Action Research on the Education Program with the "Nursing Practice Model(TK model)" for Patient Education, and the Intervention Research

• Project/Area Number: 21249096
• Research Category: Grant-in-Aid for Scientific Research (A)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Clinical nursing
• Research Institution: Japanese Red Cross Hokkaido college of Nursing (2011-2012); Japanese Red Cross College of Nursing (2009-2010)
• Principal Investigator: KAWAGUCHI Teruko 日本赤十字北海道看護大学, 看護学部, 教授 (50247300)
• Co-Investigator(Renkei-kenkyūsha): YASUKATA Fumiko 福岡県立大学, 看護学部, 教授 (10254559) ; HAYASHI Yuuko 大阪医科大学, 看護学部, 教授 (50284120) ; OOIKE Miyako 九州大学, 大学院・医学研究科, 教授 (80284579) ; KONDO Fusae 順天堂大学, 保健看護学部, 教授 (70286425) ; KOBAYASHI Takako 大阪医科大学, 看護学部, 教授 (50279618) ; OKA Michiyo 群馬大学, 医学部保健学科, 教授 (10312729) ; KONAGAYA Momoe 昭和大学, 保健医療学部, 教授 (10269293) ; KODAIRA Kyoko 関西看護医療大学, 看護学部, 教授 (40205406) ; SHIMOMURA Hiroko 日本赤十字看護大学, 看護学部, 講師 (20216138) ; YOKOYAMA Etsuko 防衛医科大学, 校看護学科設立準備室, 准教授 (40329181)
• Project Period (FY): 2009 – 2012
• Project Status: Completed (Fiscal Year 2012)
• Budget Amount: ¥33,540,000 (Direct Cost: ¥25,800,000、Indirect Cost: ¥7,740,000); Fiscal Year 2012: ¥8,580,000 (Direct Cost: ¥6,600,000、Indirect Cost: ¥1,980,000); Fiscal Year 2011: ¥8,970,000 (Direct Cost: ¥6,900,000、Indirect Cost: ¥2,070,000); Fiscal Year 2010: ¥7,800,000 (Direct Cost: ¥6,000,000、Indirect Cost: ¥1,800,000); Fiscal Year 2009: ¥8,190,000 (Direct Cost: ¥6,300,000、Indirect Cost: ¥1,890,000)
• Keywords: 患者教育 / 教育的関わり / 生活者 / アクション・リサーチ / 無作為化比較試験 / 看護 / とっかかり/手がかり言動 / 直観的解釈 / 治療の看護仕立て / 看護師 / 生活 / Progessional Learning Climate / 直感的解釈 / Professional Learning Climate / とっかかり / 手がかり言動

Research Abstract

Action research was conducted using the model at three different hospitals between February 2008 and August 2010. The model development research group of 24 researchers split up to give explanations of the model and participate in case review meetings at the three sites. There were a total of 12 clinical nurses among the research participants and 31 nurses who participated in the study meetings. The data was collected from interviews with the participating nurses; from recordings of the study meetings, case review meetings, and discussion meetings; from participant observation records, etc. The method of analysis used was to keep in mind "what kind of changes arose in the participating nurses from case review meetings using the TK model," extract the changes in the participating nurses and other nurses on the wards, and study how the researchers implemented their involvement. The purpose of the intervention research was to evaluate the outcomes of individual face-to-face patient educat ion provided by a nurse over a period of 15 months to people with type 2 diabetes. A randomized controlled trial was used. 96 adults with type 2 diabetes receiving outpatient treatment at a clinic specializing in diabetes were divided randomly into an intervention group and a usual care group. The intervention group received individual face-to-face patient education from a nurseprior to and following their outpatient treatment every four to six weeks over the 15-month period. The post test was completed with 45 participants in the intervention group and 43 in the usual care group (an attrition rate of 8.5%). Nursing intervention over the 15-month period for the intervention group averaged 10.3 sessions (SD = 1.9) and 20.4 minutes (SD = 8.0) per session. With regard to dietary and exercise self-management, a significant improvement in nutritional balance was seen in the interventiongroup (F (1, 80) = 7.28, p < .01) versus the usual care group. Scores for amount of exercise indicated a trend towards better exercise self-management (F (1, 80) = 2.81, p = .098) in the intervention group as opposed to the usual care group. There was no significant difference between the two groups with regard to control of caloric intake or changes in meal time patterns.

