岩手看護学会誌/Journal of Iwate Society of Nursing Science. Vol.6, No.2, 2012㸱ཋⴥ㸳㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜࡞ᑊࡌࡾ┫㆜ᖅࡡヾㆉ࡛ᐁ᪃≟Ἓ㸢⑋Ჯࡡ≁ᚡ࡞↌Ⅴࢅ࠵࡙࡙㸢ᑚᔪ⨶ἃᏄ㸞㸡ῳ㎮ᖶᯖ㸞㸡ᮄහ༐ᬏ㸞㸡༐⏛╤⨶㸞㸡▴ᕖࡲࡔᏄ㸞㸞ᒷᡥ┬❟ኬᏕ┫㆜Ꮥ㒂ࠈ㸞᪝ᮇಕ೸༈⒢ኬᏕಕ೸༈⒢Ꮥ㒂┫㆜Ꮥ⛁ࠈ㸞ඔᒷᡥ┬❟ኬᏕ┫㆜Ꮥ㒂こ᪠┘Ⓩ㸯⑋Ჯ࡞ໂຸࡌࡾ┫㆜ᖅࡡ㸡㧏㱃ᝀ⩽࡞ᑊࡌࡾ㏝㝌ᚃࡡ⏍Ὡࢅず㏳ࡊࡒ┫㆜ࡡࠔᚪこᛮࡡヾㆉࠕ࡛ࠔᐁ᪃≟Ἓࠕ㸡࠽ࡻࡦ⑋Ჯࡡ≁ᚡ࡞ࡻࡽࠔᚪこᛮࡡヾㆉࠕ࡛ࠔᐁ᪃≟Ἓࠕ࡞㐢࠷࠿࠵ࡾ࠾᪺ࡼ
࠾࡞ࡊ㸡㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜ࡡᙲ๪ࢅ᳠ゞࡌࡾ㸣᪁Ἢ㸯㧏㱃ᝀ⩽ࢅཱིࡽᕬࡂ⎌ሾࢅ⩻࠻㸡㧏㱃ᝀ⩽࡞ᑊࡌࡾ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜࡞ࡗ࠷࡙㡧┘ࢅషᠺࡊ㸡⑋㝌࡞ໂຸࡌࡾ┫㆜ᖅࢅᑊ㇗࡞⮤エᘟ㈹ၡ⣤ㄢᰕࢅ⾔ࡖࡒ㸣⤎ᯕ㸯ྞ㸝㸚㸞࠾ࡼ㏁ಘ࠿࠵ࡽ㸡㡧┘ධ࡙ࠔᚪこᛮࡡヾㆉࠕ࠿ࠔᐁ᪃≟Ἓࠕࡻࡽ᭯ណ࡞㧏࠾ࡖࡒ㸝㹥㸞㸣ࡱࡒ㸡⑋Ჯࡡ≁ᚡ࠿㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜ࡡ྘㡧┘ࡡ㐢࠷࡞㛭౿ࡊ࡙࠷ࡾ࠾ฦᯊࡊࡒ⤎ᯕ㸡ࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃࡞࠽࠷࡙᭩ࡵኣࡂࡡ㡧┘࡚᭯ណᕣ࠿ヾࡴࡼࡿ㸡ḗ࠷࡚ᑍ௴⫃ဤࡡ㒼⨠࡞࠽࠷࡙ኣ࠾ࡖࡒ㸣㡧┘ࡢ࠘ᐓᗖ⫴ᬊ࣬ᐓ᪐ᶭ⬗ࡡビ౮࡛ᐓ᪐࣬ᝀ⩽ࡡᕵ᭻☔ヾ࠙࠘㏝㝌ㄢᩒ㸡௒㆜ಕ㝜ࡡึ᩷࠙ࡡ㸧ᅄᏄᵋ㏸࡚࠵ࡽ㸡ࡐࡿࡼࡡ㸧ᅄᏄ࡞࠽࠷࡙㸡ࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃ࡡ᭯↋࡞ࡻࡾ᭯ណᕣ࠿᭩ࡵኣࡂヾࡴࡼࡿࡒ㸣⤎ㄵ㸯ࢪࢠ࣭ࣛࢼࣤࢡࢅᐁ᪃ࡊ㸡࠘ᐓᗖ⫴ᬊ࣬ᐓ᪐ᶭ⬗ࡡビ౮࡛ᐓ᪐࣬ᝀ⩽ࡡᕵ᭻☔ヾ࠙࠘㏝㝌ㄢ
ᩒ㸡௒㆜ಕ㝜ࡡึ࡛᩷࠙࠷࠹ഁ㟻࠾ࡼ┫㆜ࡌࡾࡆ࡛࡚㸡㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜ࡡちⅤ࠿ᙁ໩ࡈࡿࡾ࡛ྜྷ᫤࡞ᐓ᪐࡫ࡡ┫㆜ࡵඖᐁࡊ㸡┫㆜ࡡ㈹ྡྷ୕࡞ࡵࡗ࡝࠿ࡾ࡛⩻࠻ࡼࡿࡒ㸣࣭࣭࢞࣠ࢺ㸯㧏㱃ᝀ⩽ࠈヾㆉࠈᐁ᪃≟Ἓࠈ㏝㝌ᨥᥴࠈࢪࢠ࣭ࣛࢼࣤࢡ
ࠈ⡷ᅗ࡚ࡢ㸡㧏㱃⩽ᑍ㛓┫㆜ᖅ࡞ࡻࡾ᪡᭿࠾ࡼࡡ㏝㝌ࡢࡋࡴ࡞ࠈ⌟ᅹ㸡ථ㝌᭿㛣ࡡ▯⦨໩࡞ࡻࡽ㸡㏝㝌ᨥᥴࡡᚪこᛮᨥᥴ࡞ࡻࡖ࡙㸡ᅹ㝌᪝ᩐࡡ΅ᑛࡷ්ථ㝌㸡්ථ㝌ࡱ࡚㸞࠿㔔こちࡈࡿ 㸡⑋㝌㛣ࡡ㏻ᦘࡓࡄ࡚࡝ࡂ㸡ಕ೸࣬༈ࡡ᭿㛣࠿΅ᑛࡊࡒࡆ࡛࠿ሒ࿈ࡈࡿ࡙࠷ࡾ㸞㸞㸣ࡊ࠾ࡊ㸡⒢࣬⚗♬㛣࡝࡜ኣᵕ࡝⫃⛸ࡡ㛣࡞࠽࠷࡙㸡࠷࠾࡞ຝᯕ

