介護老人保健施設で暮らす自力歩行が困難な高齢者のいまを支えているもの─ライフストーリーの傾聴から

Factors Supporting the Elderly with Difficulty in Walking Independently for the Life-fulfillment of Long-term Care Health Facility Residents: An Analysis of Their Life Stories

抄録

　本研究の目的は，自力歩行が困難な高齢者の生きる意味，目的，いまを支えるものを明らかにすることである．対象は介護老人保健施設に入所している6人で，半構造化面接によってライフストーリーを聴き取り，逐語録に起こし，質的帰納的に分析し，6人のサブテーマを統合して5つのテーマを抽出した．地域高齢者のスピリチュアリティと一致する「頑張ったからこそある満足感」「過去・現在・未来の人とのつながり」「命はもらったもの，生かされている」のほかに「不自由でもできることは自分でしたい」「いまがいちばんいいとき」が抽出された．生きる意味，目的，支えを聴き取ることは，老健で生活する高齢者の自己の客観視を可能にすること，および看護が充実する可能性があり，そのような視点を取り入れたケアの必要性が示唆された．

　This study aimed to clarify the significance of life for the elderly with difficulty in walking independently, their purposes in life, and factors supporting their life-fulfillment. Semi-structured interviews were conducted with 6 long-term care health facility residents to extract their life stories, and create narrative records. The narrative records were qualitatively and functionally analyzed, and classified into 5 categories and 6 sub-categories: in addition to <satisfaction after efforts>, <past, present, and future interpersonal relationships>, and <life as a gift and an opportunity to learn its significance>, representing the spirituality of elderly community residents, <wishing to make my own decisions>, and <now is the best time of my life> were extracted. Listening to the elderly living in long-term care health facilities, focusing on the significance and purpose of life, as well as factors contributing to life-fulfillment, may enable them to develop self-insight, and improve the quality of nursing, and it may be necessary to provide care from such a perspective.