介護老人福祉施設における車いす使用高齢者のリスクとリスク因子に関する看護師の理解

Nurses' understanding of the risks and risk factors associated with elderly wheelchair users in facility covered by public aid providing long-term care to the elderly

抄録

　本研究は介護老人福祉施設に勤務する看護師を対象に，車いすを使用する高齢者に関するリスクとリスク因子についての理解を明らかにした．介護老人福祉施設6施設に勤務する看護師12人を対象に，車いすを使用する高齢者のリスクとそのリスク因子について半構成インタビューを行い，質的に分析した．その結果，リスクは転倒・転落リスク，褥瘡リスク，外傷リスクなどの10種類が述べられ，その内容は移動・移乗動作に関する事故事象や車いす座位に関連した廃用症候群などを示していた．リスクの原因と考えられるリスク因子は【施設環境】【援助者の行動・認識】【高齢者の心身状態】の3つのカテゴリーに整理された．サブカテゴリーとして［物理的環境］［人・時間］［援助者の行動］［援助者の認識］［身体状況］［ADLの状況］［精神・心理状況］が見いだされた．看護師は高齢者が車いすを使用する際のリスクとリスク因子を多角的にとらえていた．

　This study aimed to clarify nurses' understanding of risks and risk factors in the elderly using wheelchairs in facilitites covered by public aid providing long-term care to the elderly. Semi-structured interviews were conducted with 12 nurses working in 6 facilities covered by public aid providing long-term care to the elderly, focusing on the risks and risks factors in elderly wheelchair users. The data was qualitatively analyzed. Ten types of risk, including those of falls, pressure ulcers, and injury, and their specifics, such as transportation- or transfer-related accidents and disuse syndrome due to the long-term maintenance of sitting positions of wheelchair use. As risk factors, 3 categories: “facility environments”, “caregivers' behavior and recognition”, and “the elderly's mental and physical conditions”, were extracted, with the following sub-categories: “physical environments”, “manpower and time”, “caregivers' behavior”, “caregivers' recognition”, “physical conditions”, “ADL levels”, and “mental and psychological conditions”. Nurses perceive these risks and risk factors as being related to multiple viewpoints of elderly wheelchair users.