᪝ᮇ࡚ࡡ⩹ெ┫㆜ࡡᑍ㛓┫㆜ᖅ㸝௧ୖ㸡ᑍ㛓┫㆜ᖅ࡛Ⓩ࡝㏻ᦘࢅᵋ⠇ࡊ㸡ᙁ໩ࡊ࡙࠷ࡂ࠾࠿ㄚ㢗࡛࡝ࡖ࡙࠷

ࡌࡾ㸞ࡢྞ࡛ᑛ࡝࠷࠹࠻࡞㸡ᡜᒌࡌࡾ᪃シࡡᆀᇡ࡞ࡾ㸣೩ࡽ࠿࠵ࡾ㸞ࡒࡴ㸡࡜ࡡ⑋㝌࡞ࡵᑍ㛓┫㆜ᖅࢅ㒼⨠ࡌࠈཉ⏍ຘ഼┤ࡡᝀ⩽ㄢᰕࡡᴣἛ㸞࡞ࡻࡾ࡛㸡㹷⑋㝌㹸ࡡࡾࡆ࡛ࡢ㸡ெဤ☔ಕࡷࢤࢪࢹ㟻࠾ࡼ⩻࠻࡙ࡵ㞬ࡊ࠷ࡡᝀ⩽ࡡᖲᆍᅹ㝌᪝ᩐࡢ㸡ᖲᠺ㸧ᖳ࠿᪝㸡ᖲᠺᖳ

࠿⌟≟࡚࠵ࡾ㸣᪝ᮇ࡞࠽ࡄࡾ◂✪ࡢ㸡ࠔ㏝㝌ᨥᥴࠕࠔ㧏࠿᪝㸡ᖲᠺᖳ࠿᪝࡚࠵ࡽ㸡ᖳࠍᅹ㝌᪝ᩐ࠿㱃⩽ࠕࢅ࣭࣭࢞࣠ࢺ࡛ࡌࡾ࡛㸡༈Ꮥ୯ኳ㞟ヽ࡚ࡡ᳠⣬▯⦨ࡊ࡙࠷ࡾ㸣ࡊ࠾ࡊ㸡ᖳ㱃㝭⣥ื࡞ࡲࡾ࡛㸡ṋ௧࡚ࡢ㸡ఌ㆗㘋ࢅ㝎ࡂ࡛௲㸡ࡈࡼ࡞┫㆜ᩝ⊡࡞⤘ࡾ୕ࡡ㧏㱃⩽ࡡᖲᆍᅹ㝌᪝ᩐࡵᖳࠍ▯⦨ࡊ࡙࠷ࡾࡵࡡࡡ

