患者の語りから看護学生が捉えた慢性疾患を持つ人の看護 : 腎センター実習記録内容の分析から

本研究では、腎機能障害を持つ患者の語りから学生が捉えた慢性疾患を持つ人の看護を明らかにすることを目的に、腎センター実習での記録内容を分析した。その結果を以下に示す。1.慢性疾患を持つ人の看護として、対象を理解し看護師の役割やチームアプローチの必要性、社会資源の活用の必要性を学んでいる。2.対象の理解では、患者の疾患や透析の受け止め方、受容過程、セルフケアの状況、家族との関係性、社会的役割の変化、患者間の影響、また家族については心理面や協力体制について理解している。3.透析療法における看護師の役割では、精神面への支援、セルフケア確立に向けての指導的役割、家族への支援、自己実現への支援、透析看護における専門性と役割、リスクマネージメント、倫理面、環境面への配慮が必要と捉えている。4.学生は、透析における治療の意義や慢性疾患の特徴、心理的特徴を捉えセルフケアの意義や家族の役割を踏まえ本人・家族への支援、自己実現への支援のあり方、看護観、生きることなど学んでいた。In this study,we analyzed record contents from the kidney center training for chronic disease patients that a student ascertaned from talks with a patient who had renal function disorder clarifying the nursing of the person which was necessary. The following resaults were obtained. 1. As for the nursing of chronic disease patients , I understand an objective throughout the life is learning the necessity of a team approach of a nurse this, and the necessity of practical use of social resources. 2. By the understanding of objective, the situation for self-care, a relationship with the family, the change of social roles, influence between patients understand psychological side of the cooperation system about the family of the patient with disease and exbechations to how to stop dialysis, a reception process. 3. Support, of the pyschological mind side, the leadership role towards self-care establishment, family support, self-realization support specialty the dialysis nursing role, risk management, an ethical, considerations to along with environment issues a nurse to in dialysis medical treatment will need. 4. Regarding what students learned, I found a signiticance towards treatment in dialysis and the characteristic of the chronicity, as of psychological characteristis and learned the significance of self-administration support to the person himself an his family, an ideal method of the support towards self-realization

本学看護学科卒業生の看護活動に関する看護管理者の評価

本学の1～8期生の卒業生が就職している医療施設の看護部長および新卒看護師の職場の直属の上司を対象に卒業生の看護活動について調査を行い、以下のことが明らかになった。1.『看護部長』は本学の卒業生の看護活動に関する「勤務態度」、「知識・技術の専門性を高める意欲」、「職場に必要な人材価値」について、いずれも概ね肯定的な評価をしていた。また、本学卒業生に「不足していることや気になること」として、「組織が期待する行動ができる」とする肯定的な評価と「専門職に期待される行動の不足」を指摘していた。2.『上司』が新卒看護師について「不足していることや気になること」は、「専門職に期待される行動の不足」が最も多く、次いで新卒看護師に対する「肯定的な評価」、「看護技術の実践・修得の不足」、「自己管理の不足」、「他者との関係形成の不足」であった。3.『看護部長』と『上司』は本学の教育に対して共に「専門職・社会人としての人材育成」を要望していた。I conducted a survey on nursing activities of graduates with the directors of the nursing department in the medical institution where 1 st to 8th year graduates and their immediate supervisors are working, and found the following. 1. The directors of the nursing department gave an affirmative evaluation mostly on "Work attitude", "Willingness to improve their knowledge and skill" and "Value of human resources required in the work place" in respect to the nursing activities of our university graduates. With regard to "points to be concerned about" involving our graduates, they gave an affirmative evaluation on "Being able to act on the expectation of the organization", and pointed out the lack of behavior as experts. 2. Among the remarks relating to "points to be concerned about" of newly graduated nurses by their immediate supervisors, "Lack of behavior as experts" had the highest percentage, and "Affirmative evaluation", "Lack of practice and acquirement of nursing skills", " of self-control", and finally, "Lack of communication skills. 3. The directors of the nursing department and the immediate supervisors requested us to promote "the cultivation of human resources as an expert and a member of society" in respect of our university education

