Development of Nursing Care Program to Regain Daily Life Behavior for Stroke Patient with Higher Brain Dysfunction.

本研究旨在发展一套护理方案，以帮助高阶脑功能障碍患者恢复日常生活行为。数据收集自访谈、参与者观察和文献检索。分析高等脑功能障碍对日常生活行为的影响特点及干预方法。该分析的结果用于创建23a4页的“护理计划1”，作为临床和实际使用的工具。对6名专家护士、2名康复医生、2名物理治疗师、2名职业治疗师和2名语言治疗师进行小组访谈，对“护理方案1”进行评估。在对护理方案的适当性和实际应用的可能性进行小组访谈评估后，对护理方案进行了修订。随后，在两家康复机构工作的一名护士和护工实验性地使用了计划2。由护士和护理人员完成问卷调查，调查方案2的效用、实际用途和可能的实际应用。问卷调查结果表明，该护理方案遵循护士的思维过程，提供了干预方向的视角，并且具有易于理解的布局，可以应用于实践。此外，计划2通过加深对高级脑功能障碍的理解和兴趣，提供新知识，允许口头解释以前未定义的护理实践方面，并通过揭示护理实践的意义，导致护士的自我实体化和自我启蒙。作为护理实践的辅助工具和教育资源具有较高的实用性。此外，发现该计划的实际使用取决于保健专业人员的各种需求和职业。希望这一计划能够为护理实践提供质量保证。

The present study aimed to develop a nursing care program for rehabilitation of daily life behaviors lost to higher brain dysfunction. Data were collected from interviews, participant observations, and a literature search. Characteristics of daily life behaviors affected by higher brain dysfunction and intervention methods were analyzed. Results of this analysis were used in the creation of the 23 A4-page "nursing care program plan 1" as a tool for clinical and practical use."Nursing care program plan 1" was evaluated during group interviews with 6 expert nurses, 2 rehabilitation doctors, 2 physical therapists, 2 occupational therapists, and 2 speech therapists. The care program was revised following the group interview evaluations of the appropriateness and possibility of practical application of the program.Subsequently, a nurse and care giver who worked in two rehabilitation institutions used plan 2 experimentally. A questionnaire investigating the utility, practical use, and possible practical application of plan 2 was completed by the nurse and care giver. Questionnaire responses indicate that this nursing care program can be applied to practice because the program follows the thought process of nurses, provides perspective on intervention direction, and has a layout that is easy to understand. Furthermore, plan 2 led to self substantiality and self enlightenment of the nurse by allowing a deeper understanding of and interest in higher brain dysfunction, providing new knowledge, allowing the verbal explanation of previously undefined aspects of nursing practice, and by uncovering the meaning of nursing practice.It was judged to have high utility as a support tool in nursing practice and as an education resource. In addition, practical use of the plan was found to depend on the various needs and careers of health care professionals. It is hoped that this plan will lead to a quality guarantee in nursing practice.