看護師が関わりに困難さを感じる認知症高齢者との対人交流場面の様相

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  • Aspects of Interpersonal Exchange Situations with Older Adults with Dementia for Which Clinical Nurses Feel Difficulty
  • カンゴシガセキ ワリニ コンナン サ オ カンジル ニンチショウ コウレイシャ ト ノ タイジン コウリュウ バメン ノ ヨウソウ

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本研究の目的は，交流分析を用いて看護師が関わりに困難さを感じる認知症高齢者との対人交流場面の様相を明らかにすることである。介護療養型医療施設に勤務する看護師を対象に，看護師自身のエゴグラム，関わりに難しさを感じる認知症高齢者１名の推定エゴグラム，関わりに困難さを感じた場面を調査した。看護師のエゴグラムと関わりに難しさを感じる認知症高齢者の推定エゴグラムは，ともに支配的親の自我状態が高く，批判しあう交流になりやすいことが推察された。看護師が「関わりにくい高齢者」との関わりに困難さを感じた場面は，お互いの意図がくい違う交叉的交流や言葉と言葉の奥に隠れた意図が異なる裏面的交流であった。相手が発信した自我状態へ返信する相補的な交流となるよう，ニーズに合わせて対応する治療的コミュニケーションが看護師に求められることが示唆された。　The objective of this study is to clarify the aspects of interpersonal exchange situations with older adults with dementia for which clinical nurses feel difficulty, using transactional analysis. A survey was conducted against clinical nurses working in a medial long-term care sanatorium to research the followings : 1. egogram of clinical nurses, 2. estimated egogram of one older adult with dementia, 3. scenes in which difficulty was felt. It was assumed that both the nurses' egogram and the estimated egogram of older adults with dementia for which difficulty of building relationship was felt were high in dominant parent ego-state and that they tended to be critical each other. The scenes in which the nurses felt difficulty in getting themselves involved with "hard-to-handle older adults" were : crossed transaction in which mutual intentions differed ; ulterior transaction in which their covert intentions were different from each other deep behind the exchanged words. It was suggested that therapeutic communication was expected for the clinical nurses corresponding to the needs in order to make a complementary transaction which would respond to the ego-stage the other party would express.

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