Person-centred Careをめざした認知症ケアマッピングにおける研究の動向

Trends of Research Regarding Dementia Care Mapping Aimed at Providing Person-centred Care

　国内外の最近の認知症ケアマッピング（DCM；dementia care mapping）の研究の動向について文献レビューを行ない，今後の看護研究における課題について考察を行なった。国内の論文からは，医学中央雑誌にて検索された42文献の分析より，①DCMはケアの変化を促し，またその効果を捉えるために有効な観察評価手法であるものの，②ケアする側のDCMに対する肯定的な意識変化のためのかかわりの方法を検討する必要性，③認知症ケアシステムの構築の一環としてDCMを導入していくことと，その効果検証のための研究の必要性，④DCMの普及方法の開発のための研究の必要性が示された。

　海外の論文については，PubMedで検索された2006年以降の13文献から動向を探った。DCMの効果の研究以外にも，神経リハビリテーション病棟での適用の検討，国際間での比較，他評価法との比較，長期にわたるフォローアップ研究などがみられ，2006年以前の研究動向と比べると，DCMが開発された後の時間的な経過や使用国の広がりを踏まえた研究に発展していることがうかがえた。内容としては，信頼性・妥当性の検討，効果検討，DCM使用者（マッパー）の理解・経験・学びを明らかにしようとするもの，ケアスタッフの仕事満足度との関連，DCM第8版の使用感と有効性についての検討，時間合理化モデルなどであった。

　以上の結果を踏まえ，看護研究では，DCM第8版を用いることが，認知症看護の方法のさらなる開発に有用であることが明らかになった。

　In this article, we have conducted a literature review regarding worldwide treads of recent research in reference to dementia care mapping (DCM)．We have also discussed future challenges regarding this topic in nursing research. The following four needs have been identified based on 42 Japanese articles found through a database known as Japan Medical Abstracts Society: 1) DCM should be an efficient observational and evaluation tool for facilitating a change in nursing care and for evaluating its efficacy. 2) There is a necessity for discussing intervention methods in order to facilitate a change in caregivers' senses about DCM with more positive notions. 3) There is a necessity for introducing DCM, as a part of building a system for dementia care, and also for conducting studies to evaluate its effectiveness. 4) There is a necessity to conduct studies for developing means to spread DCM. In terms of the literature published outside Japan, we have reviewed 13 references that were published after 2006 and procured through PubMed database. In addition to studies evaluating the effectiveness of DCM, a variety of research topics regarding DCM have been studied, such as discussions on the applicability of DCM in neurological rehabilitation units, international comparisons and comparisons with other evaluation tools. Some studies were followed up for a relatively long time. As compared to literature published before 2006, we've discovered that current literature published after 2006 were more developed, based on the passage of time and expansion of the location where DCM was utilized since the development of this tool. The following contents were covered in these studies; discussion on reliability and validity of this tool, discussion on the effectiveness, clarification of the experience and leaning process of DCM users (mappers)，relationship between usage of DCM and job satisfaction among the caregiver staff, discussion on usability and efficacy of DCM8, along with streamlined models and so on. Based on these findings, we have discovered that DCM8 is effective to further improve nursing care for people with dementia.