介護施設における認知症ケア実践者の精神的負担の概念分析

Concept Analysis of Dementia-Related Caregiver Burden in Nursing Facilities for Elderly People

要旨

　目的：介護施設における認知症ケア実践者の精神的負担の概念を分析し，先行要件・属性・帰結による構成要素を明らかにし，概念の定義を行う．

　方法：2023年までの日英54文献を対象に，Rodgersの分析方法（Rodgers＆Knafl，2000）で分析した．

　結果：属性として【ケアの対象者にネガティブな感情を抱く】，【BPSD対応に疲弊する】，【困難なケアへの不安を感じる】，【倫理的苦悩に押しつぶされる】の4カテゴリーを抽出した．また先行要件として4カテゴリー，帰結として3カテゴリーを抽出した．

　結論：介護施設における認知症ケア実践者の精神的負担は「ケアの対象者に対してネガティブな感情を抱きながら，BPSD対応に疲弊し，困難なケアへの不安を常に感じている一方で，倫理的苦悩にも押しつぶされている状態」と定義した．認知症ケアの質確保のためには，ケア実践者の精神的負担の軽減が重要であることが示唆された．

　Aim: The aim of this study was to clarify the attributes, antecedents and consequences of the concept, dementia-related caregiver burden.

　Method: Based on a Rodgers' concept analysis approach (Rodgers & Knafl, 2000), 54 articles until 2023 were fully reviewed in both Japanese and English.

　Results: The four attributes were extracted: negative feelings to care recipients, exhaustion from dealing with BPSD, anxiety about difficult dementia care, moral distress. Also, four antecedents and three consequences were identified.

　Conclusions: The burden on formal caregivers for residents with dementia was defined as a circumstance where formal caregivers have negative feelings, feel exhausted from dealing with BPSD, feel anxious about difficult dementia care and have moral distress. In order to ensure the quality of dementia care and secure human resources, it is important to alleviate the dementia-related caregiver burden on care practitioners.