老年看護学実習において看護学生が印象に残った認知症高齢者との関わりと言葉―テキストマイニングを用いた実習記録の分析

Nursing Students' Memorable Relationship and Words with Older People with Dementia in Gerontological Nursing Practice: An Analysis of Practice Reports Based on Text Mining

抄録

　本研究は，老年看護学実習において看護学生が印象に残った認知症高齢者との関わりと認知症高齢者からかけられた言葉を明らかにし，老年看護学実習教育のあり方について示唆を得ることを目的とした．老年看護学実習を履修した134人の課題レポートをテキストマイニングで分析した結果，看護学生は認知症高齢者との関わりのなかで【認知症になった高齢者】【認知機能の低下】【行動・心理症状】【快・不快の表し】【残存能力】【言語の受け止め】が印象に残っていた．また，看護学生が印象に残った認知症高齢者からかけられた言葉は，【学生への関係を紡ぐ言葉】【学生の対応への感想の言葉】【学生への労いの言葉】【学生を認識した言葉】【学生を動揺させた言葉】【学生への不満の言葉】であった．認知症の症状に関連した観察は，抽出頻度が高かった．認知症高齢者が表出するその人らしい言動の意味や意思を汲み取ることは，認知症ケアの糸口の発見につながると同時に認知症高齢者の理解にもつながると考えられた．

Purpose: This study aimed to clarify nursing students' relationships with older people with dementia and their observations regarding their verbal communication in gerontological nursing practice, and to obtain suggestions about the nature of gerontological nursing practice education.

　Methods: Assignment reports of 134 students who took gerontological nursing practice were analyzed using text mining.

Results: While describing their interactions with older people with dementia in their assignments, nursing students focused on the following topics: “older people with dementia,” “cognitive decline,” “behavioral and psychological symptoms of dementia,” “expression of pleasure and discomfort,” “residual capacity,” and “acceptance of language.” In addition, the students noted that the verbal utterances of the older people with dementia were of the following types: “words that weave a relationship with the student,” “words of feedback on the student's response,” “words of labor to the student,” “words of recognition of the student,” “words that upset the student,” and “words of dissatisfaction with the student.”

Conclusion: Observations related to the symptoms of dementia were extracted more frequently. Capturing the meaning and intention of the unique words and actions expressed by older people with dementia could provide clues for improving dementia care, as well as a better understanding of the illness.