Abstract
We undertook a qualitative factor analysis study to clarify some aspects of practical nursing care for chronically ill patients. Using the grounded theory, we conducted on-site observations at 3 internal medicine wards in 2 medium-sized hospitals and interviewed nurses who had worked for 1 to 5 years on this type of ward. We then interviewed nurses working in other fields. The study revealed that when nurses learn skills of practical care for chronically ill patients, the influences of this type of nursing environment shape the core of learning. Phases in learning can be characterized by "learning processes" or "deviations from learning processes". "Learning processes" are made up of "retention cycles" and "processes of progress". The processes of progress lead to acquisition of the "learning contents". In wards where chronically ill patients are cared for, deviations from learning processes and cycles of retention are likely to occur, perhaps making it difficult for nurses to acquire the necessary skills for providing care to chronically ill patients. These findings suggest the importance of adjusting for the influences of nursing environments and intentionally creating processes of progress, to promote acquisition of the nursing skills necessary for the practical care for chronically ill patients.
