高齢入院患者の「動き」を促進する急性期病院における看護実践—老人看護専門看護師へのインタビュー調査

Nursing Practice in Acute Hospitals to Promote “Mobility” in Older Patients—Interview Survey of Certified Nurse Specialists in Gerontological Nursing

抄録

　本研究の目的は，老年看護の経験豊富な看護師の実践から急性期病院に入院している高齢患者の「動き」を促進する看護実践を明らかにすることである．老人看護専門看護師12人を対象として，急性期病院での高齢入院患者への看護実践に関する半構造化インタビューによってデータを収集し，質的分析を行った．結果は【入院前の生活と現状を踏まえた「動き」に関する生活の目標の見定め】【随時の適切な「動き」の見極めと発揮の支援】【患者自身の主体的な「動き」の尊重】【「動き」を促進する支援の継続に向けた環境づくり】の4つのカテゴリーが明らかになった．本研究の結果は，短い入院期間に対象者がいかに実践しているかが示され，高齢入院患者の「動き」を促進し，入院中の機能低下の予防と回復に寄与する看護技術に関する知見をもたらすものである．一方で，本研究は老人看護専門看護師を対象としたものであり，一般の病棟看護師の実践や普及の方法について検討することが今後の課題である．

　This study aimed to identify nursing practices that promote “mobility” in older patients hospitalized in acute care hospitals through the practices of certified nurse specialists in gerontological nursing. Data were collected through semi-structured interviews with 12 certified nurse specialists in gerontological nursing about their nursing practices with older patients in acute hospitals, and qualitative analysis was conducted. The results revealed the following four categories: [Identifying lifestyle goals related to “mobility” based on the patient's life before hospitalization and his/her current situation], [Constantly supporting the identification of appropriate exercises for “mobility”], [Respecting the patient's own independent “mobility”], and [Creating an environment for continued support to promote “mobility”]. The results of this study show how the subjects put these identified categories into practice during the patient's short hospital stay and thus provide knowledge on nursing skills to promote “mobility” in hospitalized old patients and contribute to the prevention and recovery of functional decline during hospitalization. Because the subjects of this study were certified nurse specialists in gerontological nursing, a future challenge will be to examine how this can be practiced by general nurses and how it can be disseminated.