著者
亀崎 路子 カメザキ ミチコ KAMEZAKI Michiko
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.18, no.2, pp.27-35, 2012-12

本研究は,地域との連携が必要な子どもの課題の解決に向けて,養護教諭が地域ネットワークづくりを推進し,協働での子ども支援を具体化する接近方法を明らかにした。熟練者の実践より作成した地域ネットワークづくりを推進する指針をアクションリサーチに用いて,地域との連携が必要な子どもの課題の解決に困難感を持つ養護教諭3名における4支援事例に対し,支援検討会を実施した。その対話記録をデータ源に,地域ネットワークづくりの取り組み過程を質的に分析した。 その結果,養護教諭は,地域との連携が必要な子どもの複雑な問題に関わる踏ん切りがつかない葛藤や,学校内外の関係者との関係づくりや問題の共有に困難感を抱き踏み込めない躊躇,さらには,地域や家庭の関係者から援助を引き出せない困難に直面している特徴が捉えられた。これに対して,養護教諭は,7つの接近方法「意識を解放する」「視点を転換する」「関係をつくり変える」「場をつくる」「支援を共有する」「子ども支援の根をはる」「立ち位置を解放する」により,地域ネットワークづくりを進展させて,協働での子ども支援を促すことが明らかになった。さらに,接近方法について,推進の鍵となる7つの性質を考察した。 本研究の知見は,困難感を持つ養護教諭に有用と考えられ,接近方法に関与している研究者の働きをさらに追究することにより他の養護教諭への活用に貢献できると考える。In the present study, I elucidated the approaches through which school nurses promote the establishment of communitynetworks and realize support for children based on collaboration with the objective of resolving issues relatedto children that require cooperation with the community. The guideline promoting the establishment of communitynetworks that was created based on pioneering research on an expert school nurse were used in action research atthree different community schools. One-on-one meetings were held with three school nurses who had difficulty inresolving issues related to children that required cooperation with the community during which support for four caseswas discussed. Using verbatim records of these meetings as data, the processes of approaches for the establishment ofcommunity networks were qualitatively analyzed.The results showed that school nurses had the following characteristics: conflict resulting from the inability tomake decisions on the complex problems related to children that require cooperation with the community, hesitation intaking action due to difficulties in developing relationships with personnel at and outside schools and sharing problems,and difficulty obtaining assistance from relevant individuals in the community and families. Nonetheless, school nursesadvanced the establishment of community networks through the seven approaches of "loosening awareness", "switchingperspectives", "modifying relationships", "creating opportunities", "sharing support", "securing support for children",and "loosening stance", and thereby promoted support for children based on collaboration. Seven key properties forpromoting these approaches were also discussed.The present findings were considered useful for school nurses experiencing difficulties, and further elucidation ofthe actions of the researcher involved in approaches is expected to contribute to their application by other school nurses.Note: School nurse( Yogokyouyu): Tea
著者
岩田 裕子 森 恵美 Iwata Hiroko Mori Emi イワタ ヒロコ モリ エミ
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.10, no.1, pp.49-55, 2004-06-30
被引用文献数
3

