||摂食嚥下機能低下を認める特別養護老人ホーム入所者の経口摂取支援のための看護職役割行動指標の作成 : 看護－介護連携に着目して
Establishing indicators of nurses role behavior to support oral intake in dysphagic special elderly care home residents : From the viewpoint of nurse-care worker collaboration
清水, みどり ,
吉本, 照子杉田, 由加里
千葉看護学会会誌 = Journal of Chiba Academy of Nursing Science
20 , 2017-08-31 , 千葉看護学会
[ABSTRACT] Objective: Many special elderly care home （SECH） residents experience dysphagia, and the role of nurses, they manage the residents’ oral intake safely and comfortably to the extent possible, in line with the wishes of residents and their families, until the terminal phase. Accordingly, this study aimed to establish indicators of nurses role behavior to support their oral intake. Methods: Semi-structured interviews were conducted with seven nursing staff and 12 certified care workers responsible for oral-intake support at SECHs with a proactive stance towards such support. Interviewees had provided relevant oral-intake support. Their collected recollections of these cases were subjected to qualitative-inductive analysis targeting support behavior, means of resolving support-related difficulties, and multidisciplinary support, to tentatively identify indicators. A specialist panel of six nurses and academic experts who are familiar with geriatric dysphagia care was then convened for detailed validation of the tentatively identified indicators. Results: Indicators for nurses role behavior were identified based on the following behaviors: exploring the residents’ potential oral intake to the maximum extent while ascertaining their limits in the medium-to-long term, assisting safe and comfortable consumption of daily meals while addressing risks, explaining the high risks associated with residents’ physical state to families and care workers and securing agreement for continuation/discontinuation of oral intake, and developing capabilities needed by nursing staff and care workers to deliver support based on reflective practice. Discussion: These indicators were focused on maximizing the residents’ potential for oral intake. We consider that behaviors and thinking were indicated as follows: SECH nursing staff accomplished their role as medical health professionals, by exploring the residents’ potentiality for oral intake while ascertaining their limits in the medium-to-long-term. Based on the findings, nursing staff, care workers, and residents’ families are collaborated, in order to meet the wishes of dysphagic residents even in a high-risk situation.