臨床看護から見た日常生活行動レベルの評価

Development of a Patient Independence Scale Usable in Clinical Nursing Setting

要旨

　理学療法・作業療法分野で開発されてきたADL評価尺度を，臨床看護用に修正した「臨床看護のための自立度判定基準（6項目4段階尺度）」を作成し，3つの大学病院で調査を行った。その結果，以下の知見が得られた。

1）一般生活レベルを最高レベルとみたときの患者の自立度のレベルが看護の視点から判定できるため，看護援助を検討する上で有用と考えられた。

2）自立度変化を新変数として設け，悪化・維持・改善の3タイプに分類することにより，自立度変化に影響するとみられる介入因子の評価が可能であった。よって，看護援助の効果をみる有用な道具になり得ると考えられた。

Abstract

　The purpose of this study is to develop'independence scale usable in clinical nursing setting.'We improved ADL (Activities of Daily Living)-scale which was used in physical therapy and occupational therapy to be utilized for clinical nursing. This scale has six categories and each category has four stages describing different state of independence. The state of elderly patient'-s ndependence was surveyed using this scale at three university hospitals, and the usefulness of the scale was discussed. The results were as follows.

1) It was considered that the scale was useful in planning nursing support, because the independence stage of a patient staying in hospital was properly identified from viewpoint of nursing.

2) It was considered that the scale could be on effective tool to assess the nursing support for elevating patient's independence stage, because it was possible to analyze intervention factors to change independence stage.