山梨医科大学紀要 第13巻，023-027(1996)
在宅介護が介護者に及ぼす影響と看護ニーズ
―脳血管障害者を介護する家族の調査から―
佐藤みつ子，山田京子，石鍋圭子，半田幸代，大下静香
本研究は，在宅の脳血管障害者を介護している介護者の実態を把握し在宅介護に向けて家族指導を考える目的で調査を実施した。対象は，脳血管障害者を世話している介護者120名である。調査は介護者白身の問題，介護内容に関する問題，医療・福祉サービスの利用状況，介護昔の家族指導に関する評価の視点から質問紙法で実施した。その結果，介護者は50才〜60才の女性，要介護者は50才〜60才の男性が多かった。介護者の80%が身体的不調を感じ，病人や家族の将来や病気の悪化の心理的不安をもっていた。 また気分転換する時間がなく，その時間もとりにくい等生活上に困難を感じていた。新たに知りたい介護方法は，急変時や興奮，無気力になった時の対応の仕方であった。介護者は，年齢や要介護者の病気の受け止め方，身のまわりの世話の必要度の要因によって影響を受けることが明らかになった。在宅における家族指導は，要介護者の疾病受容や介護の必要度をアセスメントし， 介護者のニーズに応じるための家族支援の方法を開発していくことが重要である。
キーワード：在宅・介護者・脳血管障害
How In-home Care Affects Care-takers and Nursing Needs
- Survey of Accident(CVA) Patients' Families -
Mitsuko SATO, Kyoko YAMADA, Keiko ISHINABE, Yukiyo HANDA and Shizuka OSHITA
The survey was conducted to gain a better understanding of the nursing needs of care-takers for Cerebrovascular Accident(CVA) patients, and consider counselling needs related to ln-home care of family members. Survey targets were 120 CVA patients' families. It consisted of a questionnaire about physical, psychological, and living needs of care-takers, needs for medical treatment, welfare, and instruction for family members during their patients' stay in the hospital. The results showed that many of the care-takers were women in their 50s and 60s, while many of those receiving care were men in their 50s and 60s. Physical problems cited by care-takers included fatigue, shoulder stiffness, and back problems, while psychological needs included concerns over the future of the patients and their families and worries about the patients' worsening medical problems. Living needs included time for stress reduction and time to thermselves. Care method needs included how to respond to a sudden change in patients' conditions, how to respond when they become agitated, and what to do to help lift their spirits when they become depressed. Needs of care-takers vraried by their age, experience, length of time as in-home care-takers, and the level of care avaiable to patients. Day-to-day physical and psychological stresses posed special problems for care-takers. ln particular, they suffer the psychological stress of having to restrain their own emotions to care for the patients, while worrying about the patients' worsening medical problems. These stress factors accumulate, and the care-takers' lack of time prevents them from finding any outlet. Thus it is important to develop a method to support these families to meet the care-takers' needs.
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