ニンチショウ コウレイシャ ニ カンゴガクセイ ガ イダイタ カンジョウ

本研究の目的は, 臨地実習で認知症高齢者を受け持った看護学生がどのような感情を抱いたのかを明らかにすることである. そして, 認知症高齢者を受け持つ看護学生の指導や支援の一示唆を得ることである. 8名の看護学生に対して臨地実習で認知症高齢者を受け持った際に感じたことについてインタビューし, KJ法を用い分析した. その結果, 【予期しない言動にびっくりする】【思いが通じなく, もどかしい】【受け入れてもらえて嬉しい】【一緒にいることが楽しい】【ケアのポイントに気付けて, 充実感がある】【認知症高齢者は可哀想】の6カテゴリーが抽出された. 認知症高齢者に攻撃的発言や拒否反応を示され, 困惑しながら看護学生は感情のコントロールをしていた. そのような学生には, まず感情を表出・認知させるような関わりが教員には求められる. そして感情が生じた根源や, 高齢者の心身の状態について学生と共に考える時間を持つことが必要であると考えた.The purpose of this study is to examine nursing students\u27 emotional feelings toward elderly persons with dementia and to discover how they change through clinical practice. Eventually it is hoped that the faculty can find some suggestions helpful in guiding and supporting nursing students assigned to care for elderly persons with dementia. Eight nursing students were interviewed and asked to describe how they had felt about elderly persons with dementia during their clinical practice. Their verbatim descriptions were analyzed through the Kawakita Jiro method (a.k.a. the affinity diagram method) and classified into the following six categories; "be surprised by unexpected behaviors", "feel frustrated when unable to communicate", "feel happy when accepted", "enjoy being together", "have a sense of fulfillment through learning the key to providing care" and "feel pity for elderly persons with dementia". The nursing students were trying to control their emotional feelings while perplexed by offensive remarks and refusals of elderly persons with dementia. They need to be supported by the faculty so that they can recognize and express their own emotional feelings. In addition, the faculty should have an opportunity for sharing the students\u27 reflection upon the source of their emotional feelings and the content of care

セイジン カンゴガク ジッシュウ オヨビ ロウネン カンゴガク ジッシュウ ニオイテ カンゴガクセイ ガ ケンガク マタハ ジッシ シタ カンゴ キホン ギジュツ ノ ジッタイ ガクセイ ニヨル ジコヒョウカ チョウサ ノ ブンセキヨリ

看護系大学一校の成人看護学実習および老年看護学実習における看護学生の看護基本技術についてその見学または実施状況を明らかにし, 今後の講義・演習の内容や, 実習カリキュラムと実習施設, 実習指導の在り方等を検討するための基礎資料とすることを目的に, 文献等から選定した看護基本技術118項目の「見学」または「指導者の助言・監督下で実施」について調査した. 同大学で領域別看護学実習を履修した4年生のうち協力の得られた79名(回答率98.8%)のデータを分析した結果, 成人看護学実習・老年看護学実習の全般において, 環境整備, 清潔ケア, バイタルサイン測定, 病態・症状観察等の看護基本技術を見学または実施した学生が過半数を超えた. 一方, 呼吸, 排泄, 与薬, 救急, 症状・生体機能管理, 感染予防面の看護基本技術の見学または実施は, 全体の4分の1程度にとどまった. 学生が, 多様な治療を受ける患者の看護を学ぶことを通し, 臨地実習の場で見学や実施したことを振り返り, そして現象を関連付けて理解できる実習を編成することの重要性が示唆された.The purpose of this survey is to identify the current status of fundamental nursing skills performed by nursing students in adult and gerontological nursing practicums incorporated as part of a four-year baccalaureate nursing program. There were 118 survey items about fundamental nursing skills selected from the related literature. For each fundamental nursing skill the respondents were asked to answer, "have observed demonstration of this skill", "have performed this skill under the supervision of clinical nurse instructors" or "have not had any chance for observation or performance". Seventy-nine senior students (response rate: 98.8%) agreed to fill in and submit the survey sheet. The survey showed that more than half of the respondents had observed demonstration of, or had performed under supervision, such fundamental skills as management of the environment of care (cleanliness and safety of hospital beds and rooms), personal and hygiene care, vital sign measurement, assessment and monitoring of signs and symptoms in either adult or gerontological nursing practicum, or in both. In addition, about less than one-fourths of the respondents reported that they had observed demonstration of, or had performed under supervision, skills like respiratory care, elimination care, medication, monitoring and maintenance of vital functions and infection control. These results indicate the importance of arranging nursing practicums in such a way that students can learn a variety of nursing interventions and clinical skills in diverse care settings. Furthermore, nursing students need to be encouraged to learn through observation, performance under supervision and reflection so that they can understand the meaning of a variety of interconnected phenomena

