介護保険施設で「認知症ケア体験研修」を受講した急性期病院看護師の認知症看護実践の様相

The Aspects of Dementia Nursing Practice of Acute-phase Hospital Nurses Who Had Participated in a Dementia-care Training Workshop at a Long-term Care Facility

抄録

　「認知症ケア体験研修」を受講した急性期病院看護師の認知症看護実践の様相を明らかにすることを目的に，看護師10人に半構成的面接を実施し質的帰納的に分析した．【体験研修での実感を伴った学び】があることで，看護師は【認知症高齢者の立場に立った安心につながる看護】【身体拘束をせず安全に過ごせるための看護】【その人らしい生活が継続できるための連携】を行い，【認知症看護の実践による手応え】を得ていた．これは認知症高齢者への看護や必要な連携を強化するだけでなく【認知症看護の質向上に向けた主体的な発信】を支えるものとなっていた．また，認知症看護実践には【認知症看護を実践しやすい雰囲気やシステムの存在】が必要で，実践によりさらに強化されていた．認知症看護実践の促進は，体験研修受講者の立場や組織のあり方に左右されることが示唆され，今後は認知症看護の質向上に向けた組織づくりの課題を明らかにする必要がある．

　Semi-structured interviews were conducted for 10 nurses who worked in an acute-phase hospital and had participated in a dementia-care training workshop. Data were analyzed using qualitative inductive analyses to elucidate the aspects of dementia nursing practice in nurses.

　Nurses' “personal grounded sense of learning through participating in the training workshop” enabled them to perform “nursing that promotes emotional security of elderly with dementia in the best interests of the patient,” and “nursing that ensures patient safety without using body restraint methods” as well as to actively participate in “cooperation that allows the person to continue living like him/herself.” The nurses also obtained “responses by practicing dementia nursing.” This supported “subjective expression toward improving the quality of dementia nursing” in addition to reinforcing the nursing and cooperation required for the care of elderly patients with dementia. Furthermore, “the atmosphere and system conducive to practicing dementia nursing” was found to be necessary in dementia nursing practice and was further strengthened with practice. The results suggested that the promotion of dementia-care nursing practice is influenced by the standpoint or organization of the participants in the training workshop; thus, there is need to determine the objectives for organization building aimed toward improving the quality of dementia nursing.