手術を必要とする糖尿病者の自己管理の再構築に向けたメタ統合による看護支援モデル作成に関する研究

Preparation of a Nursing Support Model through Meta-synthesis for Rebuilding of Self-management by Diabetic Patients Who Require Surgery

　本研究の目的は，手術を受ける糖尿病者への看護支援の実践的モデルを作成することである．実際に手術を受ける糖尿病者を対象とした質的研究と，糖尿病者および手術患者に関する質的研究論文のメタ統合より，手術を必要とする糖尿病者の自己管理の再構築の構造と，それを促進する看護方針を導き出した．これにより，手術を受ける糖尿病者は手術治療を医療者に委ねるだけでなく，そのなかで糖尿病者としての有能性を生かし，主体的に取り組み続ける道筋が明らかにされた．本研究で示した看護支援モデルは，糖尿病者の病いの軌跡全体をとらえたうえで，手術患者への看護の要素を取り入れたものであり，手術を必要とする糖尿病者の自己管理の再構築を支えるための看護援助の方向性を示すものとなった．

　The purpose of the current study is to create a practical model for nursing support intended for diabetic patients who are scheduled for surgery. Through a qualitative study of the actual diabetic patients scheduled for surgery and meta-synthesis from qualitative academic studies on these patients and others scheduled for surgery, the structure for rebuilding self-management by diabetic patients requiring surgery and a nursing approach to promote such a process by the patients were formulated. Thus a process surfaced in which diabetic patients facing surgery do not only rely on the medical personnel for surgical therapy, but they utilize their capability as diabetic patients and take an independent approach to life. The nursing support model shown in this study captures the entire span of these patients' illness, while incorporating the nursing elements intended for surgical patients. It gives directionality in nursing support to aid in rebuilding the self-management of a diabetic patient who requires surgery.