背景：医療の発展に伴い国内の重度の知的障害と身体障害を併せ持つ重症心身障害者の高齢化と共に、その介護を担っている親も高齢化し、今後の看護支援について検討する必要がある。
　目的：適応機能が低く日常生活に介助を要する在宅障害者の「親亡き後問題」について、研究論文をもとに在宅障害者と親の生活の実態から抱える問題について現状を明らかにすることにした。
　方法：elderly parents・disability・障害者・親亡き後・高齢家族をキーワードに論文を検索し、当事者および家族の年齢の推移や同居の有無等の属性の状況、親亡き後問題の実態、在宅障害者への地域における支援体制の現状と課題、について精読した。
　結果・考察：対象となったのは、19件の論文であった。障害者とその親は、高齢化し、親との同居によって障害者の生活を支えている状況があった。親は障害者の日常生活上の介助や金銭管理等を案じていたが、親自身が障害者よりも先に逝去した場合、親と同様に障害者の思いを汲み取れる存在がないことを何よりも案じていると考えられた。
　結論：重症心身障害者と親の高齢化は今後も継続する状況にあるため、親の不安の軽減を図るための支援体制の再構築が必要である。

View full abstract

 In this study, semi-structured interviews with 12 nursing instructors teaching a technical practicum in nursing were conducted in order to obtain ideas for instructional strategies by illuminating teaching activities that facilitate collaborative relations among students. Qualitative and inductive analysis of the interview data yielded 17 categories of teaching activities that facilitated collaborative relations among students, including “development of a teaching plan intended to facilitate communication among students,” “detection of emerging stagnation in collaborative relations and assessment of causes of the problem,” and “prompt instruction and guidance to resolve problems in collaboration.” The results revealed that the nursing instructors considered how to build collaborative relations among students when they developed their teaching plan. The nursing instructors also continually monitored and assessed students’ collaborative relations during the technical practicum and based on the results, they used different teaching techniques to facilitate collaborative relations by helping students play their role in the practicum. Furthermore, the 17 categories of teaching activities were performed at each stage of the PDE cycle （plan, do, evaluate）, suggesting that continuous implementation of a PDE cycle for building collaborative relations leads to effective support.

View full abstract

　Objectives：The objectives of this study were to investigate the dementia-nursing competencies required in acute-care hospital nurses from the perspective of nurses supporting older adults with dementia in the community, and to obtain insights about in-service training and basic nursing education.
　Methods：We sent anonymous self-administered questionnaires to 500 community-based general support centers and 500 home-visit nursing agencies in Japan, which were selected at random, and requested that one nurse at each facility complete the questionnaire.
　Results/Discussion：We obtained responses from 260 nurses （response rate: 26.0%）, with 258 valid responses available for analysis. In multiple-choice questions asking which dementia-nursing competencies are most lacking for nurses in acute-care hospitals, two areas were noted by more than half of the respondents: “understanding and respecting older adults with dementia,” and “cooperating with relevant parties and helping older adults with dementia to maintain their lives.” In addition, as the competency that all such nurses are expected to have, “collaborating with other professionals in the community” was reported most frequently.
　Conclusion：Because “understanding and respecting older adults with dementia” is fundamental to dementia nursing, this area should be continuously emphasized throughout basic nursing education. It is also thought that “cooperating with relevant parties and helping older adults with dementia to maintain their lives” should be reinforced through in-service training for nurses in acute-care hospitals.

