Abstract
Purpose : In the first report (Journal of Japan Academy of Community Health Nursing, Vol.2, No.1), focusing on the power of care to facilitate growth, as described by M. Mayeroff, we analyzed the elements necessary for home care and the abilities of visiting nurses. The analysis was performed by using the data of 6 nonvoluntary cases who were under home care, and their visiting nurses. Upon analysis, we found another 10 elements in additionto the 8 identified by Mayeroff. Among these elements, intervention with certain intentions, getting involved, remaining involved, and withdrawing are characteristic in the field of home care. Their validity, however, were not clarified because of the shortage in the number of cases. So, in the present study, we aimed to examine the validity of the elements necessary for home care by analyzing additional cases. Method : The subjects of this study were 5 nonvoluntary cases and 4 visiting nurses. The cases were reported at the annual case conference in 1999. We used the same method as used in our first report. The nurses' oral presentations to the meeting were written down as faithfully as possible, Without any added interpretations. The printed records were then confirmed and corrected by the presenting nurses. The data thus obtained was analyzed using content analysis, with an emphasis on studying growth in the cases and the nurses. The validity of the selected elements was examined considering the results of our first report. Result : Sixteen elements of care were selected. They were listening, changing rhythms, courage, getting involved, remaining involved, coordination, empowering, acceptance, withdrawing, practical use of professional knowledge, skill, responsibility, humility, touching, safety, balancing, and intentional participation. All of the elements, except practical use of professional knowledge, skill, responsibility, safety, and balancing had been found in the first report. Among them, the following 4 elements were also extracted in the first report : intentional participation, coordination, empowering, and remaining involved. Since these 4 elements were also common to all cases in this study, they are thought to have high Validity. Among these, intentional participation, which was regarded merely as one of the elements, was evaluated to be the host category which subsumes the other 15 elements in the present study. In other words, "intentional participation" is the prerequisite for longterm home care. A newly identified element of "balancing" was extracted from a case in which there was a gap between the clients' needs and the care provided, due to insufficient assessment of the family's ability to cope. Therefore, as for the validity of "balancing", the necessity of subsequent examination was suggested.