睡眠時無呼吸症候群患者の睡眠に関連した生活習慣の調査

SAS患者は日中の眠気や倦怠感などの疾患に起因する症状を紛らわすために睡眠にとって悪い習慣を取ってしまっている可能性が指摘されている。しかしSAS患者の生活実態は明らかになっていない。そこで本研究はSAS患者の生活習慣の実態を明らかにし、Apnea Hypopnea Index (AHI)、Epworth Sleepiness Scale (ESS)、Pittsburgh Sleep Quality Index (PSQI)、Body Mass Index(BMI)との関連を検討することを目的として行った。方法は質問紙およびAHIのデータをカルテより転載し、分析を行った。対象者は睡眠時無呼吸症候群と診断され治療前の方、56名を対象として行い、回収率は86%であった。AHI、ESS、PSQI、BMIと喫煙、飲酒、カフェインの摂取、睡眠時間などとの関連をみたところ、飲酒とBMIとの間に有意な関連がみられた。また喫煙とPSQIに有意な関連がみられ、睡眠の質が低いと評価している人ほど喫煙本数が多かった。睡眠時間とESSおよび希望睡眠時間と睡眠時間の差とESSの間に相関がみられ、SASによる睡眠障害だけでなく、睡眠時間の不足も問題である可能性があると考えられた。ベッドパートナーの有無が睡眠を阻害する因子になりうる可能性が示唆された。今回の対象者では治療開始前であったが、SASの治療の第一選択であるCPAP療法には家族のサポートも重要である。そのため今後ベッドパートナーの有無がCPAP療法にどのような影響を及ぼすのかについても検討していくことが重要であると考える。It has been pointed out that Sleep Apnea Syndrome (SAS) patients may have adopted life-styles which are poor for their sleep in order to alleviate symptoms that originate in disorders such as sleepiness and fatigue during the day. However, there is no clear evidence of what kind of maladaptive life-styles have been adopted by SAS patients. This research was therefore conducted with the aim of revealing the life-styles of SAS patients, and exploring the relationships between those life-styles and their correlation with the Apnea Hypopnea Index (AHI) data, the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and the Body Mass Index (BMI). It was conducted on 56 pre-treated patients diagnosed with SAS via analysis of questionnaires and AHI data from their medical records. The response-rate was 86%. An analysis of the relationships between the data derived from AHI, ESS, PSQI, and BMI to smoking, alcohol consumption, caffeine intake and sleeping hours showed a significant relationship between alcohol consumption and BMI data. Furthermore, a significant relationship was evident between smoking and PSQI data, with those who evaluated their sleep quality as poor smoking the most. A correlation could also be seen between sleeping time and the ESS data, and the difference between desired hours of sleep and actual sleeping time and the ESS data, indicating that not only sleep disturbance was caused by SAS, but also the lack of sleep time could be a problem. In addition, it was also suggested that the existence of a bed partner could be one factor disturbing sleep. While the subjects of this research had not yet been treated, family support is important to CPAP treatment. For this reason, it will also be essential to study the effect of a bed partner on CPAP treatment in the future