本研究の目的は,父親役割への適応を促す看護援助を明らかにすることであり,国内外の研究論文および専門書の内容を質的に分析することにより,父親役割への適応に関する看護援助を抽出した。医学中央雑誌,CINAHL,MEDLINEを利用したコンピューター検索により,1990年以降の文献を抽出し,最終的に和文献16,英語文献24,専門書9を分析対象とした。質的分析の結果,父親役割への適応を促す看護援助は,妊娠中に行う援助としては,1)アタッチメントの促進,2)父親役割への準備,3)夫婦間コミュニケーションの促進,4)役割調整のための夫婦間の話し合い促進,5)胎児・乳児についての情報提供の5つが抽出された。分娩時に行う援助は,父親になる男性へのサポートとしてまとめられ,妊婦だけでなく,父親になる男性にも焦点をおいた援助をすべきであるということが示された。出産後に行う援助としては,1)育児相談・教育,2)父親間での感情の共有,3)夫婦間コミュニケーションの促進の3つが抽出された。また援助を行う時期に関係なく抽出された一般的原理は,1)援助者の姿勢,2)物理的環境の調整,3)援助する際の工夫の3つであった。本研究において明らかとなった父親役割への適応を促す看護援助は,移行期の父親にケアを提供する看護実践者にとって,援助の指針となるものである。また,抽出された看護援助の内容をさらに検討あるいは精錬していくことは,日本文化を反映した新たな看護援助の指針を開発することにつながると考える。The purpose of this study was to clarify nursing care that would promote men's adjustment to fatherhood. Literature search was conducted to retrieve relevant articles written either in Japanese or English. Igakuchuouzasshi, CI-NAHL, and MEDLINE were searched since 1990. The results of 16 Japanese articles, 24 English articles, and 9 books were analyzed focusing on their content to extract nursing care that would promote men's adjustment to fatherhood. The analysis resulted in various nursing care that could be provided during pregnancy, labor, and after birth. Nursing care during pregnancy were: 1) promoting the expectant father's attachment, 2) preparing for the father's role, 3) promoting marital communication, 4) promoting marital communication for the adjustment of parental roles between the couple, and 5) providing necessary information about fetus and infant. Nursing care during labor could be categorized as providing support to the expectant/new father that emphasized men as clients. Nursing care after birth were: 1) consultation/education about parenting, 2) sharing feelings among fathers, and 3) promoting marital communication. The following three basic principles were also extracted: 1) attitudes of care providers, 2) arrangement of physical environments, and 3) consideration of care providers. The result could be a knowledge base to develop new nursing interventions that are sensitive to the Japanese culture and effective in promoting men's adjustment to fatherhood.
著者
黒田 久美子 Kuroda Kumiko クロダ クミコ
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.5, no.1, pp.39-46, 1999-07-30

糖尿病患者の自己管理における自己モニタリング時の感情や思いの表現から,自己モニタリングの性質を明らかにすることを目的に,6名のインスリン依存性糖尿病患者に自己管理場面を想起してもらう方法で面接を行い,自己モニタリング時の感情や思い,状況,行動の特徴を分析した結果,以下の知見を得た。1.糖尿病患者の自己管理における自己モニタリング時の感情や思いの表現は,以下の9に分類できた。『あれっ,なんで,おかしい。』,『大丈夫かな。』,『こうなるようにしたい。』,『こういうこともあるから心配ない。』。『この時はどうなのかな。』,『やっぱりそうなんだなー。』,『私って,糖尿病ってこうなんだなー。』,『わかってきた。』,『見ちゃうと気分がよくない。』2.各々の表現には以下のような自己モニタリングの性質が示されていた。〈異常のないうまくいっている状態とのずれのキャッチ〉,〈安心・大丈夫・確かさだと感じる基準とのずれのキャッチ〉,〈規範や目標とのずれのキャッチ〉,〈不安への対処〉,〈血糖変化のバラエティーへの関心〉,〈思い起こされる判断や状態への確信〉,〈糖尿病を持つ自分への深い理解と納得へのきっかけ〉,〈自己管理に関連する事柄の関連性やパターンのはっきりした認識への貢献〉,〈悪い状態の予想とそれに伴う不快感情の生起〉The purpos of this study were to identify expression at the time of self monitoring of self-management in pataients with diabetes, and to identify quality of self monitoring. Data was collected from six outpatients with IDDM, through interviews by looking back at some past scenes of their diabetes self-management. Their expression of feeling and emotion, situation, behavior of those scenes were analyzed. Expression at the time of self-monitoring were as follows: 『Oh! Why! Unusual!』, 『OK?』, 『I want to be like this.』, 『No anxiety because it's same as usual.』, 『I want to know how high is my blood glucose in this situation.』, 『After all I become convinced that is correct.』, 『I am diabetes patient like this. My diabetes is like this.』, 『I become to understand.』, 『Feel bad if monitor such bad results.』 Quality of self-monitoring were as follows: 〈Catch the difference from good condition〉 , 〈Catch the difference from the standards about security, OK, certainty〉 , 〈Catch the difference from my rules and goal〉 , 〈Cope to anxiety〉 , 〈Attention to variety of floating blood glucose level〉 , 〈Be convinced of my judgement at past scenes when coming my mind〉 , 〈Provide a clue for realization and conviction about myself with diabetes〉 , 〈Contribute to understand some connection and patterns of self-management clearly〉
著者
三隅 順子 前原 澄子 森 恵美 Misumi Junko Maehara Sumiko Mori Emi ミスミ ジュンコ マエハラ スミコ モリ エミ
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.2, no.1, pp.16-22, 1996-06-28

