The Study to Develop Special and Technical Nursing Competencies in Home Health Nursing

本研究的目的是通过探索具有护士意图的实际护理实践，明确从业至少5年的专业公共卫生护士所从事的家庭健康护理的特点，并培养其专业和技术护理能力。本研究调查了5例家庭健康护理中的心理健康、疑难病和虐待儿童。收集数据以评估护士的意图和行为的性质。本研究假设护士的行为是以护士的意愿为导向的。本研究揭示了家庭健康护理中的特殊功能和技术功能的特点。1)护士应在必要时与护士建立可以沟通和咨询的关系。2)护士应明确护理接受者的需求，以考虑到生活状况和疾病恶化的可能性。3)护士应发展如何构建支持系统，使护理与受照者的日常生活相一致。4)护士应支持它，以肯定的方式回应人的存在和老年生活。5)护士应从公共卫生项目和政策的可获得性出发，构建社区卫生医疗服务体系。6)护士在与其他公共卫生专业人员讨论时，应根据受照者的需要确定优先事项。这些发现表明，护士需要培养特殊的和技术性的护理能力：1)确定受照者的需求，2)估计生活状况和疾病恶化的可能性，并制定护理策略，3)构建支持系统，以及社区的健康和医疗服务系统

The purpose of this study was to clarify the characteristics of home health nursing as practiced by expert public health nurses that had practiced for at least 5 years, by exploring actual nursing practice with nurses' intentions, and to develop special and technical nursing competencies.The study examined 5 cases in home health nursing for mental health, intractable diseases, and child abuse. The data were collected to evaluate the nature of with nurses' intentions and conducts. In this study it was assumed that nurses' conducts are oriented to nurses' intentions.The study demonstrated the following characteristics of special and technical function in home health nursing. 1)Nurses should form the relationship which the person can communicate and consult on with the nurse at the time of necessity. 2)Nurses should define the needs of the care receivers, as to put the possibility of a life situation and disease aggravation into a view. 3)Nurses should develop how to construct the support system to congruent care with the daily living of the care receivers. 4)Nurses should support it to respond to existence and old life of the person in the affirmative. 5)Nurses should construct the health and medical service system in the community from the availability of public health programs and policies. 6)Nurses should decide to get her priorities right for the needs of the care receivers, as to discuss with other public health professionals.These findings suggest that nurses need to develop special and technical nursing competencies : 1)to define the needs of the care receivers, 2)to estimate the possibility of a life situation and disease aggravation, and to develop the strategy to care, 3)to construct the support system, and the health and medical service system in the community