カンゴ カンリシャ ノ ショク セイカツ ノ ジッタイ ト ショク ヘノ エンジョ ノ カンゴ カンリ

看護管理者の食生活の実態と、患者の食への援助の看護管理の実態を明らかにするため、100床以上の全国の一般病院(108施設)の看護管理者を対象に食意識・食行動・食への援助に関する自記式質問紙と簡易型自記式食事歴法質問票(BDHQ)を用いた調査を行った。調査に協力が得られた看護部長89人(回収率82.4%)、看護師長554人(回収率60.9%)のデータを分析した結果、看護部長と看護師長は、ともに食意識が高く、食意識は食行動や食物摂取にも関連していることが明らかになった。患者の食への援助では、看護部長・看護師長ともに食への援助の意識が高く、食が患者の健康や疾病治癒に及ぼす影響を認識していた。看護師長の入院患者に対する食への援助では、患者個々に見合った食事指導の確認や、食に関する勉強会や研修会開催への働きかけ、看護師が行う食事準備・食事介助・後始末の確認の実施割合が低いことが分かった。一方、食意識と食への援助とは関連が見られ、良好な食生活を送っていると自負している看護師長は、食への援助の看護管理に積極的な傾向が見られた。本研究では、看護管理者が自分自身の食生活を整えることが患者の食への援助に関する看護管理にも好影響を与えることが示唆された。十分とは言えなかった食への援助に関する看護管理をどのように日常業務の中に組みこんでいくかが今後の課題である。The aim of the research is to investigate the patterns and the degree of dietary awareness of nursing administrators. The target nursing administrators included directors of nursing and head nurses from 108 hospitals with more than 100 beds for the general patient population. The survey was conducted using a questionnaire of attributed information; the way of thinking about food, dietary behavior, and a brief-type self-administered diet history questionnaire (BDHQ) for food and nutritional intake. The number and rate of responding were 89 (82.4%) for directors of nursing and 554 (60.9%) for head nurses. The result showed that nursing administrators had high levels of dietary awareness which also significantly supports the correlation between their higher standards of dietary/eating habits and behaviors. Regarding the patients nutritional assistance, it is clear that nursing administrators were aware that diet is deeply related to the patients\u27 overall health and recovery. Although nursing administrators recognize the importance of dietary/nutritional assistance, "unsatisfactory performance in the supervision of actual dietary intervention by nurses for the patients", "inadequate number of training workshops on diets", and "poorly-supervised meal services and assistance/cleanups by nurses" have been observed. On the one hand, those who had higher awareness levels of their own eating habits and dietary routines, showed that they also tend to have good dietary habits, and better attitudes and were more diligent toward the management of a nursing practice of diets. The research suggests that, by revising the dietary habits of the nursing administrators, it will create a more positive impact on patient dietary support. It should now be our future objective to engage in adequate dietary support within daily nursing administrative routines

ニンチショウ カンゴ ニンテイ カンゴシ キョウイク カテイ ニオケル キョウイク ト ジュギョウ ヒョウカ ノ ブンセキ

認定看護師教育課程 認知症看護認定看護師コース(以下、本教育課程)の教育実践を振り返り、今後の課題を検討した。今回、授業評価を実施した研修生20名の認知症看護経験年数は平均10.4±4.45年であり、本教育課程を受講した理由の大半は自己の学習ニーズ(16名)であった。研修生の本教育課程に対する期待には「臨床実践に沿った講義内容」があり、修了生による臨床に即した実践内容を含んだ授業の工夫が必要であると考えられた。研修生は「認知症ケアを自己の言語で伝えられるようになりたい」という目標を持つ者が多く、本教育課程で看護過程の展開技術を重視した学習プログラムはニーズに一致していた。研修生は自己の目標達成において病院実習の有効性を高く評価していたが、満足度は低い傾向を示した。特に、受講理由が施設長等の勧めである研修生にその傾向が認められた。よって、入学前に研修生が自己を振り返る課題を課し、本教育課程での学びのイメージを高めさせ、認定看護師の研修の質の向上を図ることが課題に挙げられた。The purpose of the research was to look back upon the educational practice of the course for certified nurses in dementia nursing of the curriculum for of certified nurse education, (hereafter referred as to "this education course") and discuss tasks for future use. The average number of years of experience in dementia nursing for the 20 trainees of whom the class evaluation of this education course was implemented was 10.4±4.45, and the reason for attending this educational course was for the majority, a fulfillment of their own learning requirements (16 trainees). Their expectations for this educational course included the "contents of lectures consistent with clinical practice." Therefore, it was considered necessary to contrive the class in line with the clinical practice of those who have already completed this educational course. There were many trainees who had the target of "conveying dementia care in their own words," which showed that a learning program with emphasis on developing technology for the nursing process matched their needs. Although the trainees highly evaluated the eff ectiveness of hospital practice for their target achievement, they showed a low degree of satisfaction. This trend was significant among those who attended this educational course at the encouragement of the chief of their facility, in particular. Therefore, the benefit of indicating the tasks before they attend this educational course, in order to make them refl ect on themselves, enhance their image of learning in this educational course. Improving the quality of training for qualified nurses was also clarified

コウレイシャ リカイ ニオケル ガクセイ ノ マナビ ノ シテン ニ カンスル ケンキュウ

本研究の目的は、看護学生1年生がどのような視点から高齢者を理解しているのかを明らかにすることである。学生へ祖父母など身近な高齢者の生活の現状や生活史に関するインタビューを課し、その課題レポート116部を分析対象とした。複数の研究者で課題レポートにおける学びの視点を質的に検討した結果、8つの学びの視点が見出された。学生は、《インタビュアーとしての立場に立つ》ことで倫理的感受性が高まっており、インタビューによる教育効果を確認することができた。また、学生は一人の生活者として《現在の自己と重ねる》、《自己の将来を見据える》ことで、高齢者の強みを見出すことができていた。一方、学生は《高齢者の話を自己の価値観で解釈する》こともあり、自己の価値観や思考、感情を意識的に振り返り、事実と解釈の違いを理解することが重要であると考えられた。しかしながら、学生は高齢者が移りゆく時代背景や病気体験に対する《高齢者自身の解釈を知る》、《既存の高齢者像と照らし合わせる》ことで、豊かな高齢者像を描くこともできていた。以上のことから、学生は自発的な学ぶ視点で高齢者を理解しており、今後の教育過程において育みたい視点であると示唆された。The aim of this study was to elucidate from what viewpoints first-year nursing students have in understanding elderly people. We gave the students assignments to hold interviews with their closely related elders, people such as grandparents and ask them about their living conditions and histories, and then analyze 116 submitted reports. Multiple researchers qualitatively evaluated the students\u27 viewpoints for learning in these reports and identified eight such viewpoints of learning. The students\u27 ethical sensitivities were enhanced by `learning as interviewers\u27, allowing us to confirm the educational eff ect of an interviewing assignment. The students were able to recognize strong points of elders by "identifying the present state of the students with their stories" and "hearing such stories with an awareness of their own futures" as individuals. However, the students occasionally "interpreted the stories of the elderly people based on their own values", suggesting that it would be important to consciously reflect on one\u27s own values, conscious awareness, and personal feelings to better understand the difference between fact and interpretation. As a result, the students succeeded in forming a positive image of elderly people by "knowing their interpretations" of the changing times, background, and illness experiencing and "comparing this with the conventional images of elderly people". Thus, the students learned through their voluntary viewpoint, a better understanding of elderly people, suggesting that it is important `for teachers to just follow these spontaneous actions of students\u27