ktk2001007

The Movement and Problems of the Family Nursing in the Long-term Care Facilities of Elderly People in Japan

上野, 貴子

家族看護/高齢者/長期ケア施設/family nursing/elderly/long-term care facilities

本稿は、高齢者長期ケア施設における家族看護の変遷について概観し、現在のこれら施設での家族看護における課題と実践について、1993年から2001年の研究実践報告をもとに紹介するものである。 近年の高齢者医療福祉施策により、高齢者ケア施設はさまざまな変遷を遂げてきた。しかし、そのシステムは利用者に理解しにくく、療養病床、老人保健施設、特別養護老人ホームに入所・入院している高齢者の症状や処置・治療には差がないことが指摘されている。また、老人保健法や介護保険の制度は、これら高齢者長期ケア施設に勤務する看護職者に、家族を含めた看護の役割を明確に示した。 このような背景の中で、家族を利用者の背景として捉えるのではなく、家族を一つのユニットとして捉え家族システムに対してケアを提供していくという、家族看護の潮流が高齢者看護においても流れ始めた。まだ家族看護が新しい領域であるため、研究論文は数少ない。しかしこれら施設に勤務するケア担当者達の問題意識は高く、実践報告数は毎年増え続けている。テーマ別に見ると、明らかに在宅復帰を目的とした報告と、長期入院高齢者とその家族への援助報告の２つに分かれる。 報告の中には介入研究も多く見られる。その介入方法について、鈴木の家族看護援助方法の分類を用いて変遷を見ると、初期には個々の家族員に働きかける援助方法に偏っていたが、徐々に家族単位の社会性に働きかける援助が増え始め、近年になって家族の関係性に働きかける援助が増えつつある。 これらの現状を踏まえ、今後の家族看護学研究の課題と、看護実践と研究を結ぶ上での課題について私見を加えた。

This paper makes a general survey about the change of the family nursing in long-term care facilities of elderly people, and introduces the present problems and practice to the family nursing in these facilities, being founded on the research practice report from 1993 to 2001. Owing to the welfare policy for the elderly people's medical treatment in recent years, various changes have made as for the elderly care facilities. But, it is hard to understand that systemfor the users. And it is pointed out that there is no defference between the symptoms and a treatment or a remedy of the elderly people who are admitted in longterm hospitals, skilled nursing homes, and special nursing homes of the aged. Through Low for Health of the Aged, the system of the nursing insurance showed clearly the part of nursing including the family, for the persons who work in these elderly people care facilities. In such a background, as for the nursing for elderly people as well, the tide of family nursing, which dose not catch family as a user's background, but catch it as one unit, and which is provided toward the family system. There are a few research papers because the family nursing is the new domain as yet. However, the critical mind of the care person who works in these facilities is high, and the number of practical reports increases every year. Seeing reports by the theme, it is divided into two reports: a report that obviously aimed at the return for at-home and a report of support for the elderly people who are in hospital for a long term and that family. Much intervention is also seen in the report. When, about that intervention, the changes are seen using the classification of Suzuki's method of support for the family nursing, an incline to the way of working upon each family member was found. In spite of that incline, after that, support of working upon the sociality of the family unit begins to increase, and in resent years, support of working upon family's relation is increasing. Based on this present condition, a personal view is added on the future problems of the family nursing research and the problem to connect nursing practice and research.

山梨県立看護大学短期大学部

Departmental Bulletin Paper

1342-0097

AA11404594

紀要（Bulletin of Yamanashi Junior College of Nursing）

7

1

79

88

2002/3/1

jpn