介護医療院における重度要介護高齢者に対する「快適な排便ケア」の実態とそれに影響を及ぼす要因との関連検証

概要

The purpose of this study was to clarify the status of comfortable defecation care provided by
nurses to older adults with serious care needs in nursing care clinics, and to show its relationship to
factors that affect defecation care practices.
MATERIALS AND METHODS
The study used an association-testing design with a self-administered questionnaire survey.
In the conceptual framework for this study, it is predicted that six factors affect the
implementation of comfortable defecation care for older adults with serious care needs. The
response variables are original 51 items for the implementation of comfortable defecation care for
older adults with serious care needs.
The study subjects were nurses and assistant nurses working at facilities that consented to
cooperate in the study from among 570 nursing care clinics nationwide.
This study protocol was approved by the Nursing Research Ethics Committee of Shimane
University.
RESULTS AND DISCUSSION
From the results of the exploratory factor analysis of comfortable defecation care provided by
nurses to older adults with serious care needs in nursing care clinics, four factors were identified:
“Care with consideration of discomfort in bowel movements associated with disease and the side
effects of medications(Factor 1)”, “Care that takes advantage of daily living abilities(Factor 2)”,
“Care that supports the production and movement of feces (Factor 3)”, and “Care that regulates the
intestinal environment(Factor 4)”.
Factor 1 was related to participation in continence care workshops inside the clinic, presence or
absence of an adviser related to excretion, high feeling of control score, high learning atmosphere
score, having a nursing attitude that incorporates a daily living perspective, and high knowledge
related to defecation care score, etc. ...