࡛௲࡚㸡ิฝࡢᖳ࡚࠵ࡖࡒ㸝ᖳ㸧᭮᪝㸞㸣௙ࡡᖳ௥࡛Ẓ㍉ࡌࡾ࡛⩄ࢅᢜ࠷࡙㛏ࡂ㸡ഭ⑋ฦ㢦ื࡞ᖳࠍ◂✪ࡢቌ࠻࡙࠷ࡾ࠿㸡ᑍ㛓┫㆜ᖅ࡞ࡻࡾ㏝㝌ᨥᥴࡲ࡙ࡵኬ㡧┘ࡡ࠹ࡔ㸡ࠔ╉ཀྵࡦ௛ᒌჹࡡ⑄ᝀࠕࢅ㝎ࡡຝᯕ࠿᳠チࡈࡿ࡙࠷࡙ࡵ㸡ᑍ㛓┫㆜ᖅ࠿ᑛ࡝࠷⌟≟ࡂධ࡙ࡡ㡧┘࡚㸡㧏㱃⩽ࡡᅹ㝌᪝ᩐ࠿᭩ࡵ㛏ࡂ࡝ࡖ࡙࡚ࡢ◂✪ࡡຝᯕ࡛ྜྷࡋࡻ࠹࡝ᐁ㊮࡞ࡢࡗ࡝࠿ࡽ࡞ࡂ࠷㸣࠷ࡾ㸣ࡱࡒ㸡ࢪࢠ࣭ࣛࢼࣤࢡ⚂ࡡຝᯕࡷ㏝㝌ᨥᥴࡡ௒ථ◂✪㸨

岩手看護学会誌/Journal of Iwate Society of Nursing Science. Vol.6, No.2, 2012ࡡሒ࿈࠿ኣ࠷ࡵࡡࡡ㸡㏝㝌ᨥᥴ࡞࠽࠷࡙㸡⑋㝌ࡡぜᶅ㍍ࡊࡒᩝ᭡࡚ㄢᰕ༝ງࢅ౪㢏ࡊࡒ㸣◂✪࡫ࡡཤຊ࣬༝

ࡷᶭ⬗㸡ᆀᇡ≁ᛮ࡞ྙࢂࡎࡒᨥᥴࢨࢪࢷ࣑ࡡᵋ⠇࠿㔔ງࡡ᭯↋ࡢ㸡㏁ಘⴝ᭡࡞࡙௴ណ࡚ᅂ➽ࡊ࡙ࡵࡼࡖࡒ㸣㸞㸞ࡵ࠵ࡾࡒࡴ㸡⌟≟ࡡమโࢅ⩻៎ࡊ㸡⑋◂✪࡫ࡡཤຊ࣬༝ງ࠿ᚋࡼࡿࡾሔྙ࡞ࡢ㸡ㄢᰕ⚂ࡡ㒼Ჯࡡ≁ᚡ࡚㐢࠷࠿࠵ࡾ࠾ࡡ᳠ゞࡵྙࢂࡎ࡙⾔࠹ࡆ࡛ࡵᕱ㒂ᩐࢅᢍᥩࡌࡾࡒࡴ㸡༝ງ࡚ࡀࡾ┫㆜ᖅࡡெᩐࢅ㏁

ᚪこ࡚࠵ࡾ㸣ࡈࡼ࡞㸡ථ㝌୯ࡡ⑋㝌ࢪࢰࢴࣆ࡞ࡻࡾ᪝

ಘⴝ᭡࡞エථࡊ࡙ࡵࡼ࠷㸡㈹ၡ⣤ࢅ⑋㝌ࡇ࡛࡞ୌᣋ㒉

こ࡛ࡡሒ࿈

㸞

ᖏࢢ࢓࠿㸡㏝㝌ᚃࡡ⏍Ὡ࡞ᙫ㡢ࡊࡒ ࡆ࡛ࡷ㸡⥌ᣚ᭿㏞ࡊ㸡ᑊ㇗⩽࡫ࡡ㒼ᕱࢅ౪㢏ࡊࡒ㸣㸞࡞࠵ࡾᚃ᭿㧏㱃⩽࡫ࡡ⌦Ꮥ⒢Ἢࡡᚪこᛮ࠿ሒ࿈ ࡈࡿࠈᑊ㇗⩽ࡢ㸡◂✪༝ງ࠿ᚋࡼࡿࡒ⑋㝌ࡡ㸡㧏㱃ᝀ⩽࡙࠷ࡾࡻ࠹࡞㸡㧏㱃⩽ࡢථ㝌࡞ࡻࡾ㌗మ࡫ࡡᙫ㡢࠿௙ࡡ┫㆜ࢅᐁ㊮ࡊ࡙࠷ࡾ┫㆜ᖅྞ࡚࠵ࡾ㸣ࡡᖳ௥࡞Ẓ࡬࡙ኬࡀ࠷ࡒࡴ㸡㧏㱃ᝀ⩽ࡡ┫㆜ࢅ⤽⤾ࡌ㸣ㄢᰕහᐖ

