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

1.研究目的：明确涉及公共卫生护士的预防性保健需求，系统梳理护理管理的发展过程。这些需求是(1)顽固性疾病，(2)虚弱的老年人，(3)在申请之前和之后。长期护理保险2.方法：采用个人访谈的研究方法。在分析框架中使用护理管理过程行动指数，以便用自己的话阅读他们所采取的活动的情况和按单位进行的过程。结果：(1)对13例有顽固性疾病需求的患者进行分析。将10项需求提炼为改善相关医疗保健、协助S家庭护理和日常生活、改善家庭护理环境等方面的需求。护理管理的特点是开展服务，对受试者采取行动。还包括个体之间的相互关系，以使服务最符合需求，采取行动改善相关机构的制度。(2)对12例低水平护理需求的病例进行分析。11项需求被归类为这一结果。它认为，日常生活确认的需要，涵盖了非官方提供的服务，以及一项服务的发展，是这一特点的特别之处。为了应对这些需求，他们建立了非正式的支持网络，临时自己提供服务，并试图制定新的政策。(3)对申请长期护理保险前、后得到其支持的6例患者进行分析。对11项需求进行了分类。其次是护理管理的特点。当居民使用长期护理时，他们支持及时的服务。

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.