在宅介護を始めることで生じる介護者意識の経時的変化―～脳血管障害患者の介護者を対象とした質的研究～

Chronological changes in caregivers' attitudes during the initiation of home care: A qualitative study focusing on caregivers of cerebrovascular disease patients

要旨：本研究の目的は，脳血管障害患者の家族介護者を対象とした在宅介護開始初期の心理状態の特徴を捉えることである．対象となった7名に，退院前，退院1週間目，退院3ヵ月目，退院6ヵ月目の4回，半構成的インタビューを実施し，グラウンデッド・セオリー・アプローチにて分析した．その結果，介護者意識は経時的に『在宅への準備・思考の転換期』，『実践から得られる成功体験・満足体験を経ての導入期』，『将来への肯定的ビジョンの獲得と現状への適応を開始する適応準備期』，『役割意識の変化と自分らしさを表現できる再転換期』と概念化できた．介護者意識は在宅介護を始めることで経時的に変化することがわかった．

　The purpose of this study was to understand family caregivers' chronological psychological characteristics of cerebrovascular disease patients during the initial phase of home care. Semi-structured interviews were conducted prior to hospital discharge, 1 week after discharge, and 3 and 6 months after discharge, for a total of 4 times with 7 family caregivers. Analyses were performed by adopting the Grounded Theory Approach, and the results conceptualized the following periods of caregivers' attitudes in the following order: “preparing for home care and shifting the way of thinking”, “the implementation after experiencing success and satisfaction obtained from the practice”, “preparatory adjustment of identifying positive future prospects and adjusting to the current situation”, and “the second-shift during which the role recognition changes and the caregivers become capable of expressing their own individuality”. It became clear that caregivers' attitudes change over time as home care is initiated.