ࡾ࡞ࡢ㸡᪝ࠍࡡ㛭ࢂࡽࡡちⅤ࠿㔔こ࡛࡝ࡾ㸣ࡊࡒ࠿ࡖ

ࠈ㈹ၡ⣤ࡡ㡧┘ࡢ㸡ᴃᮇࡼ㸞ࡡ㏝㝌ᨥᥴビ౮㡧┘ࢅཤ࡙㸡⑋Ჯ࡞ໂຸࡌࡾᑍ㛓┫㆜ᖅ௧አࡡ┫㆜ᖅ㸝௧ୖ㸡⩻࡞㸡㧏㱃ᝀ⩽ࢅཱིࡽᕬࡂ⎌ሾࡷ㌷㝌ࡡ≟Ἓࢅ⩻࠻㸡┫㆜ᖅ࡛ࡌࡾ㸞࠿㸡㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜◂✪⩽ࡼ࡚షᠺࡊࡒ㸣රమⓏ࡞ࡢ㸡┫㆜ࡡ୯ᚨ࡛࡝ࡾ

ࡡちⅤ࡚㸡࡜ࡡ⛤ᗐᚪこᛮࡡヾㆉࢅᣚࡔ࡝࠿ࡼ᪝ࠍࡡ

㧏㱃ᝀ⩽࡛㧏㱃ᝀ⩽ࢅᨥ࠻ࡾᐓ᪐࡞ࡗ࠷࡙⌦ゆࡌࡾࡆ┫㆜ࢅᐁ᪃ࡊ࡙࠷ࡾࡡ࠾㸡⌟≟ࢅ᪺ࡼ࠾࡞ࡌࡾࡆ࡛࠿࡛࠿㔔こ࡚࠵ࡽ㸡ࡐࡡ୦⩽ࡡ42/ࢅ㧏ࡴࡾࡒࡴ࡞ࡢ㸡ᚪこ࡚࠵ࡾ࡛⩻࠻ࡒ㸣ࡐࡡ࠹࠻࡚㸡⑋Ჯࡡ≁ᚡ࡞↌Ⅴ㧏㱃ᝀ⩽ࡡ㌗మⓏ࡝≁ᚡࡷ♣ఌⓏโᗐࢅྱࡴࡒ࿔ᅑࡡ

ࢅ࠵࡙࡝࠿ࡼฦᯊࡊ㸡㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫⎌ሾ࠿㛭౿ࡌࡾ࡛⩻࠻ࡒࡒࡴ㸡ࠔ㧏㱃ᝀ⩽࡛ᐓ᪐ࡡᛦ㆜ࡡᙲ๪ࢅ᳠ゞࡊࡒࡡ࡚ሒ࿈ࡌࡾ㸣࠷ࡷ࿔ᅑࡡ⎌ሾ࡞ࡗ࠷࡙ࠕ㸡ࠔን໩ࡊࡷࡌ࠷㧏㱃ᝀ⩽ࡡ≁ᚡ࡞ࡗ࠷࡙ࠕ㸡ࠔวࡿ┘ࡡ࡝࠷┫㆜ࢅᒈ㛜ࡌࡾࡒࡴ࡞

Ϩ㸣┘Ⓩ㔔こ࡚࠵ࡾ௒㆜ಕ㝜࡞ࡗ࠷࡙ࠕ࡛࠷࠹ちⅤ࠾ࡼ㸡┫㆜ࠈᮇ◂✪ࡡ┘Ⓩࡢ㸡⑋Ჯ࡞ໂຸࡌࡾ┫㆜ᖅࡡ㸡㧏㱃ᝀᖅࡡࠔᚪこᛮࡡヾㆉࠕ࡛ࠔᐁ᪃≟Ἓࠕ࠿ᢍᥩ࡚ࡀࡾ㡧┘⩽࡞ᑊࡌࡾ㏝㝌ᚃࡡ⏍Ὡࢅず㏳ࡊࡒ┫㆜ࡡࠔᚪこᛮࡡ࡛ࡊࡒ㸣୹࡝හᐖࡢ㸡ᑊ㇗⩽ࡡᇱᮇ᝗ሒ㸝ᛮื㸡ᖳ㱃㸡ヾㆉࠕ࡛ࠔᐁ᪃≟Ἓࠕ㸡࠽ࡻࡦ⑋Ჯࡡ≁ᚡ࡞ࡻࡽࠔᚪこ⤊㥺ᖳᩐ㸞࠽ࡻࡦ⫃ሔࡡᇱᮇ᝗ሒ㸝ࢪࢠ࣭ࣛࢼࣤࢡࡡ

