介護老人保健施設入居者への生活リズム調整援助の効果の構造

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看護職,介護職が認識している老健入居者の生活リズム調整援助の効果を面接から明らかにした。その効果の性質から,生活リズム調整の援助の意義は【生体リズムの回復】,【情緒・感情の活性化】,【基本的生活ニーズの充足】,【充実した交流】, 【自立】【自律】であると考えられた.そして生活リズム調整援助はその人固有の生活リズムを見出し支え拡張を促すという発展的(,) なプロセスとして考えられた。生活リズム調整の援助は,「その人が決めたその人らしい生活を送る」という自律を目指して実施されるが,高齢者の自律は段階的に実現するものではなく,その人の状態に応じて開示可能な自律性に援助者が着目することが重要であることが示唆された。一方職員への効果としても,ケアの質の向上,職員の心身の安定,業務の円滑な遂行といった援助目的が認識されており,入居者中心のケア提供を自己評価し自己改善していく必要性が示唆された。また老健という長期ケア施設では生活の目安への援助のみでなく過ごし方の充実が課題であると考えられた。The purpose of this study was to clarify the effects of nursing support aiming at adjusting older residents' rhythms of daily living by conducting interviews and to elucidate the structure of the effects. By examining the nature of the effects, significances of the nursing support aiming at adjusting the rhythms of daily living were considered to be:[recovery of the rhythms of daily living],[activation of emotions and/or feelings],[substantiality in basic life needs],[fulfillment in interaction with others],[independence], and[autonomy]. The support was also considered as the developmental process which finds out residents' peculiar rhythms of daily living, and encourages the expansion of their rhythm. Although the nursing support aiming at adjusting older residents' rhythms of daily living had the objective in achieving their autonomy i.e. ‘spending their life under their own decision'. Older people's autonomy would not achieved by proceeding step by step. Thus it was suggested that facility staff should turn their attention to the individual residents' releasable attributes of autonomy according to their condition. On the other hand, the effects for the facility staff from the nursing support aiming at adjusting older residents' rhythms of daily living were also acknowledged. The effects were found in the significances of care such as[improvement of the quality of care],[stability of mental and physical well-being],[better work performance]. It was also suggested that staff needed to evaluate and improve themselves' resident-centered care. Furthermore, it was considered as the future subject that nursing support in the geriatric health services facilities should not only be focusing on the aims of daily living, but also on the enrichment of how older residents spend their time.
2008-12-30

介護老人保健施設入居者への生活リズム調整援助の効果の構造

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