観血的治療を受ける高齢大腿骨頚部骨折患者の回復過程と看護援助に関する研究
スポンサーリンク
概要
- 論文の詳細を見る
研究目的は,大腿骨頚部骨折で観血的治療を受ける高齢患者の心身の回復過程における特徴を明らかにし,患者の自立的生活支援と再骨折予防への看護援助を検討することである。65歳以上の研究協力を得た11名を対象に,大腿骨頚部骨折患者の入院から退院1ケ月までの期間に,看護援助並びに参加観察と面接によるデータ収集を行い,KJ法による質的・帰納的分析によって以下の結論を得た。観血的治療を受ける高齢大腿骨頚部骨折患者の言動から抽出された心理的特徴は,『心的衝撃』『骨折原因探索』『行動制限がもたらす心的苦痛』『療養環境による心的苦痛』『治療への構え』『生の断念・死への近づき』『社会的依存ニード』の7項目で,入院期,手術期,リハビリテーション(以後リハビリ)期,退院1ケ月期毎に心理的特徴間の関連は変化していた。高齢患者の自立的生活に向けた回復への援助には,特に以下の看護援助が重要である。『骨折原因探索』に関する患者の性格傾向をアセスメントし,患者が,入院期間に自己の生活習慣を調整し,再骨折予防法を学習する機会となるよう指導する。入院早期から,筋力低下予防訓練を行い,疼痛を緩和する。患者の身体的特性に適した,退院後も継続可能なリハビリ目標を設定し,患者を含めた家族とともに,退院後の環境,社会資源の活用について検討する。The aim of this research was to clarify the characteristics, both psychological and physical, involved in the recovery process of elderly patients who underwent surgery for femoral neck fractures (FNF), and to study the best way of helping them get back to leading an independent life and preventing re-fracture through professional nursing care. The subjects consisted of 11 patients aged 65 years or older, undergoing surgery for FNF who had agreed to participate in the study. From admission to one month after being discharged from the hospital, data was collected on their nursing care, by means of participative observation and interviews, and a qualitative and inductive analysis was performed using the KJ method and the following conclusions reached: from the behavior of these elderly patients undergoing surgery for FNF, seven salient features in their psychological make-up could be extracted, mental shock; a search for the cause of their fracture; mental distress caused by limited mobility; mental distress due to the hospital environment; a mental stance toward their treatment; a sense of giving up on life or getting closer to death and a need for social-dependence. However, during hospitalization, surgery, rehabilitation and the one month period after discharge from hospital, changes in how these psychological features were related occurred. With regards to supporting these elderly patients in their recovery, the following nursing care in particular is essential: for those patients "searching for the cause of their fracture" tendencies in their personality should be assessed and they should be instructed to see their period of hospitalization as a chance to control their lifestyle and to learn how to prevent a second fracture from occurring. From early on in their hospitalization, muscle strength should be built up and their pain alleviated.
- 2002-06-30