論文 - 深堀　浩樹

内視鏡室でのタイムアウト導入についての患者の意識調査

浅原, 惠子, 小沼, 千恵美, 大洞, すみ子 and 深堀, 浩樹

日本消化器内視鏡技師会会報  （ 54 ） 117 - 119 2015年03月

【看護研究から政策をうみだすために】 NINRとは何か?　その歴史と看護研究における役割

前田, 留美, 深堀, 浩樹 and 丸, 光惠

看護研究 48 （ 1 ） 23 - 31 2015年02月

ISSN  0022-8370

Nurse health-related quality of life

Oyama Yumiko, Yonekura Yuki, Fukahori Hiroki

Journal of Nursing Management 23 （ 6 ） 775 - 783 2015年01月

ISSN  0966-0429

　概要を見る

<p>Aim: To investigate the factors affecting nurse health-related quality of life (HRQOL) by considering the patient characteristics and ward characteristics. Background: Nurse health-related quality of life is an important health outcome, and should be promoted for quality nursing care. Method: This cross-sectional study was conducted on nurses who work in general acute care wards in three university hospitals in metropolitan Japan. Multilevel analysis was conducted to investigate possible factors related to nurse health-related quality of life. Result: Nurses who worked at a ward had a significantly lower physical health score (β = -0.13, P &lt; 0.01). These nurses had a higher ratio of patients who could not understand medical instructions, had cognitive disabilities, or required assistance with activities of daily living (ADL). The number of beds was the only factor significantly related to mental health status of nurses (β = 0.19, P &lt; 0.05). Conclusion: Work conditions that sustain nurse health should take into account not only the number of nurses, but also patient characteristics. Further large-scale studies are needed in order to investigate the effect of hospital characteristics on nurse health-related quality of life. Implications for nursing management: Increasing the number of nurses' aides and delegating assistance with ADL to them could support nurse health-related quality of life in the acute care setting. Copyright</p>

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A literature review of factors related to hospital nurses' health-related quality of life

Oyama Yumiko, Fukahori Hiroki

Journal of Nursing Management 23 （ 5 ） 661 - 673 2015年01月

ISSN  0966-0429

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<p>Aim: To conduct a literature review in order to determine the predictors of nurses' health-related quality of life and to clarify the implications for nursing management and future study in this area. Background: Good health is essential to the performance of health care workers. Evaluation: Relevant studies were retrieved from PubMed, Medline, CINAHL, the Japan Medical Abstract Society, and the Technology Information Aggregator, Electronic. The studies selected for this review were published in English or Japanese between 1995 and 2012, investigated nurses' health-related quality of life. The identified predictive factors of each study were categorised according to type. Key issues: Based on the criteria, 22 studies were reviewed. The predictive factors of nurses' health-related quality of life were classified into eight categories. Conclusions: Age and occupational stress should be considered when examining unknown predictive factors of nurses' health-related quality of life. In addition, it may be useful to adopt a conceptual framework and consider patient and organisational factors in future research. Implications for nursing management: It is necessary to identify nurses' occupational stressors and consider age during job placement in order to support their health.</p>

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潜在看護師が復職後に復職をした自分になじむまでの過程

榊, 茜 and 深堀, 浩樹

日本看護管理学会誌 18 （ 2 ） 114 - 124 2014年12月

ISSN  1347-0140

　概要を見る

看護職員確保対策のひとつに潜在看護師の就労促進があるが、復職後の支援に関する報告は少ない。本研究はグラウンデッド・セオリー・アプローチを用いて潜在看護師の復職後の経験を概念化し、復職後の定着を促進するための支援検討を目的とした。結婚・出産を機に前職を退職し、ブランクを経て病院に復職した女性看護師11名に半構成的面接を行い分析した結果、次のような復職後の過程が明らかになった。復職した看護師は、環境の変化の実感や家庭と仕事の間での葛藤などブランクを経た復職に伴う動揺に直面し、その動揺を軽減し日々の仕事を行うために、個人的な取り組みと周囲を巻き込む努力を含むブランクを補う取り組みを行っていた。この時に取り組みを後押しする心境に至ること、職場からの支援を受けることで取り組みが促進され、状況改善の感触を得ることができていた。その結果、今の自分ができる仕事を割り切ることができるなど復職をした自分になじむことができていた。復職した潜在看護師の定着支援のために受け入れる職場に求められることとして、当人と相談しながら役割を定め段階を踏んで発展させるなど適切な役割期待や、人生経験を重ねた強みを認め本人に伝えることなどが示唆された。また、復職する看護師自身にできる工夫として、環境の変化に圧倒されず前向きに捉える、積極的に周囲を巻き込み疑問を解決する、などが考えられた。(著者抄録)