本研究では,夫付き添い分娩において産婦の不安の軽減に効果のある夫の関わり方を明らかにすることを目的とした。対象は,研究協力の得られた25組の夫婦であり,医学的に問題のない18歳から35歳までの初産婦とその夫であった。産婦の不安を測定するために分娩中に主観的な不安と痛み,そして生理的指標として血圧・脈拍について測定し,また夫の関わり方については,極期において約90分の観察とコード記録を行った。その結果,夫の「手を握る」関わりの割合と産婦の状態不安の変化には相関(r=-0.66, p<0.05)があり,夫が産婦と共に過ごし「手を握る」ことは産婦の不安の軽減に役立っていたことがわかった。また,産婦の不安には産婦の性格や夫との関係が影響していることが考えられた。The purpose of this study was to evaluate the effects of husband's attendance attitude to reduce maternal anxiety in labor and delivery. The subjects who expressed informed consents were 25 married women and their husbands. Women were 18 to 35 years old primiparas, with no complicating medical or obstetrical conditions, and no physiological and psychosocial ploblem. In order to measure maternal anxiety, the self reported anxiety and labor pain were provided during labor and delivery. And also blood pressure and puls were measured. Husband's attendance attitude was observed and coded about 90 munites at labor room. Finding was that husband's attitude as ""taking wife's hand"" was beneficial effects to reduce maternal anxiety. This means that it's very important that husband stay with wife with feeling the sympathy of her experience. And characters of women and marital adjustment were produce effects on maternal anxiety.
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

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.
著者
三浦 弘恵 舟島 なをみ 鈴木 恵子 Miura Hiroe Funashima Naomi Suzuki Satoko ミウラ ヒロエ フナシマ ナヲミ スズキ サトコ
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.1, pp.31-37, 2005-06-30
被引用文献数
1

本研究の目的は,在宅における看護実践を自己評価するための尺度を作成し,その信頼性・妥当性を検証することである。本研究は,在宅看護を家庭で療養するクライエントとその家族に対し,その居宅を中心とする通常の生活の場において看護職者が健康上の問題を解決・回避できるよう支援する活動と定義する。尺度の開発は,(1)在宅看護場面における看護職者の行動を説明する6概念を基盤とした質問項目の作成と尺度化,(2)質問項目の内容的妥当性の検討と修正,(3)調査実施による質問項目の分析・選定,(4)選定項目により再構成した尺度の信頼性・妥当性の検討の4段階の手続きを経た。調査に用いた測定用具は,6下位尺度48質問項目から成る自己評価尺度であり,対象は無作為に抽出した保健所・市町村,訪問看護ステーションに就業し,在宅看護に携わる看護職者656名であった。質問紙回収数は380部(回収率57.9%)であり,このうち全質問項目に回答のあった311部を分析対象とした。クロンバックα信頼性係数,項目間相関,I-T(項目-全体)相関の分析,因子分析の結果に基づき合計18項目を削除し,30項目を選定した。再構成した尺度全体のクロンバックα信頼性係数は0.95であり,尺度が内的整合性を確保していることを示した。また,因子分析の結果は,尺度が構成概念妥当性を確保していることを示した。The purpose of this study was to develop Self-Evaluation Sacle on Home Health Care Nursing, which had reliability and validity. The scale was constructed six subscales, which were findings of the previous research. The previous research was conducted qualitatively and inductively to conceptualize nurses' behavior in home health care nursing. As a result of continuing comparative analysis, six explanatory concepts emerged. They were positioned six subscales. Every subscale was constructed with eight items made from the bottom of the concepts. Expert panel discussion and pilot study were conducted to establish content validity. Self-Evaluation Sacle on Home Health Care Nursing was 5-point Likert Scale with forty-eight items. The instrument packets, including the scale and a demographic questionnaire, were distributed to 656 nurses of 66 health centers and communities, and 38 visiting nursing stations which were randomly sampled. 380 (57.9%) nurse responded, and 311 valid data were analyzed. The 30 items were selected based on the result of item analysis. Chronbach alpha of the item-select version was .952. Factor analysis was used test construct validity of it. The result shows that item select version based on 6 explanatory concepts of home health care nursing, and then the construct validity was confirmed.
著者
天谷 真奈美 岩崎 弥生 Amagai Manami Iwasaki Yayoi アマガイ マナミ イワサキ ヤヨイ
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.1, pp.79-85, 2006-06-30

