表紙・裏表紙

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Reconsidering “Iki-iki Age 100 Exercise”

2014 年の介護保険法改正で一般介護予防事業が創設され, 住民主体で介護予防を行う通いの場が 重要視された. 中でも,「いきいき百歳体操」は全国的に取り組まれている. そこで,「いきいき百歳 体操」の変遷と特徴, 効果と課題の整理を行い,「いきいき百歳体操」の定義を行うことを目的に文献 検討を行った「. いきいき百歳体操」は , 誰でも取り組める簡単で安全な体操で , ハイリスクアプロー チである特定高齢者施策に対して行き詰まり感を感じていた自治体に広く受け入れられた．介護予 防として特に身体面に効果があるが, 後継者の確保や新規参加者の拡大など,「いきいき百歳体操」 の継続に関して課題を有していた.「いきいき百歳体操」は, 住民主体の体操と, その継続を支える ための支援者による仕組みやしかけがワンセットとなった, 効果的な介護予防のためのポピュレー ションアプローチの一つの形態であると定義づけられた.With the revision of the Long-Term Care Insurance Act in 2014, the General Care Prevention Project was established, placing emphasis on providing community gathering places where residents can engage in nursing care prevention. Among these, "Iki-iki Age 100 Exercise” is being promoted nationwide. Consequently, we summarized the changes, characteristics, effects, and challenges of "Iki-iki Age 100 Exercise" and reviewed the literature with the aim of defining "Iki-iki Age 100 Exercise.” "Iki-iki Age 100 Exercise” is a simple and safe exercise in which anyone can engage and which was widely accepted by local governments who felt a sense of gridlock with specific elderly measures that are high risk approaches. Despite being particularly effective in physical terms as a preventive measure for nursing care, it had issues related to the continuation of "Iki-iki Age 100 Exercise,” such as securing a successor and expanding to new participants. "Iki-iki Age 100 Exercise” was defined as a form of population approach for effective nursing care prevention, in which resident-led exercises and mechanisms by supporters to support its continuation were considered a single set.review articl

我が国におけるがんピアサポート活動の実態 ～がん診療連携拠点病院を対象に～

本研究は，我が国におけるがん領域でのピアサポート活動について調査し，実態および今後の課題を明らかにすることを目的とする．　がん診療連携拠点病院を対象に，ピアサポート活動の運用，ピアサポーターおよび養成研修に関する無記名自記式質問紙調査を行った．全国のがん診療連携拠点病院405 か所に調査票を送付し，回収率は43% であった．ピアサポート活動の運営担当者として専任がいる施設は0.8% のみで，32.2% の施設が取り組み方や問題が生じた際の対応の危惧等から活動していないと回答した．ピアサポート支援の環境については，組織の長の理解や新しいことに取り組む風土のある施設がある一方で，活動への理解・協力者が少ない，予算がつかないケースもみられた．全ピアサポーターが研修を受けている施設は約３割で，ピアサポーター養成研修に重要と考える内容は「コミュニケーションスキル」「個人情報保護・管理」が多かった．また，運用上の課題として「COVID-19 の影響で活動できない」「マンパワー不足」「取り組み方がわからない」などが挙げられた．　我が国のがん対策推進事業拡大の一環として，ピアサポートの充実が叫ばれ，多くのがん診療連携拠点病院がピアサポート活動に取り組んでいるものの，その内容は施設によって差があり，運用サイドの課題やピアサポーターの質保証に関する課題が浮き彫りとなった．This study aimed to investigate and clarify the actual situation of peer support activities in the field of oncology in Japan and future issues. A self-administered, anonymous questionnaire survey regarding the operation of peer support activities, peer supporters, and training was conducted in center hospitals for cancer treatment. The response rate was 43%. Only 0.8% of the facilities had a full-time person in charge of managing peer support activities, and about 30% of the facilities indicated that they were not active because of concerns about how to tackle issues or respond when problems arose. Regarding the environment, while some facilities understood the role of the head of the organization and exemplified a culture of tackling new challenges, cases were also seen in which few people understood or cooperated with the activities, and where no budgets were available. The most important contents for peer supporter training were “communication skills” and “personal information protection and management.” Operational challenges included “inability to conduct activities due to COVID-19,” “lack of manpower,” and “not knowing how to work on projects. As part of the expansion of cancer control promotion projects in Japan, calls have been made for the enhancement of peer support, and although many center hospitals for cancer treatment are engaged in peer support activities, the content of such activities varies by facility, which highlights concerns related to operational issues and quality assurance for peer support.departmental bulletin pape

