Bulletin of Shimane University Faculty of Medicine

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Bulletin of Shimane University Faculty of Medicine 30
2007-12-01 発行

訪問看護サービスの利用を妨げる要因 : 島根県下における訪問看護ステーション管理者の認識

The factor of preventing utilization in home-visit nursing service recognition of the home-visit nursing station administer in Shimane
Hirono, Sachiko
Nakatani, Hisae
Muramatsu, Keiko
Teshigawara, Kaoru
Sumita, Yoshiko
Kato, Noriko
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Description
The purpose of this study was to identify how managers in home-visit nursing care stations recognize the fact that the utilization of this service was not increasing. The study involved 55 managers from home-visit nursing stations in the Shimane prefecture. Using questionnaires, the status of home-visit nursing and the reasons for its interruption were investigated in February, 2006. The factors behind the non-utilization of this service included non-opening on weekends, having to visit long distances, and less full-time workers. In addition, it was found that the usage of the service did not increase because of factors including high service costs, incompatibility with clients and their family, difficulty in understanding doctors and home care managers, and the service quality falling short of client expectations. The conclusions of the research were that managers should undergo training to improve their management ability, manager should be improvement of nursing practice ability, and use of home-visit nursing care services for younger clients should be promoted.
本研究の目的は,訪問看護ステーションの管理者が訪問看護サービスの利用を妨げる要因をどのように捉えているかを明らかにすることである。島根県内の55訪問看護ステーションの管理者を対象として,平成18年2月にサービス利用の実態および利用を妨げる要因について質問紙調査を実施した。サービス利用を妨げている要因は,訪問距離が長いこと,休日に開所していないこと,常勤勤務者が少ないこと等であった。利用が増えない要因として,利用者が療養費を抑制している,本人と家族の在宅療養の意向が一致しない,主治医やケアマネジャーの理解が得られない,利用者が看護に期待していないこと等であった。管理者には,利用者の状況に応じた総合的なケアマネジメントの実践,看護実践能力の向上が求められる。また,若年患者が訪問看護サービスを利用するために広報等を行なう必要がある。
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