Care Management for the Needs of Intractable Plural Involving Public Health nurses

1.目的：本研究的目的在于厘清公共卫生护理人员参与预防性卫生保健的需求，并系统地整理这些案例的护理管理发展过程。需求是（1）疑难杂症，（2）体弱的老年人，（3）申请前和申请后。长期护理保险。方法：采用个人访谈的研究方法。护理管理过程行动指数被用于分析框架中，以阅读的情况下，和过程的单位，他们所采取的活动与自己的话。结果：（1）对13例疑难杂症患者的需求进行分析。10项需求被提取为关于改善相关医疗护理、帮助用户的家庭护理和日常生活、改善家庭护理环境的需求。护理管理的特点是服务的发展，采取行动的主题。同时也包括个人的相互关系，以使服务最适合需要，采取行动，以改善相关机构的制度。（2）分析了12例低层次护理需求的病例。11个国家的需求被列为这一结果。它认为，日常生活确认的需要，涵盖了没有正式提供的服务，以及服务的发展是其特别的特点。为了应对这些需求，他们发展了非正式的支持网络，临时自行提供服务，并试图制定新的政策。(3)并对6例在申请长期护理保险前后获得其支持的个案进行分析。11人的需求被分类。其次是护理管理的特点。当居民使用长期照护时，他们会及时提供服务。

1. Purpose : This study aims to clarify those needs of preventive health care that involve public health nurses and to systematicallyput in order the developingprocess of caremanagement for those cases. The needs were (1) intractable illness, (2) frail elderly, (3) before and after an application for the. Long Term Care Insurance.2. Methods : We used a researching method of personal interviews. Care management process action index was used in the analysis framework in order to read situations, and processes by units, of activities taken by them with their own words.3. Result : (1) The 13 cases who had intractable illness needs were analyzed. The needs of 10 have been extracted as needs concerning the betterment of relevant medical care, assistance to user' s home care and daily living, improvement of home care environments. The characteristics of the care management were development of a service, taking action on the subjects. Also included were individual interrelations so that service will best fit the needs, taking action to improve the regime of related institutions, (2) The 12 cases who had low level care needs were analyzed. The needs of 11 were classified as that result. It thought that the needs of the daily life confirmation, covering the service which was not provided officially, and development of a service were especially characteristic of that. For managing these needs, they developed informal support network, provided service by themselves temporally, and tried to formulate newpolicy. (3) The 6 cases who supported by them before and after an application for the Long Term Care Insurance were analyzed. The needs of 11 were classified. The characteristics of the care management were as the next. They supported service timely when inhabitant used the Long term Care.