ユニットケアに取り組む特別養護老人ホームの看護職と介護職の協働と教育

本研究の目的は,ユニットケアに取り組む特別養護老人ホームにおいて,看護職と介護職の協働の状況を明らかにし,協働していく上で両職種が必要とする教育の方向性の示唆を得ることである｡看護職2名,介護職3名を対象に自由回答法による半構成的･個別面接を実施した｡その結果,協働の状況は, 1)両職種のユニットケアのとらえかたや取り組みは相違し,協働に向けた工夫を行っていたものの,協働関係は成立しにくい状況であった｡2)両職種は期待されている役割を担うために教育･研修を受け専門能力を高めたいと考えていた｡両職種が協働していく上で必要とする教育の方向性として,以下の示唆を得た｡1)利用者や介護職から期待される福祉施設における看護の役割と専門性を高めるために看護職が現実的な課題を解決する力の修得を目指す｡2)様々な教育背景と教育ニーズを持つ介護職が知識,技術,ケアの実践力を習得するためには,個人の学習状況とニーズに応じて学習科目を自己管理し自発的な力を高めていく｡3)両職種がお互いの専門性を認め,向上を図ることができるようにともに課題を解決し相互作用が継続できる共同研修プログラムによる研修を実施する｡

The purpose of this study was to identify the interprofessional education and training necessary to achieve teamwork between nurses and care-workers in small-scale care units within special nursing homes. The study design employed an inductive qualitative method. Data were collected from two nurses and three care-workers through personal interviews. Qualitative inductive analysis was used to obtain results. The present situation regarding care in small-scale care units by the two occupational categories was clarified as followed: 1) Despite attempts to work as a team, there were persistent differences in understanding the role of each worker and approach between the two occupational categories, leaving gaps in care. and 2) the care providers in both categories were willing to receive education and training to improve their professional skills and knowledge in order to play their expected roles. For future education, the following training programs were considered to be necessary to achieve cooperation among the two groups in performing the work: 1) a program that helps nurses master practical problemsolving skills, as expertise in problem-solving is expected of nurses in special nursing homes, 2) a program that helps care-workers to enhance their abilities for self-directed study at their level and according to their needs, so that people with various educational backgrounds and needs can obtain knowledge, skills, and ability to practice care. and 3) a program in which both nurses and care-workers can develop mutual respect for the expertise required by each occupation and that will produce synergistic effects on overall care.