Research Products

• [Journal Article] 看護実践モデル「看護の教育的関わりモデル」開発者の立場から考える専門性 (2013)
  • Author(s): 河口てる子
  • Journal Title: 日本糖尿病教育・看護学会誌 Volume: 17(1) Pages: 63-65
• [Journal Article] 患者教育の新しい風 看護の教育的関わりモデル Ver.6.4 とは (2011)
  • Author(s): 河口てる子
  • Journal Title: Nursing Today Volume: 26(6) Pages: 12-18
• [Journal Article] 患者が出しているサインを捉える とっかかり/手がかり言動とその直感的解釈 (2011)
  • Author(s): 伊藤ひろみ・小平京子・小林貴子・小長谷百絵・横山悦子
  • Journal Title: Nursing Today Volume: 26(6) Pages: 19-22
• [Journal Article] 生活者としての理解 生活者としての事実とその意味の分かち合い (2011)
  • Author(s): 下村裕子・林優子・井上智恵
  • Journal Title: Nursing Today Volume: 26(6) Pages: 23-28
• [Journal Article] 意思・病状・認知・生活に合わせた治療・療養法のアレンジをする 治療の看護仕立て (2011)
  • Author(s): 小田和美・下田ゆかり・伊波早苗
  • Journal Title: Nursing Today Volume: 26(6) Pages: 29-33
• [Journal Article] 行動変容を支える 協同探索型関わり技法 (2011)
  • Author(s): 恩幣宏美・岡美智代・滝口成美・近藤ふさえ
  • Journal Title: Nursing Today Volume: 26(6) Pages: 34-38
• [Journal Article] 行動変容のプロモーター 患者教育専門家として醸し出す雰囲気(PLC:Professional Learning Climate) (2011)
  • Author(s): 長谷川直人・安酸史子・太田美帆・道面千恵子
  • Journal Title: Nursing Today Volume: 26(6) Pages: 39-43
• [Journal Article] 看護の教育的関わりモデルで看護師はどう変わるのか (2011)
  • Author(s): 大澤栄実・東めぐみ・大池美也子
  • Journal Title: Nursing Today Volume: 26(6) Pages: 44-50
• [Journal Article] 患者教育の新しい風看護の教育的関わりモデルVer.6.4とは (2011)
  • Author(s): 河口てる子
  • Journal Title: Nusing Today Volume: 26(6) Pages: 12-18
• [Journal Article] 患者が出しているサインを捉えるとっかかり/手がかり言動とその直感的解釈 (2011)
  • Author(s): 伊藤ひろみ・小平京子・小林貴子・小長谷百絵・横山悦子
  • Journal Title: Nusing Today Volume: 26(6) Pages: 19-22
• [Journal Article] 生活者としての理解生活者としての事実とその意味の分かち合い (2011)
  • Author(s): 下村裕子・林優子・井上智恵
  • Journal Title: Nusing Today Volume: 26(6) Pages: 23-28
• [Journal Article] 意思・病状・認知・生活に合わせた治療・療養法のアレンジをする治療の看護仕立て (2011)
  • Author(s): 小田和美・下田ゆかり・伊波早苗
  • Journal Title: Nusing Today Volume: 26(6) Pages: 29-33
• [Journal Article] 行動変容を支える協同探索型関わり技法 (2011)
  • Author(s): 恩幣宏美・岡美智代・滝口成美・近藤ふさえ
  • Journal Title: Nusing Today Volume: 26(6) Pages: 34-38
• [Journal Article] 行動変容のプロモーター患者教育専門家として醸し出す雰囲気(PLC:Professional Learning Climate) (2011)
  • Author(s): 長谷川直人・安酸史子・太田美帆・道面千恵子
  • Journal Title: Nusing Today Volume: 26(6) Pages: 39-43
• [Journal Article] 看護の教育的関わりモデルで看護師はどう変わるのか (2011)
  • Author(s): 大澤栄実・東めぐみ・大池美也子
  • Journal Title: Nusing Today Volume: 26(6) Pages: 44-50
• [Journal Article] 【看護におけるイノベーションの現在 日本の看護系学会が推進するケアの開発と実践】日本慢性看護学会 患者教育の実践研究事例「看護の教育的関わりモデル」 (2010)
  • Author(s): 河口てる子
  • Journal Title: インターナショナルナーシングレビュー Volume: 33(3) Pages: 116-122
• [Presentation] 看護実践モデル「看護の教育的関わりモデル」開発者の立場から考える専門性 (2012)
  • Author(s): 河口てる子
  • Organizer: 第17回日本糖尿病教育・看護学会学術集会
  • Place of Presentation: 京都:国立京都国際会館
  • Year and Date: 2012-09-30
• [Presentation] 看護実践モデル「看護の教育的関わりモデル」開発者の立場から考える専門性 (2012)
  • Author(s): 河口てる子
  • Organizer: 第17回日本糖尿病教育・看護学会学術集会
  • Place of Presentation: 国立京都国際会館
• [Presentation] Action Research Using the Nursing Model on Education: Outline of the Model Version 6.3 and the Usefulness in Three Action Research Implementations (2011)
