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

1. 目的：本研究旨在明确公共卫生护士对预防保健的需求，并系统地整理这些病例的护理管理发展过程。需求分别为(1)疑难杂症，(2)体弱老人，(3)前后申请。长期护理保险。方法：采用个人访谈的研究方法。在分析框架中使用关怀管理过程行动指数，以便用他们自己的话来阅读他们所采取的活动的情况和过程。结果：(1)对13例难治性疾病需求进行分析。其中10项需求被提炼为有关改善相关医疗服务、协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开发，对主体采取行动。(2)对12例低层次护理需求患者进行分析。11人的需求被归类为这个结果。它认为日常生活的需求确认，涵盖了没有正式提供的服务，而开发一种服务是特别具有特色的。为了管理这些需求，他们建立了非正式的支持网络，暂时自行提供服务，并试图制定新的政策。(3)对6例申请长期护理保险前后的赡养情况进行分析。11人的需求被分类。护理管理的特点如下。当居民使用长期护理时，他们及时支持服务。

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.