Review of the Literature on Older Adults’ Intentions to Complete Their Lives in Hilly and Mountainous Areas

中山間地域における看取り支援を行う上で必要なことは，その地域で生活している高齢者の文化的 価値観をケアに反映させることである．本研究は，中山間地域に在住する高齢者が最期まで地域で 暮らし続けるための「思い」について，文献検討で明らかにすることを目的とした．分析対象は中 山間地域に在住する高齢者が最期まで地域で暮らし続けるための「思い」に関して記述されている 17 文献とした．17 文献を分析した結果，24 コード，10 サブカテゴリー，4 カテゴリーが抽出された． 中山間地域に在住する高齢者が地域で暮らし続けることへの思いを表すカテゴリーは，【不便な生 活環境】【価値ある地域での暮らし】【限られた人とのつきあい】【子どもとの関係性保持】であった． 中山間地域の高齢者は，不便な環境と理解しながらも，他者に迷惑をかけることなく最期まで地域 で暮らし続けたいという思いを抱いていることが明らかになった. 中山間地域における高齢者の看 取り支援においては，高齢者への訪問看護等の在宅医療サービスの有効活用に関する情報提供の効 果的な方法について検討する必要がある．It is important to reflect on the values of older adults when giving end-of-life care in hilly and mountainous areas. This study conducts a literature review to clarify older adults’ thoughts about continuing to live in these remote areas until the end of their lives. The analysis examined 17 studies that described the thoughts of older adults living in hilly and mountainous areas and extracted 24 codes, 10 subcategories, and four categories. The categories included “Inconvenient living environment,” “I want to continue living in the area,” “Interaction with a limited number of people,” and “My children’s presence is key.” The results showed that older adults living in hilly and mountainous areas understand that they live in an inconvenient environment; nevertheless, they wish to continue living in these remote areas until the end of their lives without causing trouble for other people. End-of-life care for older adults in hilly and mountainous regions should consider functional ways to provide older adults with relevant information on the effective use of home-based healthcare services such as home nursing.review articl

奥付

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Health-level-specific Nursing SkillsExercises of the Fourth Year Students in Basic Nursing Education.