ᛮࡡヾㆉࠕ࡛ࠔᐁ᪃≟Ἓࠕ࡞㐢࠷࠿࠵ࡾ࠾࡞ࡗ࠷࡙᪺ࡼ

᭯↋㸡㏝㝌ㄢᩒ࡞ᑍ௴ࡌࡾ⫃ဤࡡ᭯↋㸡⑋Ჯࡡᶭ⬗➴㸞㸡࠾࡞ࡊ㸡㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜ࡡᙲ๪ࢅ᳠㌷㝌᫤࡞⑋㝌㛣ࡡ㏻ᦘ࡚ᕝኰࡊ࡙࠷ࡾࡆ࡛㸡㌷㝌࡞㛭ゞࡌࡾࡆ࡛࡚࠵ࡾ㸣ࡊ࡙ၡ㢗࡞វࡋ࡙࠷ࡾࡆ࡛㸡㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳
ࡊࡒ┫㆜࡞ࡗ࠷࡙㡧┘㸡௙㝌࠾ࡼࡡ㌷ථ࡞ࡗ࠷࡙

ϩ㸣◂✪᪁Ἢࠈ

㡧┘㸡௙㝌࡫ࡡ㌷ฝ࡞ࡗ࠷࡙㡧┘࡚࠵ࡾ㸣㧏㱃ᝀ⩽㸣◂✪ࡡᯗ⤄ࡲ࡛⏕ㄊࡡᏽ⩇ࡡ┫㆜㸡௙㝌࠾ࡼࡡ㌷ථ࠽ࡻࡦ௙㝌࡫ࡡ㌷ฝ࡞ࡗ࠷࡙

ࠈᮇ◂✪࡚ࡢ㸡⑋Ჯࡡ≁ᚡࢅ㸡ࠔࢪࢠ࣭ࣛࢼࣤࢡࡡ᭯

ࡢ㸡㸦ࡗࡡ㈹ၡ㡧┘࡞ᑊࡊ࡙ࠔᚪこᛮࡡヾㆉࠕ࡛ࠔᐁ᪃

↋ࠕ㸡⑋Ჯࡡᶭ⬗࡛ࡊ࡙ࠔ㌷㝌ᙟᘟࠕ㸡㏝㝌ㄢᩒ࡞ࠔᑍ

≟Ἓࠕࡡ㸧ഁ㟻࠾ࡼ㈹ၡࡊᅂ➽ࢅịࡴࡒ㸣ࠔᚪこᛮࡡ௴ࡌࡾ⫃ဤࡡ᭯↋ࠕ࡛ᏽ⩇ࡊࡒ㸣ࡐࡡ࠹࠻࡚㸡⑋Ჯࡡヾㆉࠕࡢࠔ㸣ᚪこ࡚࠵ࡾࠕ࠾ࡼࠔ㸣ᚪこ࡝࠷ࠕ㸡ࠔᐁ᪃≟≁ᚡ࡞ࡻࡖ࡙㸡┫㆜ᖅࡡࠔᚪこᛮࡡヾㆉࠕ࡛ࠔᐁ᪃≟Ἓࠕࡢࠔ㸣⾔ࡖ࡙࠷ࡾࠕ࠾ࡼࠔ㸣⾔ࡖ࡙࠷࡝࠷ࠕࡱ࡚ࡡ㸡Ἓࠕࡡᕣ࠾ࡼ㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜ࡡ⌟≟ࡐࡿࡑࡿ㸩ṹ㝭ビ౮࡚ᅂ➽ࢅịࡴ㸡ࠔ㸣ᚪこ࡚࠵ࡾࠕ

ࢅᢍᥩࡊ㸡┫㆜ࡡᙲ๪ࢅ᳠ゞࡊ࡙࠷ࡂࡒࡴ㸡ᅒ㸦ࡡࡻࠔ㸣⾔ࡖ࡙࠷ࡾࠕࢅ㸩Ⅴ㸡ࠔ㸣ᚪこ࡝࠷ࠕ
ࠔ㸣⾔ࡖ࡙࠷

࠹࡝ᯗ⤄ࡲ࡛ࡊࡒ㸣࡝࠷ࠕࢅ㸦Ⅴ࡛ࡊ࡙྘ᅂ➽ࢅ㸦㹳㸩Ⅴ࡚ᚋⅤ໩ࡊࡒ㸣ࠈ௑ᅂࡡሒ࿈࡚ࡢ㸡㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜⑋Ჯࡡ≁ᚡࢪࢠ࣭ࣛࢼࣤࢡࡡ᭯↋㌷㝌ᙟᘟᑍ௴⫃ဤࡡ᭯↋

