{"created":"2023-07-27T06:30:57.421293+00:00","id":16189,"links":{},"metadata":{"_buckets":{"deposit":"f6099b00-a0c1-409a-94c8-b126b1164b7e"},"_deposit":{"created_by":3,"id":"16189","owners":[3],"pid":{"revision_id":0,"type":"depid","value":"16189"},"status":"published"},"_oai":{"id":"oai:kanazawa-u.repo.nii.ac.jp:00016189","sets":["1132:1137:1223:1236"]},"author_link":["29819"],"item_7_alternative_title_2":{"attribute_name":"その他のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"脳卒中リハビリテーション看護における専門看護師 (CNS) のコンサルテーションの効果 : 高次機能障害患者の社会的行動障害に対するコンサルテーション"}]},"item_7_biblio_info_8":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2011-01-04","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"89","bibliographicPageStart":"77","bibliographicVolumeNumber":"34","bibliographic_titles":[{"bibliographic_title":"金沢大学つるま保健学会誌 = Journal of the Tsuruma Health Science Society Kanazawa University"}]}]},"item_7_description_21":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"The objective of this study is to utilize the consultation roles of the CNS that the author clarified in previous research to intervene with nurses regarding social behavior deficits in patients with higher cortical dysfunction and to evaluate the intervention. 　The study participants were 10 patients with deficits in social behavior due to higher cortical dysfunction and 14 nurses, including five research team members, on a ward for recovery phase patients in a hospital specializing in the care of stroke patients. Action research was used as the research design. Reflection notes, study group meeting records, and a post-study questionnaire of research team members were used as qualitative data, and the autonomy scale of the 14 ward nurses and the stroke scale-emotional disturbance scale and FIM scores for the study patients were examined. 　As a result, the research team members experienced the following changes : (1) Feeling that they insufficiently understood the communication characteristics of higher cortical dysfunction and could not properly assess the patients psychiatric symptoms ; (2) Noticing that their emotions affected the mental state of the patients ; (3) Sharing of information and patient handling tips among the nursing teams ; (4) Recognizing the applicability of the guidelines to patients with reduced cognitive function ; (5) Understanding the timing for calling for a psychiatrist and shifting to active engagement ; and (6) Calling conferences early and working out solutions together. Scores for the 9 ward nurses not on the research team improved on the autonomy scale but a significant difference was observed only in practical skills after the study (p＜0.05). Scores for the 10 patients on the depression scale and emotional disturbance scale decreased significantly after intervention (p＜0.05). 　These results suggest that the CNS consultation helped nurses become proactive in focusing on the causes of problematic behavior in patients and contributed to bringing stability to the mental condition of the patients. The consultation also empowered the nurses and influenced their autonomy. 本研究の目的は、高次脳機能障害患者の社会的行動障害に対し、先行研究で明らかにし たCNSのコンサルテーション機能を用いて看護師へ介入し、その効果を明らかにすること である。対象は脳卒中専門病院の一回復期病棟において、高次脳機能障害の社会的行動障 害がある患者１０名と、研究チームメンバー５名を含む当該病棟看護師１４名である。研究デ ザインはアクションリサーチを用い、振り返り記録、勉強会記録、研究メンバーの研究終 了後アンケート等の質的データと、病棟看護師１４名の自律性尺度、対象患者の脳卒中感情 障害スケール、FIMの得点を調べた。結果、研究メンバーは次のような変化を遂げた： 高次脳機能障害のコミュニケーション特性の理解と、精神症状のアセスメント力が不足し ていると感じる 看護師の感情が患者の精神状態に影響することに気づく 看護チームで 共通の情報・関わりをもつ 認知機能が低下した患者にもガイドラインが適用できること に気づく 精神科へかけるタイミングがつかめ積極的に関わる姿勢に変化する 早めにカ ンファレンスにかけみんなで対応を考える。研究チーム以外の病棟看護師９名の自律性尺 度は、研究後に向上したが「実践能力」以外有意差はなかった（p＜００.５）。対象患者１０名 の脳卒中感情障害スケールは、介入後に有意に減少した（P＜００.５）。これらより、CNSの コンサルテーションは、看護師が能動的に患者の問題行動の原因に焦点化して対処できる よう導き、患者の精神状態の安定をもたらすことに貢献した。また、看護師をエンパワー し看護師の自律性に影響を与えた。","subitem_description_type":"Abstract"}]},"item_7_description_22":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"[原著]","subitem_description_type":"Other"}]},"item_7_publisher_17":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"金沢大学つるま保健学会 = the Tsuruma Health Science Society, Kanazawa University"}]},"item_7_source_id_11":{"attribute_name":"NCID","attribute_value_mlt":[{"subitem_source_identifier":"AA11599711","subitem_source_identifier_type":"NCID"}]},"item_7_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"1346-8502","subitem_source_identifier_type":"ISSN"}]},"item_7_version_type_25":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"Shimomura, Akiko"}],"nameIdentifiers":[{"nameIdentifier":"29819","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2017-10-04"}],"displaytype":"detail","filename":"AA11599711-34-2-77-89.pdf","filesize":[{"value":"1.4 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"AA11599711-34-2-77-89.pdf","url":"https://kanazawa-u.repo.nii.ac.jp/record/16189/files/AA11599711-34-2-77-89.pdf"},"version_id":"c096d569-f5b0-4b6f-b493-33835112454d"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"stroke rehabilitation nursing","subitem_subject_scheme":"Other"},{"subitem_subject":"CNS","subitem_subject_scheme":"Other"},{"subitem_subject":"consultation","subitem_subject_scheme":"Other"},{"subitem_subject":"higher cortical dysfunction","subitem_subject_scheme":"Other"},{"subitem_subject":"action research","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"eng"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"Evaluating the consultation by a Certified Nurse Specialist (CNS) in stroke rehabilitation nursing : Consultation on social behavior deficits in patients with higher cortical dysfunction","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"Evaluating the consultation by a Certified Nurse Specialist (CNS) in stroke rehabilitation nursing : Consultation on social behavior deficits in patients with higher cortical dysfunction"}]},"item_type_id":"7","owner":"3","path":["1236"],"pubdate":{"attribute_name":"公開日","attribute_value":"2017-10-04"},"publish_date":"2017-10-04","publish_status":"0","recid":"16189","relation_version_is_last":true,"title":["Evaluating the consultation by a Certified Nurse Specialist (CNS) in stroke rehabilitation nursing : Consultation on social behavior deficits in patients with higher cortical dysfunction"],"weko_creator_id":"3","weko_shared_id":3},"updated":"2023-07-27T17:07:41.224129+00:00"}