外来看護における糖尿病患者のセルフケア確立へ向けた対人援助技術

The Role of Interpersonal Nursing Skills in Promoting Self-Care Among Diabetic Patients in an Outpatient Setting

　本研究の目的は，外来看護における糖尿病患者のセルフケア確立へ向けた対人援助技術を明らかにすることである．

　患者のセルフケア確立へ向けて看護師の支援が必要と判断された外来通院中の糖尿病患者８名に，研究者が看護実践者として行った看護プロセスの現象を対象とし，質的統合法（KJ法）により分析した．

　その結果，【対象の外来看護の支援に対する抵抗感軽減への配慮】，【問題状況の理解・把握のための医学情報収集と対象からの発言の促し】，【看護師に療養生活上の苦痛・苦労を語ることで得られる対象の安堵感の醸成】，【療養行動や自覚症状とは関係ない疑問や希望と捉えられる対象の関心事への相応】，【対象の経験した失敗や辛い出来事から導く予期的対処の備え作り】，【対象の症状変化など機を窺いながらの療養生活上の課題への照準合わせ】，【対象の関心に引き寄せた療養生活上の問題への参画】の７つの対人援助技術が明らかとなった．この結果より，対人援助技術は，対象のセルフケア確立へ向けた課題を見出し，焦点化していく援助技術として示したことに意義がある．

　The present study sought to identify the interpersonal nursing skills that will promote self-care among diabetes patients. 　Targeting 8 diabetic outpatients deemed in need of nurse assistance in order to acquire self-care capability, the study analyzed various nursing procedures and patient interactions experienced by the researchers in their capacity as nurses. The analysis was performed using a qualitative synthesis method (the“K-J Method”). 　As a result, the study identified the following 7 interpersonal nursing skills : (1) Considering the need to reduce the patient's reluctance about ambulatory care nursing ; (2) Encouraging patient input and gathering medical information to better identify and understand issues ; (3) Fostering patient peace of mind by encouraging him/her to talk to nurses about hardships and difficulties experienced while undergoing treatment ; (4) Responding accordingly to patient doubts, hopes and other concerns that are unrelated to his/her treatment or symptoms ; (5) Developing anticipatory measures based on the patient's failures and painful experiences ; (6) Encouraging the patient to notice any treatment issues they may experience due to changes in their symptoms, etc. ; and (7) Getting involved in treatment issues that concern the patient. 　The study findings were significant in that they demonstrated that interpersonal nursing skills can be used to identify and focus on challenges to achieving patient self-care.