在宅介護の継続過程における訪問看護師の役割

• Published in: 日本看護研究学会雑誌 Vol. 25; no. 5; pp. 5_83 - 5_95
• Main Author: 古瀬 みどり
• Format: Journal Article
• Language: Japanese
• Published: Japan Society of Nursing Research 2002; 一般社団法人 日本看護研究学会
• Subjects: crisis; Grounded Theory; routine; visiting nurse; グラウンデッドセオリー; ルーチン; 危機; 訪問看護師
• ISSN: 2188-3599; 2189-6100
• DOI: 10.15065/jjsnr.20020903007

The purpose of this study was to analyze the interaction between crisis and routine while family caregivers had continued to care for the mentally and physically disabled elderly at home and to identify the role of visiting nurses in the process. A Grounded Theory approach was chosen for this research design and analysis. The subjects of this study were 10 family caregivers using visiting nurse services. The study was performed using participants' observation and semi-structured interviews. We asked the caregivers to talk about their past caregiving life. They had a lot of crisis experiences. They experienced crisis over and over and then crisis sifted to routine in their caregiving process. Visiting nurses caught shifting needs of caregivers according to changes in circumstances and dealt with them appropriately. Caregivers perceived the roles of visiting nurses "model of caregiving", "coordinator of caregiving" and "emotional supporter", looking back upon their past caregiving days. 本研究の目的は，在宅介護のプロセスにおける危機とルーチンの相互関係および訪問看護師の役割を分析することである｡ 対象は，訪問看護ステーションを利用する要介護高齢者の家族介護者10名である｡ 調査方法は訪問看護場面における参加観察と半構成的面接で，介護者にはこれまでの介護経験を語ってもらった｡ 分析にはグラウンデッド・セオリー法を用いた｡ 介護のプロセスには多くの危機が存在し，危機とルーチンの繰り返しであった｡ こうした危機経験を繰り返すことにより，介護者はルーチンに落ち着くことが可能となった｡ 訪問看護師は状況の変化によって移り変わる家族のニーズを捉え，適切に対処していた｡ 介護者はこれまでの介護プロセスを振り返り，訪問看護師が果たしてきた役割を "介護のモデル" "介護のコーディネート" "情緒的支援" と認識していた｡