後見人等との連携に関する看護職の自由記述の分析：現状と看護職の意識の検討

Analysis of free descriptions of nurses, regarding collaboration with guardians: Study of the current situation and awareness of nurses

　本研究の目的は、看護職と後見人等との連携における現状と課題を明らかにすることである。地域包括ケア加算と認知症ケア加算の届け出のある全医療機関1,564ヶ所で高齢者ケアに携わる看護職のアンケートのうち、看護職と後見人等との連携に関する自由記述のあったものを対象とした（n＝53）。看護職は【高齢患者の社会的境遇】を実感しており、【後見等の知識ニーズの意識】【後見等に関する高齢者看護のニーズの自覚】【後見等に関する期待】があるが、【後見等への認知・感情】には認知の差と肯定的または否定的な感情があり、【高齢患者の意思決定やACPへの対応】【後見等に関連する実践】にも差が生じていたことが窺えた。後見等の啓発により、制度を利用する者だけでなく医療の場にも拡がることで、看護職も高齢者本人の望む人生終盤の生活を支える地域包括ケアのチームの一員として機能する可能性を考える。

　The purpose of this study was to clarify the current status and problems regarding reading skills of nurses and guardians. A questionnaire was collected from nurses involved in the care of the elderly in 1,564 medical institutions. The survey contained 53 questionnaires allowing free text responses regarding collaboration between nurses and guardians. It was roughly divided into questions about the current situation in terms of the guardianship of elderly patients from the perspective of the nurses and an awareness of the guardianship by the nurses. Nurses' members were aware of social situations for the elderly, the recognition of knowledge needed, such as guardianship, as well as the recognition of the needs of elderly nursing regarding guardianship, and expectations for guardianship. There was a difference between cognition and positive or negative emotions relevant to guardianship, and cognition / emotion. There was also a difference in the decisions of elderly patients, and responses to ACP, and practices related to guardianship. Enlightenment from the findings of this study on issues such as guardianship will expand not only to users but also to the those employed in the medical field.