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

本研究于1998年及1999年透过观察与访谈，探讨老年妇女居家维持医疗策略的特点（动机与内容）。在2000年作为最后一年，我们的研究结果，直到1999年解释了访问护士，然后实况调查的护理状态接受的战略进行了。研究者与上门护理人员一起到老年妇女家中进行家访，对老年妇女的护理内容和满意度进行调查。随着护理的实际情况接受该战略，以下特征变得明显。由于怨恨是独居被试维持生存的基础，因此，本文归纳出三种需要克服怨恨的情境。那就是“反击”、“鼓励”和“回应现实”。至于“反击”与“回应现实”的类型，则需要提供疗愈的护理方法，并假设其对生活的回忆与回顾的有效性。在“现实反应”方面，独居依恋感较弱，容易转移到住院治疗。另一方面，在白天独自居住的老年妇女被发现采取的访问护士或/和他们的家人（子女）的依恋。前者的依恋是“伪家庭的想象过程”，后者的依恋是“婴儿期母子关系的再生产”，是影响护理质量的重要观点。

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.