弁当箱法を活用した糖尿病患者への食支援（第1報）―弁当箱法を実施した患者の食生活の目安

Dietary Care for a Diabetes Patients Using the “Lunch Box Diet Method”(the first report): The patient's intent to create healthy eating habits.

　本研究の目的は，糖尿病患者の経験を尊重した食支援に向けた示唆を得るために，弁当箱法を活用した糖尿病患者の食生活の目安を明らかにすることである．研究参加への同意が得られた糖尿病患者21名に対して，2か月から12か月間，弁当箱法を活用して成人教育の考え方に基づく支援を行った．支援終了に至った13名（男性5名女性8名）の援助記録をデータとして，質的帰納的に分析を行った．その結果，弁当箱法を実施した患者の食生活の目安は【3：1：2の比率への納得の度合い】【弁当1食を“ちょうど良い”と感じること】【日々の暮らしで弁当箱法を行う自分と他者の至適距離感】【弁当箱法を行うことが自分の意向に適うこと】【弁当作りがいつもの食生活のスタイルにそぐうこと】【弁当の見た目からの満足感】が抽出された．本研究結果は，医療者が食生活を営む主体としての患者と患者の食生活の多様性への理解を深め，患者自身が食生活の目安を洗練させていく学習過程を促す個別支援の助けとなる．

　The purpose of this study was to clarify diabetes patients' intent to create healthy eating habits using the “Lunch Box Diet Method”. Participants were 13 diabetes patients (five men and eight women who had finished the care process based on the philosophy of adult education) who incorporated the “Lunch Box Diet Method” into their daily lives. Patients participated in 2 to 12 months of experiential learning conducted by nurses. Descriptive data comprised of the patients' words and actions and the nurses' words and recognition during care scenes were analyzed by a qualitative inductive method. Six categories were extracted: [degree of understanding of the “3:1:2” (rice: main dish: side dish) ratio], [feeling of satisfaction after eating one meal from the “Lunch Box Diet Method”], [suitable interrelationships under executing the “Lunch Box Diet Method”] , [satisfaction in regard to the patient's intention to use the “Lunch Box Diet Method”] , [conformity with preparation of lunch box meals in daily life], and [contentment with the appearance of the meal in the lunch box]. These results improve our understanding of the diversity of the eating habits of patients who are living with diabetes and could contribute to the development of care that supports patients' learning processes in order to refine their patients' intent to create healthy eating habits.