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㸣ฦᯊ᪁Ἢ
ࠈ㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜㡧┘࡞ࡗ࠷࡙㸡ᐁ᪃ᵋᠺᴣᛍࡡጂᙔᛮࢅࡲࡾࡒࡴ㸡ᅄᏄฦᯊἪࢅ⾔ࡖࡒ㸣ᅒࠈᮇ◂✪ࡡᯗ⤄ࡲࡈࡼ࡞㸡හⓏᩒྙᛮࡡ☔ヾࡡࡒࡴ࡞㸡㡧┘ධమ࡛ᅄ㸣ㄢᰕ᪁Ἢ࠽ࡻࡦᑊ㇗⩽Ꮔฦᯊ࡞ࡻࡽᚋࡼࡿࡒ྘ᅄᏄࡡ&URQEDFKࡡȘ౿ᩐࢅịࠈ㸶┬හࡡ⑋㝌ࡡ࠹ࡔ㸡ᑚඡࡡᑍ㛓⑋㝌ࢅ㝎ࡂ⑋㝌ࡴࡒ㸣㸧⩄㛣ࡡẒ㍉ࡢ㸡0DQQ:KLWQH\ࡡ8᳠ᏽࢅ⏕࠷ࡒ㸣ࡡ┫㆜㒂㸝┫㆜⛁㸞ࢅ✾ཾ࡞㸡◂✪┘Ⓩ࡛᪁Ἢ➴ࢅエ᭯ណỀ‵ࡢ㸪㸚ᮅ‫ࡊ࡛‮‬㸡ฦᯊ࡞ࡢ㸡⤣゛ࢮࣆࢹ6366㸩

岩手看護学会誌/Journal of Iwate Society of Nursing Science. Vol.6, No.2, 2012

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ࠈㄢᰕ᭿㛣ࡢ㸡ᖲᠺᖳ㸭᭮㹳㸮࡚᭮࠵ࡾ㸣㸣೒⌦Ⓩ㒼៎ࠈ೒⌦Ⓩ㒼៎࡛ࡊ࡙㸡◂✪༝ງࢅ౪㢏ࡌࡾ㝷࡞㸡ᩝ᭡㏝㝌ㄢᩒ㒂㛓ࡱࡒࡢ㏝㝌ㄢᩒ࡞ᑍ௴ࡌࡾ⫃ဤࠈ࠵ࡽ㸝࠷ࡾ㸞ࠈ࡝ࡊ㸝࠷࡝࠷㸞ࠈ↋ᅂ➽࠽ࡻࡦ↋ຝᅂ➽࡚◂✪ࡡ㉻᪠ࢅఎ࠻㸡㈹ၡ⣤࡫ࡡᅂ➽ࡢ⮤⏜ណᛦ࡚࠵ࡽᅂ➽ࡊ࡝ࡂ࡙ࡵ୘ฺ─ࢅ⿍ࡼ࡝࠷ࡆ࡛㸡↋エྞ࡚࠵㌷㝌ࡡᙟᘟ
ࠈ᛬ᛮ᭿ࡡ἖⒢࠿⤂஡ࡊះᛮ᭿἖⒢ࡡᚪこ࡝ࠈᝀ⩽ࡡུࡄථࡿ
ࠈ᛬ᛮ᭿἖⒢࠿⤂஡ࡊᅂᚗ࡞ྡྷࡄ࡙ࡡ㌷ฝࠈ㧏ᗐ࡝༈⒢࠿ᚪこ࡝ᝀ⩽ࡡ᛬ᛮ᭿⑋㝌࡫ࡡࠈ㌷ฝࠈ㧏ᗐ࡝༈⒢࠿ᚪこ࡝ᝀ⩽ࡡུࡄථࡿ
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ࢅᚋࡒ㸣

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1 㸡ᩐೋࡢெᩐ㸡㸝ࠈ㸞හࡢᅂ➽ᩐ࡞༥ࡴࡾ๪ྙϪ㸣⤎ᯕ㸣ᅂ཭⋙࡛ᑊ㇗⩽ࡡᴣこ㸣ᑊ㇗⩽࠿ໂຸࡌࡾ⫃ሔࡡᴣこࠈ㏳ࡡ㏁ಘ࠿࠵ࡽ㸡ᅂ཭⋙ࡢ㸚ࡓࡖࡒ㸣ࠈᑊ㇗⩽࠿ໂຸࡌࡾ⫃ሔࡡᴣこࡢ⾪㸧ࡡ㏳ࡽ࡚࠵ࡾ㸣ࠈᑊ㇗⩽ࡡᒌᛮࡢ⾪㸦ࡡ㏳ࡽ࡚㸡⏠ᛮྞ㸝㸚㸞㸡㧏㱃ᝀ⩽ࡡථ㝌᫤࡞㸡㏝㝌ㄢᩒ࡞ࡗ࠷࡙ࡡࢪࢠ࣭ࣛࢼ

