訪問看護における看護実践用語の構造と特徴

Structure and Feature of Terminology in Nursing Practice in the Home Care Field During Visiting Nurse Service

要旨

　学術用語としての看護用語の体系化を目指し，訪問看護師が自らの看護実践をどのように表現・記述しているのかを明らかにすることを目的とした．

　研究方法は，訪問時に訪問看護利用者に行った看護実践項目の記述を依頼し，その後記述された看護実践行為の内容について面接による聞き取り調査を行った．面接内容を，「行為ラベル」「行為の判断根拠」「行為のねらい」「行為内容」「同時行為ラベル」「同時行為のねらい」「同時行為内容」に分類し，項目の性質及び項目間の関係について分析を行った．

　この結果，在宅ケア領域では看護活動が日常生活の一部として存在するため，看護実践を記述する用語は日常語に引き寄せられ，口語的表現が多くなること，また，限られた時間内で看護を提供する必要があることから，一つの看護実践を記述する用語に対し，複数の看護行為が含まれる傾向があることが明らかになった．加えて，医療・保健・福祉の分野にまたがり様々な専門職と協動し，対象者を支援していくために，他職種との情報の正確な交換と共通理解が得られるような看護実践用語の必要性が示唆された．

Abstract

　The purpose of this study was to systematize nursing terminology in scientific terms by describing the way that visiting nurses expressed and described their own nursing practice.

　The subjects were 25 visiting nurses in the Kansai region of Japan. Each nurse was asked to choose a patient of the day and to describe and discuss her activities during the visit in terms of nursing. The items covered were divided by the researchers into “label of the activity”, “reason for performing the activity” “aim of the activity”, “actual nursing procedure for the activity”, “labels of simultaneous activities”, “aims of simultaneous activities”, and “actual procedures for simultaneous activities”. The data gained through this process were analyzed to determine the nature of each item and the relationships among the items.

　Because nursing is provided as one part of daily life for home health care patients, the terms used to describe nursing practice consisted of words used in daily life (for example, “greetings”).

　Sometimes the terms used were colloquial expressions. Because of the limited time available to carry out a number of nursing tasks during one visit, one term included more than one nursing activity. In addition, because nurses need to collaborate with various specialists in both the medical and the health and welfare fields in order to care for their patients, nurses should use their terms that have the communality with other fields.