Development of a nursing care manual for supporting the caregiving careers of families of patients with cerebrovascular disease or senile dementia

本研究旨在探讨脑血管病或老年痴呆患者家庭成员的护理活动，并探讨促进或阻碍护理职业发展的原因和背景因素，以建立一种支持护理职业发展的护理干预方法。基于脑血管病或老年痴呆患者家庭照护职业模型，采用五阶段流程，提取影响家庭照护职业建立的条件，比较不同疾病家庭照护职业，采用焦点小组法评估和完善照护指南。确定有助于建立和发展家庭护理事业的护理，从而制定了“支持家庭护理事业的护理指南”。本指南包括以下五项内容：1)关于家庭照护职业；2)了解家庭照护职业的要点；3)家庭照护关系的形成；4)基于家庭赋权模型的支持家庭照护职业的护理干预选择；5)材料。研究发现，以下类型的护理对促进家庭护理职业的发展是有效的：“促进护理价值的护理”对“支持护理职业基础的护理”；“支持家庭积淀智慧发展的护理”和“促进开放沟通形成的护理”为“支持护理事业建立的护理”；“支持维持患者个性的护理”、“支持维持家庭特征的护理”、“通过获得控制能力巩固护理者地位的护理”、“支持建立自信基础的护理”、“支持获得自信的护理”以“支持护理事业发展的护理”；“支持建立界限的护理”，“增强已被认可的确定性的护理”，以及“增强与患者关系确定性的护理”，以“打破恶性循环的护理”。以下因素被确定为护理干预措施，支持家庭授权这些类型的护理：“增加对家庭日常生活和自我照顾的支持”、“为家庭提供情感支持”、“教育家庭成员”、“增强家庭应对行为和能力”、“协调和加强家庭关系，促进沟通”、“管理家庭责任”、“利用亲属和当地社会资源”、“支持和倡导家庭决策”。少

The objective of the present study was to develop a nursing intervention method for supporting caregiving careers by determining the care activities of family members living with patients with cerebrovascular disease or senile dementia and elucidating the causal and background factors that promote or hinder the progress of caregiving careers. Based on a caregiving career model for families providing care for patients with cerebrovascular disease or senile dementia, we used a five-stage process, which included the extraction of conditions affecting the establishment of the caregiving careers of families, comparison of the caregiving careers of families for different diseases, and the assessment and refinement of care guidelines using the focus group method, to determine nursing care that contributes to the establishment and development of the caregiving careers of families and thereby created a "Care guideline for supporting the caregiving careers of families". This guideline comprised … More five items as follows : 1) About the caregiving careers of families, 2) Points for understanding the caregiving careers of families, 3) Formation of relationships involving care in the family, 4) Selection of nursing intervention that supports the caregiving careers of families based on the family empowerment model, and 5) Materials. The following types of nursing care were found to be effective for promoting the caregiving careers of families : "nursing that promotes the value of caregiving" for "nursing that supports the foundation of caregiving careers" ; "nursing that supports the development of the wisdom accumulated in the family" and "nursing that promotes the formation of open-minded communication" for "nursing that supports the establishment of caregiving careers" ; "nursing that supports the maintenance of the personality of the patient", "nursing that supports the maintenance of the characteristics of the family", "nursing that solidifies one's position as a caregiver through acquisition of the power to control", "nursing that supports the establishment of grounds for self confidence", and "nursing that supports the acquisition of confidence" for "nursing that supports the development of caregiving careers" ; and "nursing that supports the establishment of boundaries", "nursing that enhances the certainty of what has been recognized", and "nursing that enhances the certainty of relationships with patients" for "nursing for breaking vicious cycles". The following factors were identified as nursing interventions that support family empowerment for these types of nursing care : "increasing support for the daily lives and self care of the family", "providing emotional support for the family", "educating family members", "enhancing the coping behavior and ability of the family", "harmonization and enhancement of family relationships and promotion of communication", "management of responsibilities in the family", "utilization of relatives and local social resources", and "support and advocacy for the family's decision-making". Less