Study of Needs in Home Care Management in Public Health Nurses and Home Visiting Nurses Ascertained

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  • 保健師と訪問看護師が捉えた在宅ケアマネジメントのニーズに関する研究

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Abstract

The purpose of this study was to clarify the whole of needs and expression and characteristics of needs of clients that public health nurse and home visiting nurse used home care services. Subjects were 160 public health nurses (132) and home visiting nurses (28) who were responsible for care management of the clients living in "Y" prefecture to became home care clients in 1998 and 2000. After three-month follow-up of their clients services under the care management system of the long-term care insurance, the care managers filled-in the questionnaire and returned them to us. It consisted of demographic variables of clients and care manager's, needs and assistant goals described in care plan, and, services the clients actually received. For an analysis of the needs, seven nurses who have home care experiences for more than 9 years classified the need cards by the KJ method. A need, its assistant goals and a kind of service were described in each card that represented the needs for one analysis unit. As a result, we obtained, responses to 142 clients from 109 public health nurses (84) and home visiting nurses (25). 142 clients had 862 needs, and there were 11 areas in large, 47 items in small classifications. Health management (24.0), care (15.9) and activities of daily living (15.4) were common in large classification. There were mainly two methods to express the needs ; expressing the noun (0.9) and the sentences (99.1). The characteristics of needs were (1) briefly summarizing points, of the obvious problems and future prediction, (2) the expression of the professional word in medical treatment uses. There results suggest that care managers require techniques and competencies to appropriately assess and easily explain the clients' needs.

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