奈良県における在宅看護の変遷と現状

Abstract

在宅看護は、在宅で療養する人々に対して、彼らが望む生活の質(QOL:quality of 1ife) を維持・向上させることを目的に、本人および家族に対して提供される看護活動である。在宅看護の変遷をたどると、老人訪問看護ステーションが1992(平成4)年に新設され、その後の対象者の拡大や介護保険制度の導入に伴い、「訪問看護」「在宅療養移行支援」「自宅以外のすまい・施設での看護」の枠組みで発展してきたといえる。団塊の世代すべてが後期高齢者(75歳以上)となる2025年を視野に地域包括ケアシステムを構築することを目指し全国で取組みが進められている。このような社会情勢の変化の中、今後ますます需要が大きくなる在宅看護について、変遷をたどり現状を確認することからいくつかの課題が浮かび上がった。中でも在宅看護の質の保証のための人材育成が重要であり、訪問看護師の継続教育においては体系化と専門性の向上に向けての教育体制が、看護基礎教育においては「生活を見る視点」 の強化が必要といえる。

Home care nursing is nursing care which is provided for the recipients at their home along with their family with the objective of maintaining and improving their quality of life (QOL). Looking at the development in home care nursing, a system of visiting nurse services for the elderly was established in 1992. Since then changes have been introduced in the structure of visiting nursing services. Moving medical treatments to the home of the patients and providing nursing care in residences and facilities outside of the home have gained support following increase in patient numbers and the introduction of the Long-Term Care Insurance System. Initiatives are now being put forward nationwide to construct an integrated community care system as we approach 2025 when the entire baby boomer generation will be in the elderly stages of life (75 years old or older). Amidst these changes in social conditions, the ever increasing demand for home care nursing will bring forward several problems. Above all, the development of human resources will be important for assuring high quality home care nursing. It will be important to improve the specialty of visiting nursing services and to establish the systematic continuing education of visiting nurses. Also The life of view training as part of the fundamental nursing education will also have to be improved.