診断後2年未満の成人期クローン病患者のセルフケア構築を支援する看護アセスメント項目の開発—デルファイ法を用いた妥当性と実用性の検証

Development of Nursing Assessment Items to Support the Construction of Self-Care for Adult Patients With Crohn's Disease Less Than 2 Years After Diagnosis: Examination of Validity and Utility Using the Delphi Technique

要旨

　目的：診断後2年未満の成人期クローン病患者のセルフケア支援で活用できるアセスメントツールの開発に向け，ツールに含む看護アセスメント項目の妥当性と実用性を検証する．

　方法：クローン病患者への看護実践経験のある看護師466名に質問紙を配布して2回のデルファイ調査を実施した．同意率は80％に設定した．

　結果：第1回調査は146名，第2回調査は94名の回答があった．［自分の病気・治療・社会資源についての関心と理解］，［病気の受け止めとセルフケアの目標］，［ライフスタイル・ライフイベントに合わせたセルフケアの実践］，［病状に応じたセルフケアの実践］，［ストレスの認知と対処］，［周囲からのサポート］の視点から成る計56項目を確定させた．

　結論：確定した看護アセスメント項目は患者のセルフケア状況を包括的に捉える視点で構成され，本項目を活用することで一貫したアセスメントが可能であることが示唆された．

　Purpose: To develop an assessment tool that can be used to support self-care in adult patients with Crohn's disease less than 2 years after diagnosis and to examine the validity and utility of the nursing assessment items to be included in the tool.

　Methods: A questionnaire was distributed to 466 nurses with practical nursing experience in taking care of patients with Crohn's disease, and two Delphi surveys were conducted. The agreement rate was set at 80%.

　Results: In total, 146 nurses responded to the first survey and 94 to the second survey. A total of 56 items were determined from the perspectives of "concern and understanding of one's disease,treatment, and social resources", "perception of disease and self-care goals", "self-care practice inaccordance with lifestyle and life events", "self-care practice in accordance with the medicalcondition", "recognition and coping up with stress" and "support from surroundings".

　Conclusion: The finalized nursing assessment items was derived from the comprehensive perspective of patient self-care status, suggesting that consistent assessment is possible by utilizing these items.