ケア効果としての痴呆性老人の変化の構造—痴呆棟で働く看護職への質問紙調査を通して

The Structure of Patient's Outcomes in Dementia Elderly Care : Questionnaire to Nursing Staff at Dementia Units

　本研究は，痴呆性老人に対するケアの質を測定する指標となるようなケアのアウトカムを探ることを目的とした調査研究である．痴呆性老人の専門的ケアに従事する看護職がケア効果として捉えている痴呆性老人の変化を抽出し，その構造を明らかにするために質問紙調査を行った．対象者は准看護婦・士57.5％，看護婦・士42.2％，専門的ケア従事年数は平均6.2年（SD4.05）であり，勤務先は老人保健施設痴呆専門棟・加算棟62.2％，老人性痴呆疾患治療・療養病棟37.8％であった.718部の有効回答をクラスター分析した結果，ケア効果としての痴呆性老人の変化は「自立性の回復」「情緒の安定」「行動の安定」「ケアの受け入れ」「自発性の発現」「対人関係・社会性の広がり」の6つが階層構造をなしていることが明らかになった．

　The purpose of this investigation was to clarify the structure of care outcomes for the patients with dementia. The questionnaire was utilized for this study. The questionnaire was developed by the interview to expert nurses. They were asked about the patient's major changes when they received high quality of care. Seven hundred sixteen nurses participated this study. Characteristics of the subjects were that 57.5% of them was LPN, and 42.2% of them was RN. The average of their experiences was 6.2 years (SD 4.l) and their working places were at Geriatric Health Services Facility (62.2%) and Hospital for Patient with Dementia (37.8%). As the result of cluster analysis, six structures were emerged as outcome of effective nursing care : "Recovery of self-care", "Stability of emotion", "Stability of behavior", "Acceptance to nursing care", "jihatsusei", and "Development of personal and social relations".