View full abstract

　Purpose：This study aimed to examine the actual practice and strategies of COVID-19 infection prevention care for elderly patients with dementia in long-term care facilities.
　Methods：An anonymous, self-administered questionnaire survey was conducted with one nurse each from 600 randomly selected long-term care facilities in Japan. Descriptive statistics and qualitative analysis were also performed.
　Results：Responses were received from 157 nurses （collection rate 26.2%）, who reported difficulties in implementing basic infection control measures. However, about 30% said that there was no change in the conditions or symptoms of elderly patients with dementia resulting from the implementation of infection control measures, including visitation restrictions. Specific methods used to explain infection control measures were “repeated explanations,” “careful communication of facts,” “visual approaches,” “rephrasing into easy-to-understand words,” and “implementing infectious prevention measures together.” As an alternative to family visitation, the following care strategies were suggested: “increasing opportunities for communication,” “creating opportunities for physical exercise,” and “creating a relaxing environment,” as well as providing care for the family members.
　Conclusion：The results showed that providing the basic care required by elderly patients with dementia enabled nurses to provide infection prevention care and respond to its impact. Furthermore, the restriction on visitation had a substantial impact on patients’ family members, suggesting the importance of providing care for them.

View full abstract

　The purpose of this study was to clarify the team management processes of experienced discharge support nurses. Considerations include teamwork, providing assistance, and obtaining the practical skills required to support others. Discharge support nurses need to understand how team management is performed in the clinical setting as well as consider the practical abilities required to perform this duty. A semi-structured interview survey was conducted of 10 discharge support nurses with more than 2 years of experience. The data were analyzed qualitatively.
　The results showed that experienced support nurses handled team management in the following ways: gathering people who felt the need for shared collaboration in a multi-disciplinary work environment; assessing patients and their families; and building relationships between the discharge support nurses and professionals in other occupations. Discharge support nurses managed the collaboration of the multidisciplinary professionals by using a process combining skills and talent without overstepping any boundaries.
　Discharge support nurses must consider the personalities and working styles of the community-related professionals around the facility, the status of discharge support, and the impact they want to have on their team members. They must form a team of professionals that consider the relationships among occupations.
　A discharge support nurse must know how and when to take charge or follow the team leadership, make proactive assessments that consider relationships among multiple professions, and manage the team behind the scenes rather than being the center of attention.

View full abstract

　Objective：The aim of this study was to identify the coping strategies and methods used by patients with Parkinson’s disease （PD） to prevent falls and secondary disability caused by falls.
　Methods：Semi-structured interviews were conducted with six PD patients （Hoehn & Yahr classification stage Ⅰ-Ⅳ）, five of whom had never experienced secondary disability due to falls, as well as with one family member. The interview data were analyzed qualitatively.
　Results：In total, 10 categories of coping strategies and methods were identified that PD patients used to prevent falls and secondary disability. There were six categories of behavioral coping strategies and methods: “self-management to maintain good physical condition,” “actions in accordance with wearing off,” “ensuring stability when walking,” “learning how to fall to reduce the impact of a fall,” “learning how to get up on one’s own after a fall,” and “maintaining and strengthening muscles and bones.” Two categories of cognitive coping strategies and methods were “walking with attention to falls” and “noticing and coping with situations where a fall is likely to occur.” Two categories of coping strategies and methods involved social support：“preventing falls during walking by relying on others and getting prompt assistance to get up after a fall” and “having family members help with medication adjustment.”
　Conclusions：The PD patients in this study, who had never experienced secondary disability due to falls, were considered to prevent falls and secondary disability arising from their symptoms and decrease the risk of falling through self-management to maintain a good physical condition. This suggests the need to engage medical professionals and establish a support system for PD patients so that they can recognize their own symptoms and risks.

