著者

齋藤 智子 佐藤 由美 Saitou Tomoko Satou Yumi サイトウ トモコ サトウ ユウミ

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.12, no.2, pp.8-14, 2006-12-30

被引用文献数

4

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本研究は,介護支援専門員(以下CMとする)がケアマネジメントを行う上で感じる対応困難の実態を明らかにし,CMへの支援の方向性を検討することを目的とした。調査方法は,N県内の居宅介護支援事業所に勤務するCM693名を対象に,無記名の自記式アンケート調査を実施し,345名(回収率49.8%)からの回答を得た。対応困難の実態として,独自に作成した対応困難内容41項目について(1)対応困難と思う程度(2)実際に対応困難を感じた経験頻度について尋ねた。その結果,困難と思う内容として特に高かったのは虐待への対応,独居認知症者へのケアプラン立案であった。困難を感じた経験では,家族内の意見が不一致の際の意見調整が高かった。対応困難内容41項目を困難感の程度と困難経験の頻度との関係でみると,困難感・経験頻度とも高い項目,経験頻度は低く困難感は高い項目,困難感は低く経験頻度は高い項目,困難感・経験頻度とも低い項目に分類された。また,困難感の程度には,経験年数,基礎資格,以前の在宅療養支援経験の有無が関連している項目もあった。CMへの支援として,困難感・経験ともに高い項目は,CM全般に対する研修内容として優先的に取り上げていく,経験頻度は低く困難感は高い項目は,個別支援に重点を置いていくなど,対応困難の実態やCMの特性に合わせた支援内容・方法を検討していくことが必要であることが示唆された。The purposes of this study were to identify difficulties experienced by care managers in care management and to find ways to adequately support them. The anonymous self reporting questionnaire survey was conducted to 693 care managers in N prefecture. Forty one items of difficulties were extracted from the preceding research. The questionnaire asked the subjects to rate the degree of difficulty and frequency of their experience. The highest degree of difficulties they perceived were response to abuse cases and care plan designing for the demented living alone. In terms of frequency, many reported coordination of families with different and contrasting opinions. Forty one items were further grouped by degree and frequency into four; "high in both degree and frequency", "high in degree but low in frequency", "low in degree but high in frequency" and "low in both degree and frequency". We have to prioritize and plan our support of care managers based on the data we collected. It is important to train all care managers on the items of high degree of difficulty and frequency. Concerning items of high degree but low frequency, individual support of managers is recommended. It was also found to be critical to design adequate training, taking the care managers' professional experience into consideration since sense of difficulty was correlated with their years of experience, type of background qualification and previous experience in home care.