本研究の目的は社会的ひきこもり青年を抱える親のパワーレスと,そのエンパワメントの拡大に働く看護援助を明らかにすることである。対象は社会的ひきこもり青年の親で3事例である。ひきこもり青年は20歳半ばから30歳前半の全て男性で,3年から7.5年ひきこもっていた。看護援助指針に基づいて親に援助を実施し,質的分析を行った。また看護援助の効果を測定する質問紙調査を行った。結果,社会的ひきこもり青年を抱える親のパワーレスは7カテゴリーが抽出された。親のエンパワメントの拡大に働く看護援助カテゴリーは,【パートナーシップを確立し孤立感を和らげる援助】,【子育ての振り返りを見守る援助】【否定的自己感と向き合いつつ自尊感情を取り戻す援助】,【適切な対人距離がとれるよう認識を促す援助】,【親が見逃している他者の力量・可能性・思いに対する感受性を高める援助】,【多様な見方・意味づけの提示で,柔軟な物事の理解・とらえ方を拡大する援助】,【問題解決能力を養う援助】の7つが抽出された。これらの看護援助によって,家庭内のコミュニケーション,協働関係の再構築,ひきこもり青年の社会参加行動にも変化が得られた。特に子育ての振り返りを見守る援助は,過去の子育てに関する親の負担感と子供に対する罪悪感の表出を促し,葛藤の整理を行う上で効果的であった。家族の課題に現実的に対処する力を生み出す意味でも重要であることが示唆された。The purpose of this study was two-fold: a) to elucidate factors associated with parents' powerlessness in caring for the children who were socially withdrawn; b) to help those parents empower themselves in their struggles with their socially withdrawn children. Participants in the study were 3 mothers whose children have been socially withdrawn for long time. The socially withdrawn children were in their mid-twenties through mid-thirties. They had confined themselves in their homes from 3 to 7.5 years. Nursing care was given to those mothers after delineating intervention guide-lines on their enhancing empowerment. Data, which were collected for the study period of six months, were analyzed qualitatively and inductively. A questionnaire was used to measure the effects of nursing care. There were 7 categories of the mothers' powerlessness with regard to their children's socially withdrawnness. As well, there were 7 categories of the nursing care provided to those mothers.: 1) partnership established between the mothers and the nursing researcher, 2) looking back their parenting, 3) regaining self-esteem despite regrets, 4) setting a distance appropriately between their children and themselves, 5) enhancing the levels of sensitivity in identifying their family strengths, 6) being able to interpret different meanings form multiple perspective, and 7) enhancing problem-solving skills. As a result of nursing care provided for their mothers, higher levels of empowerment were observed on the mothers as well as on the rest of the family members. In particular, the following behavioral changes were noted: a) improved communication patterns among the family members; b) re-established mutual support between parents; c) no longer socially withdrawn, but getting out of their houses, getting employed, or going to vocational school. Especially nursing intervention supporting mothers to reflect their own parenting have been contributed providing the opportunities to express parenting burden and feeling of guilty, and regulate th