特別養護老人ホームで入居者を看取った家族介護者の経験

那須, 佳津美 and 深堀, 浩樹

老年看護学 19 （ 1 ） 34 - 42 2014年11月

ISSN  1346-9665

　概要を見る

本研究の目的は、特別養護老人ホーム(以下、特養)で入居者を看取る家族介護者の経験を明らかにすることである。地方都市にある特養3施設で、調査時点からさかのぼり2ヵ月以上1年以内に死亡した入居者の主な面会者であった家族介護者15人に、入居者を看取った経験について半構成的面接法を用いてデータ収集した。分析は、Colaizziの現象学的分析方法を用いて、質的帰納的に行った。分析の結果、特養で入居者を看取る家族介護者の経験として、【入居者との絆の実感】【入居者のために自分にできるケアの模索】【職員や同室者との折り合い】【医療処置と看取りの場の選択における葛藤】【大切な人を失っていくことへの対処】【入居者の人生と看取りの意味づけ】の6つのテーマが導かれた。看護職は、家族介護者が入居者との絆を感じて行う模索や葛藤を理解し、入居者の死後、家族介護者が入居者の人生や看取りをより満足感をもって振り返ることができるよう支援することが重要である。(著者抄録)

【看護学において若手研究者をどう育てるか?(II)】 若手看護学研究者としてどう育っていくか?　日本看護科学学会研究・学術情報委員会の若手調査に携わった立場から

深堀, 浩樹

看護研究 47 （ 2 ） 97 - 110 2014年04月

ISSN  0022-8370

Family caregiver strategies to encourage older relatives with dementia to use social services

Takai Yukari, Yamamoto-Mitani Noriko, Okamoto Yuko, Fukahori Hiroki, Ko Ayako, Tanaka Makoto

Journal of Advanced Nursing 69 （ 12 ） 2675 - 2685 2013年12月

ISSN  0309-2402

　概要を見る

<p>Aim: To elicit the strategies used by Japanese family caregivers in the community to encourage older relatives with dementia to use adult daycare and respite stays. Background: Older adults with dementia often require adult daycare and respite stays for their family caregivers to gain respite from care-giving. However, persons with dementia often face difficulty in new environments and timely access to sufficient services may be difficult to achieve. Few studies have examined how family caregivers encourage their service use. Design: A qualitative method. Methods: Semi-structured interviews were conducted with 16 family caregivers who were caring for relatives with dementia at home between 2005-2007. Data were analysed qualitatively. Results: Family caregivers used various strategies to encourage older relatives to use services, allowing the older adult to decide whether to use the service, yearning and searching for the least harmful service, tailoring the service to the older adult, persuading the older adult to use the service, conforming the older adult to the service and coercing the older adult to use the service. Different strategies were used depending on factors such as desperation in needing respite, willingness to do what is best for the older adult, confidence in taking care of the older adult and the anticipated response of the older adult to services. Conclusion: Nurses should carefully assess caregivers' strategies in their attempts to encourage service use and should provide adequate assistance in accordance with those strategies.</p>

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Factors associated with nurses' reporting of patients' aggressive behavior

