A study for developing a nursing care skill model of end of life for elderly with dementia about nurses at the long term care welfare facilities

摘要本研究旨在探讨长期照护机构护理人员提高老年失智症临终护理技能的模式。研究对象为长野县老年痴呆症长期护理机构的护士（n=336）。47.9%的护士回答了这个问题。老年痴呆患者临终护理技能需求分为15个部分。全年共创建临终关怀技能模型课程11次。模型创建的目的是为了发展护理人员的护理技能能力，提高机构老年痴呆患者的临终关怀质量。并将其作为临终关怀的过程来实施，构成临终关怀的指南。全年共进行11次临终关怀。参与者共18名护士。临终关怀指南（Q and A）以7个部分的50页小册子的形式印刷。该模型可作为培养护理人员护理技能能力的有效途径，旨在提高机构老年痴呆患者的临终关怀质量。特别是，该模式改变了被拒绝在机构中照顾痴呆老人的护士的认知和价值观。此外，本研究还表明，在老年痴呆症患者的临终关怀质量中，重点关注护士的护理技能提高是重要的。

The purpose of this study was to clarify the model of toward improving nursing care skill for end of life of elderly with dementia about nurses at the long-term care institution.The subjects were nurses (n=336) working at the long-term care institutions for the elderly with dementia in Nagano prefecture. Forty-seven and nine% of nurses answered the question. Their needs of nursing care skill for end of life of elderly with dementia were 15 parts. The courses of end of life care skill model were created eleven times in year. The aim of model creation was aiming at development of the care skill capability of nurses aiming at improvement in the quality of end of life care of the elderly people with dementia in institution. And it was carried out as the courses of end of life care, making up the guideline of end of life care. The courses of end of life care were carried out eleven times in year. The totals of participants were 18 nurses. The guideline (Q and A) of end of life care was printed as the booklet that was 50pages of 7 parts.The model may be an effective way to development of the care skill capability of nurses aiming at improvement in the quality of end of life care of the elderly people with dementia in institution. Especially, the model had changed the perception and values of nurses who were rejected care of the elderly people with dementia in institution. Furthermore, this study has suggested that it was important to focus on care skill-up of nurses in the quality of end of life care of the elderly people with dementia.