老人保健施設の在宅支援機能と関連する因子および取り組みに関する文献検討:1987-2010年  [in Japanese] Factors and approaches related to home support in health facilities for the elderly : a review of literature between 1987 and 2010 in Japan  [in Japanese]

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Abstract

本研究の目的は,老人保健施設の在宅支援機能と関連する因子および取り組みに関する文献検討を行い,在宅支援機能を高めるための研究課題を明らかにすることである。データベースは医学中央雑誌,検索期間は1987-2010年,検索語は「老人保健施設×(在宅復帰,家庭復帰,在宅支援,家庭×退所等)」,論文の種類は原著論文,総説,解説とした。関連する要因に関し,11文献を抽出した。入所者・家族,老人保健施設,地域各々の特性および在宅サービスの利用に関して検討しており,複数の報告に見られた在宅復帰の促進要因は,入所元が家庭である,移動能力あるいはADLが高い,認知症が重度ではない,子供との同居,入所期間が相対的に短いこと,定期的短期入所の利用であった。一方,施設の取り組みに関する文献は6件,うち5件は2000年代の報告であった。施設の在宅復帰率は50-80%と比較的高く,共通して施設の方針として在宅支援を明示し,在宅支援の取り組みとして,家族との信頼関係・協力,チームケアをあげ,家族とのきめ細かいコミュニケーション,多職種のケア目標や利用者の状況変化の共有,さらに在宅サービスとの連携による円滑な在宅移行に取り組んでいた。以上の結果から,利用者の身体・精神的状態を整えることと適切な入所期間との両立が期待され,家族および老健内外の多職種連携による在宅支援方法に関する検討が必要と考えられた。

The purpose of this study was to examine factors and approaches related to home support in health facilities for the elderly based on a literature review, and clarify issues concerning improving home support. The Ichushi-Web was employed as a database between 1987 and 2010. We searched the database using "health facilities for the elderly" × ("return home", "home support", etc.) as keywords, involving original articles, reviews, and comments concerning the type of article. As for factors, eleven articles were reviewed. They examined the characteristics of users and family caregivers, facility or region-related factors, and the use of in-home services. Factors facilitating the home return, which several articles reported, included residing at home before admission, higher level of ADL or having no severe cognitive impairment in users, living with children, shorter period of admission, and periodical use of short-stay care. Meanwhile, approaches in facilities were reported in six articles, consisting of five articles after 2000. In these facilities, 50-80% of subjects returned home. They clearly pointed out home support as a policy in facilities. Regarding approaches of home support, they pointed out trusting relationships and cooperation with the family, and team care; and detailed communication with the family, sharing of caring goals in various types of medical field and users' conditions, and, in addition, a smooth shift to home care in coordination with home care services. Based on these studies and practices, it is necessary to managing both care for physical and mental condition of users and period of admission, and to discuss a model of interprofessional care for home care support including coordination with the family and home care services in health facilities for the elderly.

Journal

  • 千葉看護学会会誌

    千葉看護学会会誌 17(1), 61-68, 2011-08

    千葉看護学会

Codes

  • NII Article ID (NAID)
    120005929760
  • Text Lang
    JPN
  • Article Type
    journal article
  • ISSN
    1344-8846
  • Data Source
    IR 
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