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医療観察法入院対象者の主体的なクライシス・プランの 活用に向けた看護実践
Get PDF本研究の目的は、医療観察法入院対象者の主体的なクライシス・プランの活用に向けた看護実践を明らかにし、その特徴を考察することである。全国の医療観察法指定入院医療機関に所属する看
護師1,012名に質問紙を配布し、317名（回収率 31.3％）から回答を得た。このうち、自由回答式質問に回答した258名の記述を、Berelson, B. の方法論を参考にした看護教育学における内容分析を用いて分析した。その結果、【クライシス・プランに該当する現在の状態とそれへの対処の意向を聞く】【クライシス・プランを基に現在の病状と必要な対処行動を自己評価できる機会を設ける】【クライシス・プランの活用状況と実用性を把握する】【対象者が常時把握可能な場所にクライシス・プランを掲示する】など17カテゴリが形成された。また、考察により、17カテゴリが、4 の特徴を持つことを示した。本研究の成果は、看護師が自己の実践を客観的に理解し、改善の方向性を見出すために活用できる。This study aimed to identify the nursing practices toward utilization of proactive crisis plans for patients hospitalized under the Medical Treatment and Supervision Act and examine the characteristics of these plans. A questionnaire was distributed to 1,012 nurses affiliated with inpatient institutions under the Medical Treatment and Supervision Act nationwide, and responses were obtained from 317 (31.3％ response rate). Of them, 258 statements in response to open-ended questions were analyzed using content analysis for nursing education based on Berelson’s methodology. Consequently, 17 categories were formed, including conveying “Asking about the participants’ current status that corresponds to the crisis plan and their intention to use the crisis plan to cope with it”;“ Setting up opportunities to allow the participants to use the crisis plan to evaluate their own current medical condition and necessary coping behaviors”;“ Keeping track of the crisis plan’s status of use and practicality”; and “Displaying the crisis plan in places where the participants can keep track of it at all times.” The discussion showed that the 17 categories have four characteristics. The results of this study can be used by nurses to objectively understand their own practices and find directions for improvement.原著論文departmental bulletin pape
発話明瞭度の信頼性について ―理学療法士、作業療法士との比較による発話明瞭度の限界 ならびに課題と聞き取り力向上の可能性の検討―
Get PDF発話明瞭度の信頼性について検者内信頼性、検者間信頼性の両面から検討したところ、共に0.7以上の高い信頼性が得られた。特に検者内信頼性は高く、また簡便な評価となるため同一の言語聴覚士が適宜評価として行う評価としては適している。しかし、言語聴覚士間の検者間信頼性は他のリハビリテーション職種に比べ低く、正しい障害像の把握のためには、発話明瞭度の評価の差の原因となったバイアスを除去するための検討が必要となるが、現実として早急な解決は難しく、現状では他の言語聴覚士に正しく伝えるためには発話明瞭度の評価に加え、他の客観的評価との列記が望ましい。一方で多くの構音障害患者の音声を聞くことで、“聞き取り力”が向上する可能性が示されており、聞き取りのトレーニングを行うことで、特に聴き取りの難しい重症患者の音声が聞き取りやすくなりコミュニケーションが円滑になる可能性が示唆された。The reliability of speech intelligibility assessment was examined in terms of inter-rater and intra-rater reliability. The results showed that both the inter-rater and intra-rater reliability with Speech-Language-Hearing Therapists, Physical Therapists, and Occupational Therapists were higher than 0.7. The intra-rater reliability was particularly high with the Speech-Language-Hearing Therapists, and, as intra-rater assessment is simple, such assessment is suitable to use. However, when the speech intelligibility of a single patient was assessed by multiple Speech-Language-Hearing Therapists, a considerable difference in assessment could also be observed. Therefore, in addition to using other objective assessments, methods to reduce differences in the assessment of speech intelligibility should also be examined so that speech intelligibility can be accurately assessed. On the other hand, when speech intelligibility was assessed by both Speech-Language-Hearing Therapists and Physical Therapists and the same utterance was produced twice, both the Speech-Language-Hearing Therapists and the Physical Therapists heard the utterance more clearly the second time, indicating that their “listening comprehension” may have improved. These findings suggest that training in listening comprehension may help facilitate communication with patients by making it easier to understand the speech of patients, especially those with severe speech impediments whose speech is particularly difficult to understand. The findings also suggest that more accurate sharing of a patient’s speech ability among various professions may be possible.原著論文departmental bulletin pape
Approach and Issues of Basic Nursing Practice under the COVID-19 outbreak -From the self-evaluation of students for Basic Nursing Practice I-
Get PDFThe learning outcomes and challenges in the practical training program were examined and compared between in 2019 and 2020 in order to obtain the approach of Basic Nursing Practice I and the insights into basic nursing education in face of COVID-19 outbreak. 1 . The self-evaluation score in 2020 was 77.09±8.13 (mean±SD), which was lower than 79.92±10.16 (mean±SD) in 2019. 2 . In FY 2020, 124 units (43.8％) of “observe” were freely described by students, accounting for about half of all recording units. The fewest was“ explain” at 15 units (5.3％). Students were able to “observe” and “learn” but were not able to develop our thoughts that means “understanding” such that cannot explain the facts linking them to the prior learning and that we could not deepen our learning due to lack of images. Students learn more by placing themselves in an actual medical environment and gaining hands-on experience. Therefore, it is important to adjust the training environment so that students can learn in the field even for a short time. Furthermore, the future challenge is to build a system that interactive communication while incorporating learning tools such as the Internet and Virtual Reality.COVID-19流行下における基礎看護学実習Ⅰの取り組みと2020年度の学生の自己評価表を2019年 度と比較し、学習成果や課題について検討した。 1 ） 2020年度の自己評価点は77.09±8.13（mean±SD）点、2019年度の79.92±10.16（mean±SD）点に比し低かった。 2 ） 2020年度の学生の自由記述では「観察する」124記録単位（43.8％）で全記録単位の約半数を占めていた。最も少なかったのは「説明する」15記録単位（5.3％）であった。「観察する」「知る」ことはできたが、事前学習と結びつけることやイメージができず、学びが深まらないなど「理解する」という思考の発展までは至らなかった。学生は実際の医療環境に身を置き、体験をすることで学びが深まる。よって短時間でも臨地で学ぶことができるよう実習環境を調整することが重要である。さらにインターネットやVR などの学修ツールを取り入れながら、双方向的なコミュニケーションができるシステムを構築することが今後の課題である。Notedepartmental bulletin pape