ዥᛮྞ㸝㸚㸞㸡↋ᅂ➽ྞ㸝㸚㸞㸡ᖳ㱃ࡢ㸡ࣤࢡ㸝௧ୖ㸡ࢪࢠ࣭ࣛࢼࣤࢡ࡛ࡌࡾ㸞ࢅ⾔ࡖ࡙࠷ࡾ࡛

ṋ㹳ṋ࡚ᖲᆍṋ㸝ᵾ‵೩ᕣs㸞࡚࠵ࡖࡒ㸣ᅂ➽ࡊࡒெࡢྞ㸝㸚㸞㸡ࢪࢠ࣭ࣛࢼࣤࢡࢅ⾔ࡖ┫㆜⫃ࡡ⤊㥺ᖳᩐࡢ㸡㸩ࣧ᭮࠾ࡼᖳ㸨࡚ࣧ᭮ᖲᆍ⣑࡙࠷࡝࠷࡛ᅂ➽ࡊࡒெࡢྞ㸝㸚㸞㸡↋ᅂ➽࠽ࡻᖳ㸝ࣧ᭮㸞㸝ᵾ‵೩ᕣs㸞࡚࠵ࡖࡒ㸣ࡦ↋ຝᅂ➽ྞ㸝㸚㸞࡚࠵ࡖࡒ㸣⑋㝌࡞㏝㝌ㄢᩒ㒂㛓ࡱࡒࡢ㏝㝌ㄢᩒ࡞ᑍ௴ࡌࡾ⫃ဤ㸝௧ୖ㸡ᑍ௴⫃ဤ࡛⾪ࠈᑊ㇗⩽ࡡᴣこࠈࠈࠈ㡧ࠈ┘ࠈࠈࠈࠈࠈࠈࠈࠈࠈெᩐ㸝㸚㸞
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ࠔ⥾࿰ࢢ࢓࡞㛭ࡌࡾࡆ࡛ࠕ㸡ࠔࣛࣀࣄࣛࢷ࣭
㸣㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜࡞ࡗ࠷࡙ࠈ㸞྘㡧┘ࡡᚋⅤࠈ㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜㡧┘࡞ࡗ࠷࡙㸡྘㡧┘ࡡᖲᆍⅤࡢ⾪ࡡ㏳ࡽ࡚࠵ࡾ㸣ࠔᐁ᪃≟Ἓࠕࡡᖲ
ᆍⅤ࠿㧏࠷㡨࡞㸡㈹ၡ㡧┘ࢅ୩࡬᭨࠻ࡒ㸣ࠔᚪこᛮࡡヾㆉࠕࡡᖲᆍⅤࡢ㸡㡧┘ධ࡙௧୕࡛㧏࠾ࡖࡒ㸣ࠔᐁ᪃≟ἛࠕࡡᖲᆍⅤࡢ㸡㹳࡛ࡣࡼࡗࡀ࠿࠵
ࡽ㸡ࠖᐓ᪐ᵋᠺࡡᢍᥩࠗࠖᐓ᪐ࡡ௒㆜ງࡡᢍᥩࠗ
ࠖᐓ᪐ࡡࡆࡿ࠾ࡼࡡ⒢㣬࡞㛭ࡌࡾᕵ᭻ࡡ☔ヾ࡛ࠗ࠷ࡖࡒᐓ᪐࡞ࡗ࠷࡙ࡡ⌦ゆࡷᢍᥩ࡞㛭ࡌࡾහᐖ࠿㸡௙

1 㸡ᩐೋࡢெᩐ㸡㸝ࠈ㸞හࡢᅂ➽ᩐ࡞༥ࡴࡾ๪ྙ

ࡡ㡧┘࡛Ẓ࡬ࡾ࡛ࠔᚪこᛮࡡヾㆉࠕࠔᐁ᪃≟Ἓࠕ࡛ࡵ

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岩手看護学会誌/Journal of Iwate Society of Nursing Science. Vol.6, No.2, 2012⾪ࠈ㧏㱃ᝀ⩽ࡡ┫㆜㡧┘ࡡᖲᆍⅤ㸯ࠔᚪこᛮࡡヾㆉࠕ࡛ࠔᐁ᪃≟Ἓࠕࠈ㡧┘␊ྒ

