糖尿病看護の高度実践者による高齢者への糖尿病教育プログラム実施上の影響要因と工夫—成人との比較

Influencing Factors and Nurse's Strategies in Practicing a Diabetes Education Program for the Elderly by the Expert Nurses for Diabetes Nursing: Comparison with the Adult

要旨

　目的：高度看護実践者（以下，高度実践者）による高齢者への糖尿病教育プログラム（以下，教育プログラム）実施の影響要因と工夫について，成人との比較により明らかにすることを研究目的とした．

　方法：2009年9〜10月に無記名自記式調査票による郵送調査を行った．調査では，教育プログラム実施の影響要因はその頻度を4件法で，高度実践者が行っている工夫は自由記載形式で回答を求めた．なお，前者はFisherの直接確率法等の統計的手法により比較・分析をし，後者は記述内容の類似性に沿ってまとめカテゴリー化した．

　結果：有効回答の93票を分析した結果，以下が明らかとなった．①教育プログラム実施の影響要因として高齢者では理解度，家族の事情，糖尿病以外の病気を挙げる割合が成人に比べて有意に高かった．②高度実践者による教育プログラム実施上の工夫として，【その人らしさと生活の質の確保】等の高齢者に特有なカテゴリーが抽出された．

　考察：高度実践者は，豊富な臨床経験の中で高齢者には自立した生活の継続に対する強いニーズがあることを把握できているため，【その人らしさと生活の質の確保】を維持する関わりを意識的に行っているのではないかと考えられた．

　Purpose: To clarify the influencing factors and strategies in practicing a diabetes education program (hereinafter called education program) for the elderly by expert nurses by making a comparison with the adult.

　Method: We made a mailing survey using an unsigned, self-writing questionnaire in the period of September-October 2009. For the influencing factors of the education program, the reply was requested to be made from 4 choice questions in the order of frequency, and, for the strategies that were practiced by expert nurses, the reply was requested to be provided in a free-style writing. Regarding the former, we made a comparative analysis using a statistical analytical method such as the Fisher's exact test, and regarding the latter, we arranged and categorized the replies based on similarity in the contents.

　Result: As a result of 93 valid replies, the following findings were obtained: (1) As the influencing factor in practicing the education program, the numbers of respondents about levels of understanding, circumstances of the family members, and the disease except diabetes in case of elderly were significantly more than those in case of adults. (2) As the strategies in practicing the education program by expert nurses, a category peculiar to the elderly such as “Ensure individuality and QOL,” etc. was extracted.

　Discussion: The expert nurses provided intentional care such as “Ensure individuality and QOL,” because they understood in abundant clinical experience that there were strong needs for continuation of independent life in case of the elderly.