A STUDY OF PUBLIC HEALTH NURSE'S ROLE IN HOME CARE SUPPORT OF THE BEDRIDDEN ELDERLY AND THEIR CAREGIVERS

本研究旨在探讨公共卫生护士在利用健康福利服务支持有身心健康问题的卧床老人及其家人中的协调功能和辅导功能。首先，对广岛市51名接受公共卫生护士和照顾者家庭保健服务的卧床老人进行为期3年的跟踪调查。日常生活自理能力按卫生福利部标准评定为B、C级。访谈内容包括老年人的健康状况、日常生活能力、资源数量和照顾方式。结果：3年后仍居家34例，死亡14例(B级6例，C级8例)，住院3例。在个人资源利用、家访服务和家政服务的数量和强度方面，…更多的恶习增加了。最多的老年人接受了3名以上卫生福利人员的服务，其利用人数在3年内有所增加和减少。在其他资源中，利用最多的服务是洗浴服务，其次是短期服务和日间服务/托儿所。这些服务的使用量有所增加，但一些老年人不再接受这些服务，因为他们的需求在机构老年服务中得不到满足。在护理用品资源上，除1名老年人外，其余均购买或租用护理床位、床垫。一些老年人开始使用轮椅、辅助洗澡用品和移动厕所，其中一些人停下来使用。第二，广岛县的物理治疗师和职业治疗师同意自我报告与他们的活动和工作中的问题有关的问题。他们中的大多数人在医院从事康复计划或日间护理。他们面临的主要问题是如何与其他机构和其他专业人员合作。较少

The objective of this research is to suggest the coordinating function and the counseling function of public health nurses for supporting the bedridden elderly with physical or mental problem and their families by utilizing health and welfare service.First, a 3-year follow up (1995-1997) was conducted of a sample of 51 bedridden elderly who had been receiving home health care service by public health nurses and caregivers in Hiroshima city. Their levels of independence in ADL were in Rank B or C according to the standard of the Ministry of Health and Welfare. Interviews were composed of elderly's condition, ADL,amount of resources and caregiving. As a results at 3 years, 34 elderly were still at home, 14 (Rank B=6, RankC=8) were died and 3 were institutionalized. The ADL levels of the 2 who had been at home were upped (from Rank B to Rank A) and of the 3 were down (from Rank B to Rank C).On personal resource utilization, amount and intensity of home-visitting services and home-help ser … More vices were increased. The most elderly person received services by over 3 health and welfare care staffs, and the utilization number of them had been increased and decreased dugin 3 years. On the others resources, the most utilized service was bathing-service, next were short-stay and day-service/day-care. The amount of utilization of those services and had been increased, but some elderly stopped receiving them, because their needs not be satisfied in institution service for elders. On care goods resources, excepting for 1 elderly, they bought or rented care beds, mattresses. Some of the elderly started to use wheelchairs, assistant bathing goods and portable toilets, and some of them stopped to use them.Second, Physical therapists and Occupational therapists in Hiroshima Prefecture agreeded with self-report questionairs relating to their activities and problems on their works. Most of them engaged in rehabilitation program or day care in hospitals. The main problems of them were how to coorporate with other agancies and other professional staffs. Less