岡本 菜穂子

ABSTRACT Background While rapid population ageing is occurring worldwide, its speed is especially prominent in Asian countries. In Asia, cultural diversity might significantly affect care burden; however, few studies have investigated the differences in care burden, and mental, physical and social conditions among Asian countries. This study aimed to clarify the situations of and differences in family caregivers (FCs) of older persons in Japan and Thailand, and evaluate the factors associated with care burden in both countries. Methods A cross‐national survey of 217 in‐home FCs was conducted in Japan and Thailand and mainly included items regarding care burden and psychosocial conditions. Differences between the two countries were obtained, and the factors associated with care burden were analysed by multiple regression analyses. Results The FCs' and care receivers’ mean ages (64.8 ± 11.1 and 84.8 ± 8.6 years, respectively) in Japan were significantly higher than the mean ages (49.1 ± 13.3 and 77.1 ± 9.5 years) in Thailand. In Japan, FCs had more severe care burden, loneliness, and stress compared to those in Thailand. In Thailand, FCs had more social connections and informal support than those in Japan. The factors associated with care burden were different in each country; thus, severe stress, low emotional care preparation, and low willingness to continue care at home were significantly associated with severe care burden in Japan, whereas poor relationships with care receivers, few social connections, low confidence in providing care, low emotional care preparation, and lack of informal support were significantly associated with severe care burden in Thailand. Conclusions Despite there being a long‐term care insurance system in Japan, which is absent in Thailand, care burden and psychosocial conditions of FCs might be worse in Japan. There was a clear difference in the factors associated with care burden between Japan and Thailand.

目的:急性期病院で必要とされる認知症看護実践能力を明らかにすることを目的とした.方法:急性期病院で認知症看護を実践している看護師15名を対象に,半構成的インタビューを行い,質的記述的研究を行った.結果:認知症看護実践能力は「認知症患者に対する基本的なケア姿勢」,「認知症患者が入院中安全安楽に過ごすための対策の実施」,「認知症患者の入院前後の生活や周囲の環境に目を向けた,継続的なケアの展開」,「認知症患者に適切なケアを提供するための組織人としての行動」により構成されていた.結論:本研究により,基本的な認知症患者に対する姿勢だけではなく,急性期病院で必要とされている包括的な認知症看護実践能力が明らかとなった.今後認知症高齢者の入院が急増する背景からも,こういった視点で効果的に能力が向上されることが望まれる.(著者抄録)