Development of an Assessment Scale that Guides the Decision to Commence Home-Visit Nursing

Research Project

Project/Area Number	17H07375
Research Category	Grant-in-Aid for Research Activity Start-up
Allocation Type	Single-year Grants
Research Field	Community health nursing
Research Institution	University of Shizuoka (2018) National Defense Medical College (2017)
Principal Investigator	Shimohigoshi Naoko 静岡県立大学, 看護学部, 講師 (50805108)
Research Collaborator	Yatsushiro Rika
Project Period (FY)	2017-08-25 – 2019-03-31
Project Status	Completed (Fiscal Year 2018)
Budget Amount *help	¥2,600,000 (Direct Cost: ¥2,000,000、Indirect Cost: ¥600,000) Fiscal Year 2018: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000) Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Keywords	ケアマネジメント / 訪問看護 / ケアマネジャー / 介護保険制度 / アセスメント / 介護保険 / アセスメント指標 / 在宅療養者 / 在宅高齢者 / 看護学
Outline of Final Research Achievements	This study aimed to examine a construct of assessment criteria upon which geriatric care managers would decide to commence home-visit nursing services. To this end, we conducted a postal survey among 200 such care managers. Having removed 17 items based on the results of the item analysis, we analyzed the remaining factors to confirm construct validity. This factor analysis yielded 96 items that consisted of four factors: 1) user’s daily life condition and the support he/she requires for daily living, 2) strengthening medical support for users, 3) scheduling medical treatment/management or recuperation, and 4) preparing for mental and physical changes in the user and preventing the situation from deteriorating. The Cronbach’s alpha was 0.974 overall, and for each of the four factors it ranged from 0.933 to 0.963, denoting that the 96 items are sufficiently reliable as a scale for assessing whether to commence home-visit nursing.
Academic Significance and Societal Importance of the Research Achievements	本研究は、訪問看護導入に伴うアセスメントツールの開発の第一段階として、ケアマネジャーが訪問看護を導入する判断となる要因の構成概念、構成する項目を明らかにすることであった。その結果、構成概念は【利用者の生活状況と必要な日常生活の支援】（37項目）【利用者への医療面の支援の強化】（19項目）【利用者の医療的処置・管理と療養の時期】（18項目）【利用者の心身状態の悪化予防と備え】（22項目）であり、96項目で構成された。ケアマネジャーのアセスメントの偏りに影響されることなく、訪問看護が在宅療養者へ適時に提供されるよう、各因子を構成する項目を精選し、実用化ヘ向けて、さらに、分析をすすめる必要がある。