住民の援助ニーズに応じた地域ケアシステム構築における行政保健師の看護実践知の創出 : 研究成果のメタ統合
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概要
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本研究は,地域を受け持つ行政保健師の立場から地域ケアシステム構築に関わる活動方法及び役割に関連する論文の研究成果をメタ統合(Meta-synthesis)の手法によって統合し,行政保健師の看護実践知を新たな統合概念によって創出することを目的とした。Noblit&Hare, Barbara L.Patersonらのメタ統合(Meta-synthesis)の手法を参考に,千葉大学大学院看護学研究科の地域看護学教育研究分野の修士・博士論文から3論文を一次論文として選定し,知見の統合を試みた。統合の結果,15の知見に統合できた。これらの知見間の関係性をデータの文脈に沿って分析したところ,「援助ニーズをもつ住民一人ひとりに責任を持ち,関係者と協働して援助することを通じて,住民支援のための良質な地域ケアシステムを形成する」という主要な概念とそれに包含された5つの概念「住民一人ひとりのセルフケア力を高める援助の過程を通じ,非公的な支援システムをつくる」「住民一人ひとりのセルフケアカを高める援助の過程を通じ,保健福祉サービスの適切化をはかる」「外部支援者と協働して,在宅療養者を支援する過程を通じて,支援者同士の協働システムをつくる」「外部支援者と協働して,在宅療養者を支援する過程を通じて,援助ニーズを持つ特定集団を把握し,そのニーズを満たすために保健福祉サービスの適切化をはかる」「外部支援者と協働して,在宅療養者を支援する過程を通じて,援助ニーズを持つ特定集団を把握し,医療・看護サービスの質向上を図る」が見出された。The present study identified newly integrated concepts related to the establishment of care systems for community members from the practical knowledge of public health nurses in administrative settings. This study was carried out in accordance with a novel method of meta-synthesis, incorporating meta-ethnography (Noblit & Hare) and meta-study (Paterson & Thorne). From community health nursing-related theses at the Chiba University School of Nursing, 3 original articles were included in the meta-synthesis. These articles focused on the role and practices of public health nurses in administrative settings. Meta-synthesis of the theses identified 15 findings. Through the analysis of the relationships between these findings, we identified a major concept consisting of 5 sub-concepts. The major concept is the establishment of high-quality care systems for community members, through the process of supporting, and providing responsible and individual care to community members by cooperating with various concerned individuals. The following 5 sub-concepts were contained in this major concept. 1. The establishment of an informal support system through the process of enhancing individuals' self-care abilities. 2. The establishment of health and welfare administrative services available for all community members through the process of enhancing individuals' self-care abilities. 3. The establishment of a formal home care support network comprised of various concerned individuals. 4. The assessment of specific communities' needs and the establishment of health and welfare administrative services in order to address these needs through the process of home care with various persons concerned. 5. The assessment of specific communities' needs and the improvement of the quality of nursing services by various concerned individuals involved with the process of home care.
- 2005-12-30
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