介護老人保健施設における認知症ケアガイドラインの開発  [in Japanese] Development of Guidelines for Dementia Care in Geriatric Health Service Facilities  [in Japanese]

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Abstract

本研究は,介護老人保健施設に適用できる認知症ケアガイドラインを開発することを目的とした。看護・介護職員594人に調査票を配布し380人の有効回答を分析した。認知症ケアガイドラインの因子モデルは「安心を高める環境づくり」「生活の継続性への支援」「その人の潜在能力を引き出す支援」「安全に社会とのつながりをもてる暮らしへの支援」「家族との協働を含めた一貫したケア」「家庭での療養への移行に向けた支援」を一次因子,「認知症高齢者ケア」を二次因子とするモデルとし,その構成概念妥当性を因子モデルと外的基準(仕事満足度)との関係において構造方程式モデリングで検討した。その結果,6因子29項目で構成したガイドラインの因子モデルのデータへの適合性,ならびに認知症高齢者ケアと仕事満足度の関係が統計学的に支持された。この認知症ケアガイドラインは,介護老人保健施設の認知症ケアの質確保に有効に機能することが示唆された。

The purpose of this study was to develop dementia care guidelines that can be applied in geriatric health service facilities. Questionnaires were distributed to 594 nurses and professional caregivers working in geriatric health service facilities, from which 380 valid responses were obtained and analyzed. A second-order factor model was used in this study, comprising "creating an environment where residents can feel safe and at home," "support for residents in maintaining the lifestyle that they had at home," "helping residents maximize their remaining abilities," "helping residents remain connected to society," "consistent and coordinated care including cooperation with residents' families," "support for shifting to home care" as first-order factors, and "care for demented elderly people" as a second-order factor. The construct validity of the guidelines was assessed in terms of the relationship between the factor model and an external criterion (job satisfaction) using structural equation modeling. As a result, the fitness of the factor model comprising six factors and 29 items to the data and the relationship between dementia care practice and job satisfaction were statistically supported. These results suggest that the dementia care guidelines developed in this study are effective in ensuring the quality of dementia care in geriatric health service facilities.

Journal

  • Journal of Japan Society of Nursing Research

    Journal of Japan Society of Nursing Research 35(4), 4_75-4_81, 2012

    Japan Society of Nursing Research

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