Sato Kana, Wakabayashi Takeko, Kiyoshi-Teo Hiroko, Fukahori Hiroki

International Journal of Nursing Studies 50 （ 10 ） 1368 - 1376 2013年10月

ISSN  0020-7489

　概要を見る

<p>Background: Aggressive behavior and violence directed by patients at nurses are increasing worldwide. Aggressive behavior against nurses in their workplace can result in personal problems, such as impairment of physical and mental well-being, and, consequently, in organizational problems. Underreporting of patients' aggressive behavior is prevalent among nurses. Although underreporting might lead to inefficient attention to strategies for preventing aggressive behavior, the reasons for such behavior not being reported frequently have not been well examined. Objectives: To explore the frequency of nurses' reporting to their managers of patients' aggressive behavior by type and degree of impact suffered by the nurses, to examine the association between reporting of aggressive behavior and demographic factors, and to determine the reasons for underreporting. Design: A questionnaire-based cross-sectional survey. Setting: Six acute care hospitals in two regions in Japan. Participants: A total of 1953 nurses working at general acute care hospitals participated. Methods: Data were collected through a questionnaire seeking sociodemographic information, information on experience of aggressive behavior from patients, and the frequency with which they had reported such behavior in the previous month. The questionnaire also contained items assessing barriers to reporting of patients' aggressive behavior. The association between the possible influencing factors and reporting behavior was assessed using multiple logistic regression analyses. Results: Of the 1953 questionnaires distributed, 1498 (76.7%) were returned, and 1385 (70.9%) fully completed questionnaires were analyzed. More than one-third of the respondents had experienced the mildest assessed level of impact from patients' aggressive behavior, and 70% of those hardly reported any incidents. The milder the impact was, the less the nurse victims tended to report the incident. Nurse's tendency to feel that aggressive behavior was mitigated by the situation, less work experience, and lack of confidence that management would defend staff nurses from patients' aggressive behavior were found to be negatively associated with reporting behavior. Conclusions: This study identified factors associated with nurses' reporting of patients' aggressive behavior. Underreporting was found to be associated with the level of impact, managerial attitudes, nurses' work experience, and nurses' perception that the behavior was mitigated by the situation. Improving education among nurses to promote reporting incidents and establishing an organized system is needed.</p>

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The process of Japanese nurses' emotional experience in their first international disaster relief activity

尾立, 篤子, 佐藤, 可奈 and 深堀, 浩樹

お茶の水看護学雑誌 8 （ 1 ） 1 - 15 2013年10月

ISSN  1881-2112

　概要を見る

日本の災害支援チーム(JDRT)のメンバーとして途上国に派遣され、国際的災害支援活動(IDRA)に初めて従事した自衛隊看護師11名の体験を面接調査した。IDRAに対する情動反応の主な基盤はJDRTのメンバーとしての使命感であった。看護師は派遣前はIDRAがはっきりしないことに不安を感じ、周囲の人々の期待を強く感じていた。感情は高ぶっており、これを抑えて平静を保とうとしていた。到着後支援活動に初めて取り組んだが、過酷な状況下での絶え間ない支援活動によりストレスが蓄積し、疲労困憊した。この状況下で、自身の健康を優先したいという望みと、優先することへのためらいとの間で内なる葛藤を感じていた。派遣が長引く可能性があれば、健康を維持するための対策を講じざるを得ないと思うようになった。各種対策によりプラスの結果が得られたことにより、自身の健康が活動の持続性に影響を及ぼすことを徐々に認識し、維持するようになった。

Nursing ward managers' perceptions of pain prevalence at the aged-care facilities in Japan

Takai Yukari, Yamamoto-Mitani Noriko, Fukahori Hiroki, Kobayashi Sayuri, Chiba Yumi

Pain Management Nursing 14 （ 3 ）  2013年09月

ISSN  1524-9042

　概要を見る

<p>This study aimed to examine nursing ward managers' perceptions of pain prevalence among older residents and the strategies of pain management at the Health Service Facilities for the Elderly Requiring Care (HSFERC) in Japan and to investigate the factors related to the prevalence. Nursing ward managers in 3,644 HSFERC were asked to participate in this study. Questionnaires were sent to them regarding pain prevalence among the older residents in their wards, their provisions for pain care, and other pain management strategies. The perceived pain prevalence factors were examined statistically. The final sample comprised 439 participants (12.0%). A total of 5,219 residents (22.3%) were recognized as suffering from pain on the investigation day. Only 8 wards (1.8%) used pain management guidelines or care manuals, and 14 (3.2%) used a standardized pain scale. The ward managers' age (p = .008) and nursing experience (p = .006) showed a significant negative association with pain prevalence estimation. Moreover, there was a significant association between the groups' pain prevalence estimation and the nursing managers' beliefs that older adults were less sensitive to pain (p= .01), that pain was common among older people (p = .007), and that the time to treat residents' pain was insufficient (p = .001). The ward managers' perceptions regarding pain prevalence varied; the perceived pain rates were possibly lower than the actual percentages. Insufficient pain management strategies at the HSFERC were also suggested. An appropriate pain management strategy for Japanese aged care and its dissemination are urgently required.</p>

