在宅高齢者の介護予防に向けたフットケアプログラムの開発—第1報：フットケア方法習得のプロセスおよび介入内容の分析

Development of a Foot Care Program for Health Promotion and Disease Prevention in Elderly Persons Living at Home—First Report: Examination of the Process of Foot Care Skills in Elderly Persons and the Contents of Intervention—

要旨

目的：高齢者自身が実施するフットケア方法習得のプロセスを明らかにし，セルフケアのための具体的な介入方法を導き出すことを目的とした．

方法：デイサービスを利用している在宅高齢者7名に週1回12週間フットケアの指導的介入を実施し，介入場面の会話を内容分析した．

結果：介入場面における出現数の特徴から，導入期・前半・中盤・後半・全般の5つに分類できた．フットケア方法は中盤におおむね獲得し，後半では高齢者同士での指導や確認，工夫などがみられるようになった．介入内容では，導入期にはケアの意義や実施方法の説明，前半には観察や判断の方法・疑問の解決による理解の促進，中盤にはケアの適切性の確認とケア方法の支持，後半では見守りや声かけ，励まし等，心理的側面への介入，全般にわたり，理解度の確認や侵襲の予防を行っていた．

結論：高齢者が実施するフットケア方法習得のプロセスにおいて，ケア活動を支援するための介入内容が導き出された．

Purpose: We clarified the process of the acquisition of foot care skills by elderly people so they could perform them by themselves, and aimed to derive a concrete intervention method for self care.

Method: We taught foot care methods to 7 elderly persons living at home, using a day-care service. Instruction continued for a total of 12 weeks, once per week, and content analysis of the conversations during instruction was conducted.

Results: The contents of each instructional day and the implementation situation of care continued to change. These contents were classified into five groups according to the number of the apparent conversation during instruction. Elderly people acquired foot care skills in the middle stage, and in the second half, instruction, testing, and device usage were performed by elderly people. In intervention contents: The introduction of the intervention explained the meaning of care and the execution method, the first half of the intervention promoted the understanding of the method and the resolution of any doubts about the observation and judgment, the middlestage of intervention supported a caring, appropriate confirmation and caring method. In the second half of each intervention, the frequency of observation and encouragement increased. The confirmation of understanding was solidified by and the troubles of the body were prevented by the total process of intervention.

Conclusion: In the process of foot care skill acquisition which a group of elderly people performed, the intervention's contents of supporting care activities were acquired successfully.