在宅精神障害者を支援する訪問看護師が抱える困難感─虐待とグレーゾーンの狭間で─  [in Japanese] Difficulty of visiting nurse who responds to inappropriate nursing care by carer to home mentally handicapped  [in Japanese]

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Author(s)

    • 森田 牧子 Morita Makiko
    • 首都大学東京大学院人間健康科学研究科看護科学域 Department of Nursing sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University
    • 山村 礎 Yamamura Motoe
    • 首都大学東京大学院人間健康科学研究科看護科学域 Department of Nursing sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University
    • 習田 明裕 Shuda Akihiro
    • 首都大学東京大学院人間健康科学研究科看護科学域 Department of Nursing sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University

Abstract

本研究は在宅精神障害者を支援する訪問看護師が,虐待まで至らない不適切な介護に対応する中で生じる困難感について,その実態を明らかにすることを目的とした。全国訪問看護事業協会に登録している訪問看護ステーションの訪問看護師を対象に自由記載質問紙調査を実施した。136 名の看護師から回答が得られ,質的帰納法を用い分析を行った。その結果,不適切な介護を認識した看護師に生じる困難感として,看護師は【問題とする事実を表面化する難しさ】【虐待者と被虐待者に同時にケアする難しさ】を感じ,家族と関係構築が出来ているために生じる【虐待者に感情移入してしまう】困難を覚えながら訪問を行い,【介入することのためらい】【多職種と認識を共有できないジレンマ】を感じていた。虐待のグレーゾーンという状況に介入する上で重要となる客観的な判断力と連携力を向上させる教育体制,そして看護師の心的負担を軽減する環境の整備の必要性が示唆された。

In this study, we aimed to elucidate the types of difficulties faced by home-visitnurses in caring for home-care patients with mental disabilities in intervening in case ofinappropriate care of home-care patients, but which are not classified as abuse. An open-endedquestionnaire survey was conducted on home-visit nurses at member home-visitnursing stations of the National Association for Home-visit Nursing Care. We performed aqualitative regression analysis on the responses from 136 nurses and identified the followingdifficulties experienced by nurses when they recognized abuse: "Difficulties to surfacingproblem facts" and "Difficulties in intervening with the abuser and the abuse victim at thesame time." They visited homes while recognizing a growing "Empathy with the abuser"because they had built a relationship with the family and experienced "Hesitation in makingthe intervention" and "Dilemmas due to difficulties in not being able to reach a commonmulti-professional understanding." The results suggested the need for an educational systemto reinforce an objective judgment and collaboration, which are essential for intervening incase of gray-area abuse and an improvement of the environment to reduce the nurses'psychological stress.

Journal

  • The Journal of Japan Academy of Health Sciences

    The Journal of Japan Academy of Health Sciences 21(1), 14-22, 2018

    Japan Academy of Health Sciences

Codes

  • NII Article ID (NAID)
    130007521491
  • NII NACSIS-CAT ID (NCID)
    AA12001334
  • Text Lang
    JPN
  • ISSN
    1880-0211
  • NDL Article ID
    029144142
  • NDL Call No.
    Z74-B494
  • Data Source
    NDL  J-STAGE 
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