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患者やその家族による看護師への暴力に看護師長が対応する際の困難とその要因

佐藤, 可奈, 深堀, 浩樹 and 湯本, 淑江

日本医療・病院管理学会誌 50 （ Suppl. ） 197 2013年08月

ISSN  1882-594X

高齢者訪問看護質指標(転倒予防)を用いたインターネットによる訪問看護支援システムの有効性　訪問看護師の自己評価からの分析

鈴木, みずえ, 上野, 桂子, 中間, 浩一, 深堀, 浩樹 and 山本, 則子

コミュニティケア 15 （ 8 ） 60 - 64 2013年07月

看護政策に携わる看護職が現在の職業・立場につくまでの経験

田川, 晴菜, 窪田, 和巳, 山口, さおり and 深堀, 浩樹

日本看護管理学会誌 17 （ 1 ） 48 - 56 2013年06月

ISSN  1347-0140

　概要を見る

本研究は、看護政策に携わる看護職の現在の職業・立場につくまでの経験を明らかにし、彼らの意見から看護職の看護政策に関する興味・関心を高める方略についての示唆を得ることを目的とした。看護政策へ携わる看護職6名を対象に半構造的インタビューを実施し、質的に分析した。分析の結果、看護政策に携わる看護職の現在の職業・立場につくまでの経験として「看護政策に関心を持ったきっかけとなった経験」、「看護政策への理解を深めた体験」、「周囲の人々から対象者への反応」の3カテゴリーが、看護政策に関する興味・関心を高める方略についての意見や考えとして「看護政策への関心を高める上での障害」、「看護政策への関心を高めるために考えられる取り組み」の2カテゴリーが得られた。将来看護政策に携わりたいと考える看護職にとって、看護政策に直接携わる人との関わりが重要であるとともに、基礎教育の段階で医療・看護政策に関する内容を学び、看護以外の分野の知識や海外の医療制度・看護実践について知ることが有益であることが示唆された。また、今後より多くの看護職が看護政策に関心を持つようになるための体制を考える上で、多忙な臨床現場でも効率的に看護政策に関する情報が得られる環境整備や看護職の情報リテラシーを高める取り組み、若年層に対するアプローチが重要であることが示唆された。(著者抄録)

【ELNEC-J研修を振り返る】 ELNEC-J高齢者プログラムの試験的運用から得られた今後の課題

深堀, 浩樹, 得居, みのり, 吉岡, 佐知子, 西山, みどり, 松本, 佐知子, 塩塚, 優子, 高梨, 早苗, 高道, 香織, 齊田, 綾子, 田中, 和子 and 桑田, 美代子

看護管理 23 （ 4 ） 278 - 284 2013年04月

ISSN  0917-1355

Stressor Scale for Clinical Research Coordinators

Matsumoto Kazufumi, Sumino Kumiko, Fukahori Hiroki, Kitaoka Kazuyo, Kamibeppu Kiyoko, Nagamura Fumitaka

