特別養護老人ホームにおける介護職員との連携による認知症高齢者の易怒・興奮を緩和する看護師の実践

Nursing Practices to Alleviate Irritability and Agitation in Older Adults with Dementia Involving Collaboration with Care Workers at Special Nursing Homes

抄録

　本研究の目的は，特別養護老人ホームにおいて認知症高齢者の，易怒・興奮を緩和するための介護職員との連携による看護師の実践を明らかにすることである．特養の看護師10人を対象に個別の半構造化インタビューを行い，帰納的方法を用いて分析を行った．看護師の実践として【居住スペースで認知症高齢者や介護職員の普段の様子を観察する】【介護職員がもつ認知症高齢者の日常生活の状況に関する情報を活かして共に易怒・興奮の原因を探る】【認知症高齢者の易怒・興奮の状態とその場の状況に応じて介護職員と共に対応する】【認知症高齢者の易怒・興奮と向き合えるように介護職員を精神的に支える】【認知症高齢者の易怒・興奮の緩和が困難な機会をとらえて介護職員の援助技術の向上を図る】の5カテゴリーが抽出された．看護師の実践は，介護職員と連携しながら易怒・興奮の原因を探り，介護職員の援助技術が向上するようサポートし，共に易怒・興奮の緩和に取り組んでいることが示唆された．

　The purpose of this study is to identify nursing practices through collaboration with care workers to alleviate irritability and agitation in older adults with dementia at special nursing home. Individual semistructured interviews were conducted with 10 nurses. As general nursing practice, the following five categories were identified by using an inductive coding approach: “observation of everyday situations in living spaces involving elderly with dementia and their caregiver,” “utilization of information that the care workers have on the daily life situation of older adults with dementia to investigate the cause of irritability and agitation,” “responding with caregivers according to the state of irritability and agitation of older adults with dementia and the situation at hand,” “emotional support for caregivers to face irritability and agitation in older adults with dementia,” and “perceiving opportunities where it is difficult to alleviate irritability and agitation in older adults with dementia, and improving the care workers' skills in providing assistance.” It was suggested that the nurses work together with caregivers to find the cause of the irritability and agitation, to support caregivers to improve their assistance skills, and to work together to alleviate irritability and agitation.