「看護の教育的関わりモデル」を用いたアクションリサーチ

Action Research Using the “Nursing Practice Model for Patient Education”

要旨

　患者教育にかかわる看護師が「看護の教育的関わりモデル（TKモデル）」を学習し，TKモデルを分析の視点として事例検討を行うことによって，研究者と参加看護師の相互関係と参加看護師の変化，それに伴う周囲に及ぼす影響を明らかにすることを目的とする．

　方法は，アクションリサーチを用い，2008年2月〜2010年4月に実施した．研究参加者は4名であり，学習会を14回行い，1回の参加者は7名から15名であった．

　参加看護師が学習会による実践的な知識を自己の中に取り込み，参加看護師自身の患者教育に関する願いをかなえる過程には，〈出会い〉〈芽生え〉〈停滞〉〈躍進〉〈定着〉〈波及〉のフェーズがあった．TKモデルを学習する過程で，参加看護師と病棟看護師との対立の時期があり，また，参加看護師はTKモデルが実践で役に立つのか半信半疑の時期を経て，看護実践とモデルとの結びつきを理解し患者との関わりに変化が生まれた．さらに，他病棟の看護師にも波及する変化が生まれた．

　TKモデルを活用した学習会は看護実践を変える可能性があることが示唆された．

　The purpose of this study was to clarify changes that occurred among nurses who participated in a learning relationship with researchers, while the nurses were performing patient education. The nurses learned to use the “nursing practice model for patient education (TK Model)” and the study was conducted on their learning experience.

　This action research study was conducted between February 2008 and April 2010. There were four nurses who participated. Fourteen case study sessions and teaching sessions were held and 7 to 15 nurses attended each study session.

　During the process of learning to use the TK Model, the nurses increased their practical skills. The phases of Introduction, Emergence, Stagnation, Breakthrough, Adoption, and Propagation were observed. Also during the process, changes occurred. There was a period of conflict between colleagues and doubt about the utility of the model had to be eliminated. Finally the nurses achieved understanding about the relationship between nursing practice and the model. Furthermore, the experience generated changes among nurses in other wards and at the outpatient clinics.

　These positive changes demonstrate the usefulness of the TK Model.