要介護高齢者の排便ケアに対する家族介護者の順応の状況とその関連要因

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  • ADJUSTIVE CONDITIONS TO BOWEL ELIMINATION CARE AND RELATED FACTORS IN FAMILY CAREGIVERS OF ELDERLY ADULTS
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Abstract

本研究の目的は,要介護高齢者の排便ケアに対する家族介護者の順応の状況とその関連要因を明らかにし,排便ケアを必要とする要介護者の家族介護者に対する看護の方向性について検討することである。訪問看護サービスを利用している高齢者の排便ケアを行っている家族介護者11名を対象に半構成的面接等を実施し,面接内容を逐語録に起こしたものを質的帰納的に分析した。家族介護者の排便ケアに対する順応の状況は,《排便ケアを要する要介護者の状況を受け入れる》《便に対する生理的嫌悪感・抵抗感が和らぐ》《排便ケアの手際を会得する》《要介護者の排便をコントロールする》《他者の協力を得ながら排便ケアに取り組む》《排便ケアを訪問看護師に完全に委ねる》の6カテゴリーにまとめられた。《排便ケアを要する要介護者の状況を受け入れる》という【認知面の順応】には『時間の経過』と『要介護者の障害の理解』が,《便に対する生理的嫌悪感・抵抗感が和らぐ》という【情緒面の順応】には『排便ケアの経験の蓄積・慣れ』が,《排便ケアの手際を会得する》という【技能面の順応】には『排便ケアの経験の蓄積・慣れ』と『排便ケアに関する学習』が,《要介護者の排便をコントロールする》《他者の協力を得ながら排便ケアに取り組む》《排便ケアを訪問看護師に完全に委ねる》からなる【排便への対応の仕方の確立】には『会得した排便ケア内容』『排便ケアのサポート体制』が関連していた。

This study sought to clarify adjustive conditions in family caregivers in respect to bowel elimination care for elderly adults, and related factors. Semi-structured interviews were conducted with 11 family caregivers caring for elderly adults with bowel dysfunction. Interviews were taped, transcribed, and then analyzed qualitatively. The adjustive conditions for family caregivers in respect to bowel elimination care involved: 1) accepting the conditions of elderly adults who required bowel elimination care, 2) alleviating antipathy and resistance to feces, 3) achieving skill in bowel elimination care, 4) controlling bowel movements of elderly adults, 5) working on bowel elimination care by enlisting help of others, and 6) entrusting bowel elimination care completely to home care nurses. “Accepting the conditions of elderly adults who require bowel elimination care"as cognitive adjustment was promoted by the course of time and an understanding of the elderly adult's disorder. “Alleviating antipathy and resistance to feces" as emotional adjustment was promoted by accumulating experience and getting used to bowel elimination care. “Achieving skill in bowel elimination care" as skill adjustment was promoted by learning about bowel eliminationcare, as well as by accumulating experience and getting used to bowel elimination care. “Controlling bowel movements of elderly adults",“Working on bowel elimination care by enlisting help of others", and “Entrusting bowel elimination care completely to home care nurses" as the establishment of ways to deal with bowel elimination were affected by acquiring the particular skills applicable to bowel elimination care and by having support for their bowel elimination care.

source:Journal of Chiba Academy of Nursing Science

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