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期痴呆患者家属照护行为，并探讨其影响或阻碍其事业发展的原因及背景因素，以发展一套支持其事业发展的护理介入方法。本研究以脑血管病或老年期痴呆患者照护家庭生涯模式为基础，采用五阶段过程，包括影响家庭生涯建立的条件提取、不同疾病家庭生涯的比较、焦点小组法评估与修正照护指引，确定有助于建立和发展家庭职业生涯的护理，从而制定了“支持家庭职业生涯的护理指南”。该准则包括 ...更多信息 五项内容如下：1）关于家庭的事业发展，2）理解家庭事业发展的要点，3）家庭中与照顾有关的关系的形成，4）根据家庭赋权模型选择支持家庭事业发展的护理干预，5）材料。下列类型的护理被认为是促进家庭职业生涯的有效护理：“促进职业生涯价值的护理”为“支持职业生涯基础的护理”;“支持家庭中积累的智慧的发展的护理”和“促进开放式沟通的形成的护理”，支持建立职业生涯的护理”;“支持维持患者个性的护理”、“支持维持家庭特征的护理”、“通过获得控制权巩固护理者地位的护理”、“支持建立自信基础的护理”，以及“支持获得自信的护理”为“支持职业发展的护理”;以及“支持建立界限的护理”、“增强已被认可的确定性的护理”，将“加强与病人关系确定性的护理”改为“打破恶性循环的护理”。以下因素被确定为护理干预措施，支持家庭赋权这些类型的护理：“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”，“提高家庭的应对行为和能力”，“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”以及“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