看護用具・用品の開発の実態と健康生活支援の観点からみた課題 : 文献調査(1995-1999)から

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本研究の目的は,看護職者による看護のための用具や用品(看護用品)の開発の実態と人々の健康生活支援の観点からみた課題を明らかにすることである.文献調査の対象は,看護用品に関する報告を恒常的に掲載している11誌(看護管理,臨床看護,看護技術,日本看護学会論文集7誌,臨床看護研究の進歩 ; 1995-1999年)を選択した.抽出した139件について,開発した看護用品,使用する対象者,開発の必要性を抜粋し,開発の目的の類似性をもとに分類して,実態と課題を分析した.139件は療養生活支援のための看護用品74件及び診療補助のための看護用品65件に分類された.療養生活支援のための看護用品は,対象の安全性の向上11件,対象の安楽性の向上37件,ADLの拡大25件,環境適応1件に分類され,診療補助のための看護用品は,看護の目的をもとに,検査における看護9件,手術中の看護9件,手術後の看護15件,治療における看護12件,薬剤投与における看護9件,治療環境における事故防止11件に分類された.開発の必要性は,患者が既存の看護用品にもとめる機能を質的・量的に充足するための改良(115件)が主であり,看護職者の負担軽減やコスト低減(26件)もみられた.新たな看護技術としての看護用品の開発(10件)は比較的少なかった.この結果はコストの制約の中で,看護職者が業務遂行のために,既存の看護用品を改良することにより,患者個別のニーズを充足している実態を示すと考えられる.一方,体位固定用品(12件)や抑制用品(11件)は,同様な開発例が重複して報告されていたが,各々が開発の要件の一部をあげ,開発の要件を総合的に捉えた例はあまりみられなかった.患者の総合的なニーズを捉えて看護用品の要件を明らかにし,共通性の高い看護用品を開発す

The objective of this research is to clarify the present status of the development of nursing instruments and to evaluate problems from the viewpoint of supporting healthy living. Among many reports on nursing instruments in 11 nursing journals published between 1995-1999,139 cases were extracted. The instrument, user, the necessity were extracted. The cases were classified according to nursing purposes, and future problems in developing nursing items were analyzed.There were 74 items for daily life support consisting of 11 for improvement in patient safety, 37 for improvement in comfort, 25 for enhancingADL, and 1 for environmental adaptation.There were 65 items for treatment assistanceconsisting of 9 for examination, 9 for useduring surgery, 15 for use .after surgery, 12 fortreatment, 9 for drug administration, and 11 forthe prevention of accidents in the therapeuticenvironment.Nursing instruments were developed primarilyfor qualitative and quantitative supplementationof the functions of existing nursing instruments(115 items), frequently for reducing theburden or the cost of nursing (26 items), andrelatively infrequently for establishing a novelnursing skill (10 items). These results suggestthat nurses are trying to modify existing nursinginstruments to meet the needs of individualpatients within cost limitations. Instrumentswere developed for immobilization of the bodyposition (12 items) or restriction of body move- .ments (11 items), and few items were developedwith comprehensive evaluation of the necessityfor their development although multiplepurposes were mentioned for the developmentof each item.It is considered to be necessary to analyzefunctions required of nursing instruments onthe basis of comprehensive understanding of patients'needs, to develop instruments withgreater universality, the use of which constitutesa new skill of nursing, to modify universalinstruments to be used more readily by morepeople, and to develop new ski

source:Journal of School of Nursing, Chiba University