  • Author(s): Kawaguchi, T., Shimomura, H., Yokoyama, E., Higashi, M., Yamada, E., Oike, M., Hasegawa, N., Inoue, C., Kondo, F., Konagaya, M., Kobayashi, T., Oda, K., Kodaira, K., Hayashi, Y., Yasukata, F., Oka, M., Iha, S., Takiguhi, N., Ito, H., Ota, M., Onbe, H., Domen, C.
  • Organizer: 2nd International Nursing Research Conference
  • Place of Presentation: Cancun, Mexico
  • Year and Date: 2011-07-14
• [Presentation] Action Research Using the Nursing Model on Education: Study Meetings and the Study of Nursing Practice Facilitated by a Staff Nurse (Certified Nurse Specialist) (2011)
  • Author(s): Yamada, E., Inoue, C., Oda, K., Kobayashi, T., Hayashi, Y.,Onbe, H., Yokoyama, E., Shimomura, Y., Kawaguchi, T.
  • Organizer: 2nd International Nursing Research Conference
  • Place of Presentation: Cancun, Mexico
  • Year and Date: 2011-07-14
• [Presentation] Action Research Using the Nursing Model on Education : Outline of the Model Version 6.3 and the Usefulness in Three Action Research Implementations (2011)
  • Author(s): Kawaguchi, T., Shimomura, H., Yokoyama, E., Higashi, M., Higashi, M., Yamada, E., Oike, M., Hasegawa, N., Inoue, C., Kondo, F., Konagaya, M., Kobayashi, T., Oda, K., Kodaira, K., Hayashi, Y., Yasukata, F., Oka, M., Iha, S., Takiguhi, N., Ito, H., Ota, M., Onbe, H., Domen, C.
  • Organizer: 2nd International Nursing Research Conference
  • Place of Presentation: Cancun, Mexico
  • Year and Date: 2011-07-14
• [Presentation] Action Research Using the Nursing Model on Education : study Meetings and the study of Nursing Practice Facilitated by a staff Nurse (Certified Nurse Specialist) (2011)
  • Author(s): Yamada, E., Inoue, C., Oda, K., Kobayashi, T., Hayashi, Y., Onbe, H., Yokoyama, E., Shimomura, Y., Kawaguchi, T.
  • Organizer: 2nd International Nursing Research Conference
  • Place of Presentation: Cancun, Mexico
  • Year and Date: 2011-07-14
• [Presentation] 患者教育について学ぶ 「看護の教育的関わり」-患者教育の実践知-「看護の教育的関わりモデル」 (2010)
  • Author(s): 河口てる子
  • Organizer: 第48回日本がん治療学会学術集会
  • Place of Presentation: 京都市:国立京都国際会館
  • Year and Date: 2010-10-29
• [Presentation] 患者教育について学ぶ「看護の教育的関わり」・患者教育の実践知・「看護の教育的関わりモデル」 (2010)
  • Author(s): 河口てる子
  • Organizer: 第48回日本がん治療学会学術集会
  • Place of Presentation: 京都市:国立京都国際会館
  • Year and Date: 2010-10-29
• [Presentation] 「看護の教育的関わりモデル」を用いたアクションリサーチ:病棟看護師主導のアクションによる看護師の変化 (2009)
  • Author(s): 山田栄美、林優子、小林貴子、井上智恵、小田和美、河口てる子他7名
  • Organizer: 第29回日本看護科学学会学術集会
  • Place of Presentation: 幕張メッセ(千葉県)
  • Year and Date: 2009-11-28
• [Presentation] 「看護の教育的関わりモデル」を用いたアクションリサーチ:モデルVer.6.1の概要 (2009)
  • Author(s): 河口てる子・下村裕子・横山悦子
  • Organizer: 第29回日本看護科学学会学術集会
  • Place of Presentation: 幕張メッセ(千葉県)
  • Year and Date: 2009-11-28
• [Presentation] 「看護の教育的関わりモデル」を用いたアクションリサーチ:院内教育担当者のアクションによる看護師の変化 (2009)
  • Author(s): 東めぐみ・横山悦子・下村裕子・河口てる子
  • Organizer: 第29回日本看護科学学会学術集会
  • Place of Presentation: 幕張メッセ(千葉県)
  • Year and Date: 2009-11-28
• [Presentation] 看護の教育的関わりモデル」を用いたアクションリサーチ:大学研究者からのアクションによる看護師の変化 (2009)
  • Author(s): 大池美也子・横山悦子・下村裕子・河口てる子
  • Organizer: 第29回日本看護科学学会学術集会
  • Place of Presentation: 幕張メッセ(千葉県)
  • Year and Date: 2009-11-28