Journal of Advanced Nursing 68 （ 7 ） 1636 - 1645 2012年07月

ISSN  0309-2402

　概要を見る

<p>Aim. This article is a report of the development and psychometric testing of the Stressor Scale for Clinical Research Coordinators. Background. Job stress is viewed as a situation where working conditions interact with individual worker characteristics and result in disruption of psychological or physiological homeostasis. Clinical research coordinators, also known as research nurses, are professionals who play a central role in clinical trials. They face various problems associated with their responsibilities; however, few studies have reported on their stress. To manage their stress, it is necessary to identify the sources of stress (i.e. stressors). Method. The 56-item preliminary instrument was developed based on literature review and expert discussions. A total of 589 clinical research coordinators in 186 hospitals in Japan were surveyed in 2011. Statistical analyses on construct and concurrent validity, internal consistency, and test-retest reliability were performed. Results. A six-factor solution with 23 items was selected using exploratory factor analysis: 'quantitative workload', 'conflict with investigators', 'ambiguity of work', 'conflict with other clinical research coordinators and with supervisors', 'demands from an affiliate other than the hospital', and 'difficulty in caring for trial participants'. Confirmatory factor analysis affirmed construct validity, with a demonstrated acceptable fit between the factor structure and the observed data. All factors had significant correlations with burnout and psychological distress, which indicated acceptable concurrent validity. Cronbach's alpha coefficients ranged from 0·73-0·82. Intra-class correlation coefficients indicated almost satisfactory test-retest reliability. Conclusion. Our new instrument has acceptable validity and reliability for evaluating job stressors for clinical research coordinators.</p>

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Aggression Exhibited by Older Dementia Clients Toward Staff in Japanese Long-Term Care

Ko Ayako, Takasaki Kinuko, Chiba Yumi, Fukahori Hiroki, Igarashi Ayumi, Takai Yukari, Yamamoto-Mitani Noriko

Journal of Elder Abuse and Neglect 24 （ 1 ） 1 - 16 2012年01月

ISSN  0894-6566

　概要を見る

<p>This study examined the experiences of staff members from seven Japanese hospitals who had been treated aggressively by older dementia clients. Altogether, 170 questionnaires were analyzed. In the past year, 75.3% and 63.5% of staff members had experienced physical and verbal aggression, respectively. Working numerous night shifts, working shifts other than 3-shifts, and being allotted assignments with clients who had a lower average level of physical capacity were the factors associated with recurrent client aggression. Those staff members who spent adequate time caring for their clients, who gained client consent before providing care, and who tried to build a trusting relationship with their clients were found to have experienced less aggression. Burnout, which is likely to enhance the risk of the staff mistreatment and neglect of older clients, was found to be higher among those who experienced aggression.</p>

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Healthcare services for Japanese elderly long-staying in Thailand from the perspective of the patient and healthcare providers

Fukahori Hiroki, Baba Yuji, Hioki Fumika, Monkong Supreeda, Intarasombat Prakong, Malathum Porntip

Archives of Gerontology and Geriatrics 53 （ 2 ）  2011年09月

ISSN  0167-4943

　概要を見る

<p>Long-stay refers to a long visit abroad by retired middle-aged and older people. This study describes the attitudes/opinions of elderly Japanese long-staying subjects and healthcare providers in Thailand. Two cross-sectional questionnaire surveys were conducted in Chiang Mai Province, Thailand. Questionnaires were sent to a sample recruited from a self-help group of Japanese elders in Thailand (n= 68) and to Thai healthcare providers (n= 101). About half of the Japanese subjects routinely used a Thai medical service, although only 15% had been admitted to the hospital. Half of the Japanese subjects thought the quality of Thai medical services was high. Many elderly Japanese subjects were unable to speak either English or Thai, leading to communication difficulties. About 80% of healthcare professionals found no difference between caring for elderly Japanese subjects and people from Thailand. Most healthcare providers agreed that Japanese language training should be available to medical staff as translators were not always available. Healthcare providers agreed with the Thai government policy promoting long-stays. The most recognized obstacle in caring for Japanese long-stay elderly was the language barrier. More research on Japanese elders staying abroad is needed to promote effective communication between Japanese elderly and other ethnic healthcare professionals.</p>

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【ソーシャルメディアと研究】　ソーシャルメディアが看護学の研究にもたらすもの--変わらないものと新たな可能性

深堀, 浩樹

看護研究 44 （ 4 ） 458 - 466 2011年07月

ISSN  0022-8370

精神科の男性看護師が患者を「押さえる役割」を引き受けるまでのプロセス

宮武, 郁夫 and 深堀, 浩樹

精神看護 14 （ 4 ） 69 - 75 2011年07月

ISSN  1343-2761