Educational program based on the accuracy of nursing diagnosis and qualitative evaluation of nursing case

本研究旨在根据不同护理专科的护理诊断与诊断的准确性来评估护理服务的质量，以此来提高护理诊断的准确性，并探讨以病人为中心的护理教育方案。调查采用收集1997年至2003年在三家医院住院的晚期乳腺癌患者的护理记录的方法。调查问卷以伦尼(1997)制定的准确度测量标准、Nanda分类和NIC分类方法为基础。1)慢性疼痛、感染风险、活动不耐受、受伤风险和焦虑被列为护理诊断的高频率。(2)协作性问题使生活自理障碍综合征复杂化的趋势明显。(3)护理诊断住院目的与护理干预目的不同。4)认为在看不到与死亡相关的护理诊断记录的背景下，存在着与之对抗的人和护士的信念和消极的情绪和态度。2004年，对护理临床领域护理诊断和护理干预调查的准确性、护理诊断标签和护理诊断难点进行了检验。24日，在日本护理科学学会杂志交流会上，讨论了基于本研究结果和教育的护理实践问题。这项研究的结果在2005年的日本护理诊断学会会议上发表。

This research is to evaluate the quality of the nursing caring corresponding to the accuracy of the nursing diagnosis performed in a variety of nursing specialty areas and the diagnosis, to improve the accuracy of the nursing diagnosis based on the result, and to examine the educational program to offer the patient-centered care.In 2003, the actual situation of nursing diagnoses and the nursing interventions in the terminal care were investigated. The investigation was executed by the method of collecting data from the nursing record of the terminal breast cancer patients who had been hospitalized in three hospitals between 1997 and 2003. The questionnaire was made based on accuracy measurement standard develop by Lunney (1997), the NANDA classification, and the NIC classification method.The results were as follows. 1)Chronic Pain, Risk for Infection, Activity Intolerance, Risk for Injury and Anxiety had been enumerated as a nursing diagnosis of high frequency. 2)The tendency which used collaborative problems to complication and self care deficit syndrome was seen. 3)The difference was seen by the purpose of hospitalization by the nursing diagnosis and the nursing intervention. 4)It was suggested that in the background from which the record concerning nursing diagnosis related death & dying was not seen, there was belief of people and the nurse who confronted it and negative feelings and attitudes. These results were reported at NANDA/NIC/NOC international conference.In 2004, the accuracy of the investigation of the nursing diagnosis and nursing intervention in the nursing clinical area and the nursing diagnosis labels and difficulties were examined. The 24th, issue of the nursing practice based on the result of this research and the education was discussed in the exchange meeting of Journal of Japan Academy of Nursing Science. The result of the research is reported at the conference of the Japan Society Nursing Diagnosis in 2005.