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精神科看護における認知症高齢者のBPSDへの対応と課題 : 「問題行動」をキーワードとしたケーススタディの文献検討から
片丸, 美恵;宮島, 直子;村上, 新治
Permalink : http://hdl.handle.net/2115/35523
JaLCDOI : 10.14943/33986
KEYWORDS : elderly patient with dementia;psychiatric nursing;literature review;認知症;BPSD;精神科看護;文献検討
Abstract
認知症高齢者のBPSDへの看護介入と看護研究の課題を明らかにする目的で，過去10年間の文献検討を行なった。精神科看護におけるBPSDを示す認知症高齢者のケーススタディ6編が選択され，「なじみの関係をつくる」，「安定した場所の確保」，「行動症状・心理症状の背後にある要因をアセスメントする」，「自尊感情を守る関わり」，「コミュニケーションの工夫」，「介入のタイミングを見計らう」，「セイフティマネジメント」，「非薬物療法への参加を奨める」という8項目に分類された。精神科看護技術の統合に向けて，1.ケーススタディにおいて，神経学的要因， BPSD，看護介入，結果を丁寧に記述し，それぞれを認知症タイプや病期において比較検討する， 2. BPSDに対するコミュニケーション技法を検討する， 3. 認知症の重篤なBPSDに対するセイフティマネジメントを検討する，の課題があげられた。
This literature review in from the last 10 years was done for the purpose to reveal nursing interventions and study themes to behavioral psychological symptoms of dementia (BPSD) in elderly patients with dementia. We overviewed six case studies of elderly patients with dementia, who showed problem behavior at psychiatric hospitals. On the nursing interventions, we classified eight intervention which are "to make familiar relationship", "to keep the steady position ", "to back for the BPSD", "to protect their self-esteem", "better way to communicate with patients", "to consider the timing", "safety management" and "to recommend non medication treatments". We chose three nursing points for studying further. One was to compare the type and stage of dementia and to describe exactly the brain function deficit, BPSD, nursing interventions and their results. Secondly we considered how to communicate with patients who are exhibiting BPSD. Thirdly we looked at safety management for severe cases of BPSD.
This literature review in from the last 10 years was done for the purpose to reveal nursing interventions and study themes to behavioral psychological symptoms of dementia (BPSD) in elderly patients with dementia. We overviewed six case studies of elderly patients with dementia, who showed problem behavior at psychiatric hospitals. On the nursing interventions, we classified eight intervention which are "to make familiar relationship", "to keep the steady position ", "to back for the BPSD", "to protect their self-esteem", "better way to communicate with patients", "to consider the timing", "safety management" and "to recommend non medication treatments". We chose three nursing points for studying further. One was to compare the type and stage of dementia and to describe exactly the brain function deficit, BPSD, nursing interventions and their results. Secondly we considered how to communicate with patients who are exhibiting BPSD. Thirdly we looked at safety management for severe cases of BPSD.
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