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糖尿病外来における電子メールを使った看護相談システムの開発に向けて,その可能性を探求するために,「糖尿病外来における電子メールを使った看護相談に関する研究(1)(電子メールを使った看護相談に関するニーズ調査)」に引き続き研究を行った.糖尿病外来通院患者11名を対象に,電子メールを使った看護相談システムを試行し評価した結果,以下のことが明らかになった.受信時間帯は夜間帯に集中し,対象者は自宅や職場などから各自の都合のよい時間に送信していた.受信内容は質問・相談で知識や情報をもとめたり,抱いている思いを表現したり,自己管理・生活状況の報告で支持や確認をもとめていた.システム利用状況は単身赴任先から利用したり,納得いくまで頻回に利用するなどさまざまであった.外来におけるシステムの評価として,外来で勧めるだけでは実行できなかった運動療法が継続できたケースがあった一方で,対象者が自らアクセスしないので,システムによる看護相談の効果が得られなかったケースもあった.対象者によるシステムの評価として,自己管理実践的側面,社会生活的側面,精神的側面からの対象者にとってのさまざまな有効性があった.また利用場所が限られているなどの対象者が考える問題点や,精神的なケアを望むなどの対象者が抱く期待もあった.
This study followed an E-mail nursing consultation study that took place at diabetic outpatient clinics and tests the theoretical possibility that the E-mail Nursing Consultation System will work. The consultation system was trailed by 11 diabetic outpatients who used and evaluated the system. Results show that the system was used mainly at night after the clinics had closed and patients were able to access the system from home or work at a time convenient for them. They asked for information on care, gave information on their self-care and health condition, asked for support and appointments for medical checks. The author advised one subject to take exercise using the system, advice that was needed but not given clinic. The system also gave patients a chance to express their feelings, some patients expecting more from the system than was available by asking for psychological counseling. Accessing the system proved to be difficult for some of the patients for various reasons and one patient did not access the system of his own accord. However one subject used the system after leaving his family and moving to the city and another used the system until he could confidently and competently manage his diabetes. Overall the system was successful providing the nurse with much information on self-care, social-life style and the patients mental condition while giving good nurse patient interaction that helped patients maintain good self-care.
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