View full abstract

　The purpose of this study was to clarify the current situation of health literacy （HL） and related factors among the elderly living in urban Japan. Anonymous, self-administered questionnaires were distributed to members of seniors’ clubs in an urban area in Japan. The survey contents included basic characteristics, sources of health information, and self-perceived health. In addition, participants were asked to complete the 47-item European Health Literacy Survey Questionnaire （HLS-EU-Q47 Japanese-language version）.
　Descriptive analysis was performed and compared according to three HL domains and four HL competencies after calculating the HL standardization index. Of the 561 questionnaires distributed, 381 responses were received; of these, 368 were included in the analysis. The participants’ mean age was 76.9 years old （range, 65−95 years）. Nearly all the participants （97.0%） answered that they were “very interested in health” or “somewhat interested in health.” Television was the most common source of health information, followed by friends and family, health care professionals, newspapers, community papers, and the Internet.
　Regarding the HL standardization index, The mean （SD） total HL was 27.5 （8.8）, which was considered “slightly insufficient.” In terms of competency, “understanding HL” was the highest, followed by “obtaining HL” and “evaluating HL.” The participants in this study were basically very interested in health, and it was likely that they had acquired HL through having many opportunities to see health information on disease prevention. However, it became clear that they had some difficulty accessing needed health information by themselves as well as evaluating the necessity and reliability of the information.

View full abstract

　Objective:To clarify esophageal cancer patients’ views on the preoperative patient education they received, we interviewed such patients during their postoperative hospital stays.
　Methods:Semi-structured interviews were conducted with 8 esophageal cancer patients who had undergone surgery and consented to participate in this study. Data representing their views on the preoperative patient education they had received were extracted and then qualitatively and inductively analyzed.
　Results and Discussion:The analysis results yielded 86 summaries, 20 sub-categories, and the following 5 categories: “trusting healthcare professionals who have expertise, and relying on them in all aspects,” “understanding the necessity of preoperative patient education based on one’s own experience and those of close relatives,” “being unsatisfied with the contents of the education and the support from healthcare professionals,” “being unsure of the necessity and effect of preoperative patient education,” and “considering the timing of the preoperative patient education inappropriate.” The patients had a sense of dissatisfaction with the contents, method, duration, and timing of preoperative patient education. To resolve such dissatisfaction, it may be necessary to provide information in as much detail as possible in an easy-to-understand manner, thereby providing preoperative patient education that is more effective in promoting favorable behavioral changes in patients.

View full abstract

　The purpose of this study was to clarify the actual conditions of paired training guidance using an instruction manual in child health nursing practical training. We conducted an interview survey of instructors and analyzed the data qualitatively and inductively. The actual conditions of paired training guidance using the instruction manual were classified into four categories: “common understanding and guidance on paired training guidance,” “guidance on unified paired training,” “recollection of paired training guidance,” and “concern about the relationship between the pair.”
　To date, we have yet to clarify specific details regarding the paired training guidance, including the outline of the student pair practice and attention during guidance. Within this context, as a result of providing practical training using the paired training guidance management, the instructor commented that the contents of the guidance was clear and that common understanding and unified guidance were possible. Meanwhile, the instructors expressed concern about the relationship between paired students.
　The results suggested that in order to provide unified guidance, mutual cooperation between instructors was indispensable for paired training guidance. The results further suggested the importance of the effective utilization of the instruction manual.

View full abstract

　目的：国内外の中絶ケアにおける看護職の感情を明らかにした文献から、陰性感情および陰性感情が生じた要因を抽出し概観することで、看護職の陰性感情および要因を明らかにし、対処方法について検討する。
　方法：国内外の検索エンジンでのキーワード検索およびハンドサーチによる文献検索を行った。対象文献から陰性感情および陰性感情が生じた要因を抽出し、陰性感情は演繹的に集約、要因はコードにまとめ質的帰納的に分析した。
　結果：国内文献8件、国外文献15件の計 23件を分析対象とした。中絶ケアにおける看護職の陰性感情は、演繹的に14の陰性感情に分類された。陰性感情が生じた要因は、【看護職個人の価値や信念】【中絶ケア】【中絶を受ける女性】【中絶される児】【中絶ケアに携わる看護職をとりまく環境・システム】の5カテゴリに分類された。
　結論：中絶ケアにおける看護職の陰性感情が生じる要因は、変容困難と推察されるものも多くみられたが、一部は介入による変容の可能性が考えられた。今後は、陰性感情の関連要因と影響の強さを明確化し、変容に向けた介入について検討していくことが必要である。

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract