心不全患者のセルフモニタリングの概念分析

Concept Analysis of Self-monitoring for Heart Failure Patients

要旨

　【目的】心不全患者が自分自身の体調変化を把握し，増悪の兆候を早期発見するための支援において，セルフモニタリングは重要な概念であるが，統一した見解はない．そこで，心不全患者への支援に資するためにセルフモニタリングの概念を明らかにした．

　【方法】Rodgersら（2000）の概念分析法を参考に概念を特定した．

　【結果】31件の文献を分析した結果，心不全患者のセルフモニタリングは，身体症状の変化，身体活動の変化，体調管理の状況をとらえることであり，概念の属性は「自覚」「測定」「解釈」という3つの側面で構成されていた．概念の先行要因には「知識」「技術」「関心」が存在し，帰結として「適切なセルフマネージメント」と「QOLの改善」が認められた．

　【結論】今回抽出された新しい概念は，心不全患者のセルフモニタリングを強化する看護支援の基盤として活用できることが示唆された．

Abstract

　[Objective] Self-monitoring is an important concept in order for support of patients to selfobserve the condition of their heart failure and grasp the actuality of its progression, but its meaning in the context of care for heart failure patients has not been sufficiently clarified. Thus, we have now clarified the concept of self-monitoring in heart failure patients.

　[Methods] The concept is identified with reference to the concept analysis method of Rodgers et al. （2000）.

　[Results] In the results from analysis of 31 cases from the literature, self-monitoring in heart failure patients involved staying aware of the changes in physical symptoms, changes in physical activity and the status of health management, and conceptual attributes were composed of three aspects：“awareness,” “measurement,” and “interpretation.” “Knowledge,” “skills,” and “concern” exist as antecedents of the concepts, and “adequate self-management” and “QOL improvements” were the consequences observed.

　[Conclusions] It is suggested that novel concepts extracted from the present work be applied as the basis for nursing care support to strengthen self-monitoring by heart failure patients.