Characteristics of strategy and effect of visit nurse services in order to maintain medical treatment at home for elderly women

本研究通过1998年和1999年对老年妇女的观察和访谈，明确了老年妇女居家医疗策略(动机和内容)的特点。在2000年作为最后一年，我们向来访护士解释了直到1999年的研究结果，然后对接受该策略的护理状况进行了实况调查。研究人员在护理人员的陪同下，对老年妇女进行家访，并对护理内容和老年妇女满意度进行了研究。随着CARE的实际情况接受这一战略，以下特征变得清晰起来。由于怨恨是独居受试者维持生活的基础，因此推导出了三种需要克服的语境。这就是“反击”、“鼓励”和“回应现实”。对于“反击”和“对现实的反应”的类型，需要护理方法来提供治愈，并假定他们对生活的回忆和回顾的有效性。在“对现实的反应”方面，他们对独居的依恋似乎较弱，容易转变为住院。另一方面，白天独居的老年妇女被发现对来访的护士或/和她们的家人(子女)有依恋。对前者的依恋是“伪家庭的想象过程”，对后者的依恋是“婴儿期母婴关系的再现”，是影响护理质量的一个重要观点。

In this research, characteristics of strategy (motives and contents) to maintain medical treatment at home for elderly women were clarified by subjects' observation and interviews in 1998 and 1999. In 2000 as the final year, the results of our research up to 1999 was explained to the visiting nurses and then fact-finding for the state of cares accepted the strategy was carried out. Researchers visited the elderly women at their homes with the visiting nurses and conducted the research on contents of cares and elderly women's feeling of satisfaction. The following characteristics have become clear as the actual conditions of cares accepted the strategy. As resentment is the foundation to maintain their living for the subjects living alone, three types of contexts to overcome that were deduced. Those were "counterattack", "encouragement" and "response to reality". As for the types of "counterattack" and "response to reality", nursing approach to provide healing was required and also assumed the effectiveness of recollection and review of their lives. Regarding "response to reality", their attachment to maintain their living alone seemed to be weak and easy to shift to be hospitalized. On the other hand, elderly women staying alone during daytime were found to adopt attachment to visiting nurses or/and their family (children). The attachment for the former is "the imaginary process of pseudo-family" and for the later is "reproduction of relations with mother and child in infancy" and that could be concluded to be an important standpoint to affect on the quality of nursing care.