研究科の修士論文・博士論文で糖尿病患者を対象に看護援助や面接を通して行われた質的研究8論文を選択し,質的分析によりセルフケア能力の要素を抽出し,その要素の構造が導き出された。抽出されたセルフケア能力の要素は,【糖尿病や自己管理に関する基礎知識】【ストレス対処力】【サポート活用力】【モニタリング力】【応用力】【調整力】【自己の身体を捉える力】【自己管理の自己推進力】【糖尿病をもちつつ自己実現していく力】の9つの要素であった。セルフケアの能力の要素は,【糖尿病や自己管理に関する基礎知識】を基点に,【応用力】【調整力】を高めつつ発展する『自己管理方法の確立』という方向と,【自己の身体を捉える力】【自己管理の自己推進力】を高めつつ発展する『自己理解の深まりと自己実現』という方向の2つの方向が見出され,両方向の能力の中心に【モニタリング力】が位置づけられた。そして,これらの能力を総合的に活用していく中で,【糖尿病をもちつつ自己実現していく力】を高め,2つの方向が融合していく構造が導き出された。また,【ストレス対処力】【サポート活用力】は,この全てのプロセスで活用するセルフケア能力として位置づけられた。The purpose of this study was to extract the self-care agency elements for patients with diabetes toward the development of nursing effect measurement tools. From among the masters' and doctoral theses written by students of the Graduate School of Nursing at Chiba University after 1990, which involved the provision of nursing support for or interviews with diabetics, eight theses that dealt with qualitative study were selected to extract the self-care agency elements for diabetics by qualitative analysis. As a result, the structure of these elements was drawn. The nine self-care agency elements extracted are as follows: "basic knowledge of diabetes and self-management," "stress-coping ability," "ability to make the most of support," "monitoring ability," "application ability," "adjustment ability," "ability to obtain a clear understanding of one's body," "ability to promote self-management," and "ability to achieve self-realization despite having diabetes." With "basic knowledge of diabetes and self-management" as the starting point, the self-care agency elements are divided into two directions. One direction is toward the 'establishment of self-management methods' while enhancing "application ability" and "adjustment ability." The other is toward 'deeper self-understanding and self-realization' while enhancing the "ability to obtain a clear understanding of one's body" and the "ability to promote self-management." On the other hand, the "monitoring ability" is positioned at the center of those two directions. As a result, the structure was found wherein, the utilization of these abilities in a comprehensive manner leads to the enhancement of the "ability to achieve self-realization despite having diabetes" and the eventual fusion of the two directions. The "stress-coping ability" and the "ability to make the most of support" are positioned as the abilities used in all processes.