本稿は，本学の学士課程4 年次における健康レベル別看護技術演習の実践を，教員の立場から報告することを目的とする．本演習の目的は，健康レベルの各期にある患者とその家族を対象に，クオリティオブライフの向上を目指す看護実践に必要となる基礎的技術を学ぶ，目標は，急性期・慢性期・回復期・終末期の各期のケアに必要な看護技術を習得することである．演習の内容は，4 つの健康レベル別に12 の演習項目を設け，それぞれに適切な時間，使用物品，事例・シナリオ，担当講師等を検討し計画した．また，演習の学習資料として，各項目の事例・シナリオを掲載し，演習中の観察者としてのチェックリストと気づきメモ，事前・事後学習に用いる記録様式などをまとめた電子媒体文書を配布した．スケジュールは，2 週間を1 クールとし，この初日で演習ポイントの説明し，その後，演習日までに11 日の期間を設け，学生はこの期間に自己・グループで事前の学習，技術練習をすることとした．実践の演習前後においては，教員がファシリテーターとなりプレブリーフィング，デブリーフィングを実施した．これらの内容で構成した本演習は，学生が演習後の臨地実習に十分に活用することに有効であったと考えられた．別稿では学生の立場で本演習の有効性を分析し，本稿と統合して評価し，新たな課題を見出し，より充実した健康レベル別看護技術演習を確立したいと考える．This study examined the implementation of health-level nursing skills exercises given to fourth year nursing students from the perspective of the teaching staff. The aim of the program was to teach students the basic skills required for nursing practice to improve the quality of life of patients and their families at various stages of health, with the goal of acquiring the nursing skills necessary for care in the acute, chronic, convalescent, and terminal phases of life. The exercises were planned by considering the appropriate timing, materials, examples, scenarios, and instructors for each of the 12 items, tailored to the four different health levels. As learning materials for the exercises, students were provided with an electronic document containing examples and scenarios for each item, a checklist, observation notes for use during the exercises, and recording forms for pre- and post-exercise learning. The schedule consisted of a two-week session. On the first day, a briefing on the key points of the exercise was given. This was followed by an 11-day period during which students were expected to engage in preliminary study and practice skills independently and in groups. Before and after the practical exercises, teachers acted as facilitators, conducting pre-briefings and debriefings. We hypothesized that this exercise structure would be effective in helping students apply the skills in their clinical practice afterward. We will analyze the effectiveness of this exercise from the students' perspective, integrate the findings with this study, evaluate the results, and identify new issues with the aim of establishing a more comprehensive nursing skills exercises program tailored to different health levels.departmental bulletin pape

投稿編集規定

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老年看護学実習前後における 看護学生の高齢者イメージの変化と影響要因

The objective of this study was to clarify changes in nursing students’image of the elderly after gerontological nursing practice and the factors influencing these changes. A questionnaire survey using the elderly image scale was carried out in 201 third-year nursing students at a nursing university before and after gerontological nursing practice in 2017-2019, and the responses were statistically analyzed. Eighty-eight students who responded before and after the practical training (valid response rate: 43.8%) were included in the analysis. The nursing students’image scores of the elderly showed changes after the practice except for cooperation. Furthermore, influencing factors on the image of the elderly included the practice facility with an impact on four factors: competence, activity/independence, well-being, and social extraversion, and the presence of aphasia or dysarthria affecting competence and activity/independence. It was revealed that students who practice in special nursing homes and those who care for the elderly with aphasia or dysarthria tend to have difficulty in positively changing their image of the elderly. To form a positive image of the elderly among students, the results highlight the importance of educational approaches for training instructors and faculty members to convey their own perceptions of the elderly to students, and to help students become able to focus on the elderly's strengths based on current conditions and life histories, in addition to consolidating and integrating gerontological nursing knowledge learned before the practice.本研究の目的は、老年看護学実習前後の看護学生の高齢者イメージの変化および影響要因を明らかにすることである。A 看護系大学2017 ～ 2019 年度の３年次の看護学生201 名を対象に、老年看護学実習前後に高齢者イメージ尺度を用いた質問紙調査を行い、統計的分析を行った。実習前後に回答があった88 名（有効回答率43.8％）を分析対象とした。看護学生の高齢者イメージ得点は、協調性を除き実習後の高齢者イメージが肯定的に変化していた。また、高齢者イメージへの影響要因として実習施設が有能性、自立・活動性、幸福性、社会的外向性の4 因子に影響し、失語症および構音障害の有無が有能性、自立・活動性に影響していた。特別養護老人ホームで実習した学生、失語症および構音障害のある高齢者を受け持った学生は高齢者イメージを肯定的に変化させにくいことが明らかとなった。本研究により、学生の肯定的な高齢者イメージの形成に向けて、実習指導者や教員は、自らの高齢者の捉えを伝える支援、高齢者の状態や生活史を踏まえた強みなどに着目できるための支援、加えて実習前に学んだ老年看護学の知識の定着と実践での統合ができるように支援するという教育的アプローチの重要性が示唆された。departmental bulletin pape

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