脳血管障害後のうつ状態の患者への看護過程の発展をもたらすアセスメントにおける看護者が描く像に関する文献研究
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研究目的は,脳血管障害後のうつ状態からの回復を支援する看護実践が記述された文献を対象に,脳血管障害後のうつ状態からの回復を支援する看護過程を展開するためのアセスメントの際に描かれた看護者の像を明らかにし,描き方の特徴を導き出すことである。医学中央雑誌による検索を行い評価選定の後,3文献を分析対象とした。文献の記述から,看護過程展開とそのときのアセスメントを再構成し,うつ状態の局面ごとに看護者のアセスメントを再構成し分析素材を作成した。分析では,看護過程展開の再構成から,看護過程の性質をひき出し,脳血管障害後のうつ状態が回復し,看護過程が発展していることを示した。次いで,その看護過程を展開した看護者に描かれた像を明らかにした。3文献から得られた,脳血管障害後のうつ状態の患者への看護過程の発展をもたらす看護者に描かれた像から,【発症後からの生活と社会関係の変化のプロセスを患者の位置からたどり,心理的側面とのつながりの像を描く】【うつ状態になった患者の自己イメージの形成過程を描く】【日常生活行動の実際と,その体験を患者が認知することで患者に生じる感情とのつながりを描く】【患者には力があるという視点を持ち,その力を生活過程の中から探る】【うつ状態とその他の類似の症状とは健康障害の違いとして区別して描く】【急性期の器質的なうつ状態と,回復期の環境の変化やストレスの増大による反応性のうつ状態とを,健康の段階の違いとして描く】という描き方の特徴が導き出された。The purpose of this study was to clarify the image of nurses imaged in the assessment to develop a nursing process to support persons suffering from depression after cerebrovascular disease in their recovery, and to derive features regarding description by analyzing publications that imaged practiced nursing care to support persons suffering from depression after cerebrovascular disease in their recovery. After searching Igakuchuozassi and making evaluative selections, three publications were targeted for analysis. From the description in the publications, the development of the nursing process and the assessment at that time were reorganized, then according to the aspects of the state of depression, the assessment of nurses was reorganized and analysis materials were created. In the analysis, based on the reorganized nursing process, the nature of the nursing process was brought out, and it was shown that the state of depression after cerebrovascular disease could be improved and the nursing process developed. Next, the image which imaging nurses that developed the nursing process was also clarified. From the image which imaging nurses that developed the nursing process for patients suffering depression after cerebrovascular disease, that was obtained from the three publications, features regarding the description are: 1) Follow the process from onset of changes in life and social relationships from the position of the patient, and image the connection from the psychological side, 2) Image the process of the formation of the self-image of the patient suffering from depression, 3) Image the connection with patient's feelings occurred by recognizing actual daily life behavior and experiences, 4) Keep the point of view that the patient has power, and search for such power in the daily life process, 5) Image depression and similar symptoms so that it is clear that they are different types of health disorder, 6) Image the acute organic depression and reactivity of depression of convalescence caused by･･･
- 2007-12-30
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