Abstract
Purpose : Elements essential for providing home care and the abilities required of visiting nurses in order to provide home care were analyzed, focusing on the concept of promoting the personal growth of the people involved, which is a major function of care. Methods : The subjects of this study were 6 visiting nurses who provided care at home to 6 nonvoluntary clients and who were included among the subjects of the case review meeting for fiscal 1998. The nurses' oral presentations to the meeting were written down as faithfully as possible, without added interpretation. The printed records were then confirmed and corrected by the presenting nurses. The data thus obtained were analyzed by the content analysis, with an emphasis on studying changes in the patients and the nurses. The result of analysis were compared with the 8 elements proposed by M. Meyalov, to identify the kinds of abilities required of visiting nurses Results : (1) In addition to the 8 concepts which M. Meyalov described as essential elements (knowledge, changing rhythms, endurance, honest, reliance, humility, desire and courage), the following 10 elements were also extracted : listening to what others say, acceptance, adjustment, acting as a spokesperson for others, empowering, intentional participation, unintentional participation, remaining involved quitting and approving. (2)Of the 8 elements pointed out by M. Meyalov, "knowledge" and "changing rhythms" were found to be particularly important in this study. Four nurses whose knowledge was in sufficient or not well defined, the quality of the nursing care they provided was determined by whether or not they made active efforts to get adequate or clear knowledge. Changing rhythms was found to have two aspects (attempting other method and stopping certain actions). (3)Of the 10 additional elements revealed by this study, four (intentional participation, unintentional participation, remaining involved and quitting) were particularly characteristic. (4)Although the relationships between the visiting nurses and the care receiver varied greatly from case to case, and no universal features could be deduced from them, it was found that the nature of the relationship did affect the quality of care.