新卒看護師の看護実践能力の実態と傾向 : 本学卒業の新卒者の自己評価と上司による他者評価から

大学教育における卒前教育のプログラム開発への基礎資料を得るために、新卒看護師の11ヶ月時点を対象に大室らの「大卒看護師の看護実践能力の到達度評価100項目」を用いて看護実践能力評価を実施した。その結果、看護実践を行う卒業生とその職場の上司から看護実践能力評価の差異が確認された。新卒が有意に高く評価していた内容は、領域では、患者の自己決定を尊重することができる等3項目、領域では、罨法など心身に必要な安楽促進ケア、口腔ケアができる等17項目であった。領域では、新卒と上司の間に明らかな差異は認めなかった。また看護実践能力の大室らと本学新卒の調査結果を比較すると30%の差がみられた項目は、「個別性の高い看護計画を立案できる」、「医師や他の医療者に、自分の考えを表現できる」の2項目であった。To get a basic document for developement of the program for the front education before graduation in the university, we used "100 items of the evaluation of achievement in the nursing practice ability of the university graduate nurse" by Omuro, and carried out the evaluation of the nursing practice ability for an object of the new college graduate nurse in the 11 monts\u27 carrier. As a result a differnce was recognized in the evaluation between the graduate nurse who is practicing nursing and her bosses at her workplace. The things the new college graduate significantly highly evaluated were 3 item-they could respect the patients\u27 self-decision, etc. in the domain of "knowledg

Iintention of nurses to continue working in long-term care establishments

【目的】介護サービス事業所における看護職の職業継続意思の実態を明らかにする.【方法】Ａ県介護サービス事業所529施設の看護職を対象に横断的質問紙調査を実施し，回答の得られた305（有効回答率57.7%）を分析対象とした．【結果】継続意思あり67.2%，なし32.8% であった．転職を希望する理由は，勤務体制の不満が最も多く，次いで施設看護の難しさ，健康上の理由が多かった．継続意思がなかった者は，こころの健康状態がよくない，身体的健康状態がよくない，仕事以外の悩みあり，他職種間協力なし，スタッフ間の情報交換なし，上司が要望をきいてくれない，施設管理・ケアの指導マニュアルを知らない，職場外での認知症研修受講なしと答えた者が多かった．【結論】対象者の約３割は職業継続意思がなかった．職員の職場定着への対策として，個人の健康，職員間の良好な関係，施設管理・認知症を含めたケアの理解促進等，労働環境及び教育体制整備の重要性が示唆された．Purpose: To clarify the actual status in regard to the intention of nurses to continue working in long-term care establishments.Methods: An anonymous questionnaire cross-sectional survey was conducted of nurses working in 529 long-term care establishments in prefecture A, and 305 valid responses were retrieved (valid response rate: 57.7%).Results: The percentages of respondents with and without the intention to continue were 70.6% and 29.3%, respectively. The most common reason for desiring a career change was dissatisfaction with the working conditions, followed by difficulty in providing institutional care, and concerns about one’s own health. The most common reasons for the lack of intention to continue were “unfavorable mental health status,” “unfavorable physical health,” “worries besides work,” “no cooperation with other professionals,” “no exchange of information among staff members,” “superiors not listening to requests,” “no knowledge of the guidance manuals for institutional care management,” and “have never attended training on dementia care outside the workplace.”Conclusions: About 30% of respondents indicated a lack of intention to continue. These results suggest the importance of improving the working environment and training systems (e.g., individual health, good relationships among staff members, and promotion of understanding of institutional care management, including dementia care) as measures for securing a sustainable workforce in the long-term care sector

Support from nurses leading to improvement of dialysis patient\u27s motivation in their health management

透析を受けている患者の健康管理上の意欲向上につながった看護師のサポートを明らかにすることを目的に,透析を受けている5名の患者を対象に半構造化面接調査を行った.その結果,透析を受ける患者の健康管理上の意欲向上につながる看護師のサポートを表す以下の6カテゴリー【相互交流がもたらす情緒的サポートの体験】,【指導的な関わり】,【信頼できる存在】,【友人のような存在】,【患者と医療者の交流】,【患者同士の交流の促し】が導き出された.患者の意欲を支えていることとして,情緒的な支援が多く挙げられていた.全人的に患者を理解しようとする看護師の姿勢は,患者にとって,時に友人や仲間のような存在として受け止められていた.正確な知識・技術に対する信頼に加え,患者と医療者,患者同士の交流の中での関わりや1人の人間として患者を支える姿勢が健康管理上の意欲向上に重要であることが示された. A survey by semi-structured interviews was conducted on 5 patients undergoing dialysis therapy to clarify the support from nurses that leads to improvement of patient\u27s motivation in health management while under dialysis therapy. Subsequently, the following 6 categories emerged as representative of support related to the improvement of patient\u27s motivation : "experience of emotional support based on mutual exchange,""guiding relationship,""trust,""friendship,""interactions between patients and medical personnel,"and "encouragement of interactions between patients."Emotional support was often cited assupporting patient\u27s motivation. The attitude of nurses, who try to understand patients holistically, is sometimes perceivedby patients as being like that of a friend or peer. In addition to reliance in relation to accurate knowledge and technical skills, involvement in the interaction between patient and medical personnel and between patients themselves and an attitude that supports patients as individual human beings were shown to be important from the standpoint of improving motivation in terms of health management