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⾪ࠈ⑋Ჯࡡ≁ᚡ࡞ࡻࡾ㧏㱃ᝀ⩽ࡡ┫㆜㡧┘ࡡᚋⅤ㸝ᚪこᛮࡡヾㆉ㸞ࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈᖲᆍsᵾ‵೩ᕣ㸝Ⅴ㸞㡧┘␊ྒࢪࢠ࣭ࣛࢼࣤࢡᐁ᪃㡧ࠈࠈ┘᭯↋㸝㹣㸲㸞 㸝㹣㸲㸞㹥ೋ㏝㝌ㄢᩒ࡞ᑍ௴ࡌࡾ⫃ဤࡡ㒼⨠᭯↋㸝㹣㸲㸞 㸝㹣㸲㸞

㌷㝌ᙟᘟ
㹥ೋ

᛬ᛮ᭿⑋Ჯ ះᛮ᭿⑋Ჯ
㸝㹣㸲㸞 㸝㹣㸲㸞㹥ೋ ථ㝌᪡᭿ࡡ㏝㝌ㄢᩒࡡᚪ こᛮࡡ࢓ࢬࢪ࣒ࣤࢹ

s s

  s s

  s s ථ㝌᪡᭿ࡡᅂᚗᚃࡡ⒢㣬
 ሔᡜࡡ࢓ࢬࢪ࣒ࣤࢹ

s s

  s s

s s

s s

s s  ථ㝌୯࡞$'/࠿࡜ࡡࡻ࠹
s s  ࡞ን໩ࡊ࡙࠷ࡂ࠾ࡡ஢ῼ ௒㆜ಕ㝜ࡡᚪこᛮ࡞ࡗ࠷ ࡙ࡡ࢓ࢬࢪ࣒ࣤࢹ

s s

  s s

s s ௒㆜ಕ㝜࠿ᚪこ࡛ࡈࡿࡾ ᫤ࡡ⏞ㄫ࡫ࡡ㛭ࢂࡽs s

  s s

s s  ᝀ⩽࠿࡜ࡡࡻ࠹࡝⏍Ὡࢅ ᭻ࢆ࡚࠷ࡾࡡ࠾ࡡ☔ヾs s

s s

s s ᝀ⩽ࡡࡆࡿ࠾ࡼࡡ⒢㣬࡞ 㛭ࡌࡾᛦ࠷ࡡ☔ヾs s

s s

s s

 ᐓ᪐ᵋᠺࡡᢍᥩ

s s   s s

s s  ᐓ᪐ࡡ௒㆜ງࡡᢍᥩ

s s

  s s

s s  ᐓᒁࡡᵋ㏸ࡷపᏩ⎌ሾࡡ ᢍᥩ

s s

  s s

s s  ᐓ᪐ࡡࡆࡿ࠾ࡼࡡ⒢㣬࡞ 㛭ࡌࡾᕵ᭻ࡡ☔ヾs s

s s

s s  ⤊ῥງࡡᢍᥩ

s s

s s

s s ࣭࢞ࣂ࣭ࢮࣤ࠿ᶭ⬗ࡌࡾ ࡻ࠹࡝഼ࡀ࠾ࡄ

s s

s s

s s ࠈࠈೋ㸯0DQQ:KLWQH\ࡡ8᳠ᏽ㸰 㸡S㸱
S


ࠈ





ࠈ

࡞Ⅴᩐ࠿㧏ࡂ㸡ࠖᝀ⩽࠿࡜ࡡࡻ࠹࡝⏍Ὡࢅ᭻ࢆ࡚࠷ࡾࡢ㸡ࠔᚪこᛮࡡヾㆉࠕࠔᐁ᪃≟Ἓࠕ࡛ࡵ࡞᭩ࡵ఩࠾ࡖࡒ㸣࠾ࡡ☔ヾࠗࠖᝀ⩽ࡡࡆࡿ࠾ࡼࡡ⒢㣬࡞㛭ࡌࡾᛦ࠷ࡡ

ࠈḗ࡞㸡㡧┘ࡐࡿࡑࡿࢅࠔᚪこᛮࡡヾㆉࠕ࡛ࠔᐁ᪃≟☔ヾ࡛ࠗ࠷ࡖࡒᝀ⩽ᮇெࡡᕵ᭻ࡷᛦ࠷ࡡ☔ヾ࡞㛭ࡌࡾἛࠕࡇ࡛࡞㸡ࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃ࡡ᭯↋㸡ᑍ௴⫃ဤහᐖࡻࡽࡵ㔔こちࡈࡿ࡙࠷ࡾലྡྷ࠿ヾࡴࡼࡿࡒ㸣㡧ࡡ㒼⨠ࡡ᭯↋㸡㌷㝌ᙟᘟࡡ㐢࠷࡞࠽࠷࡙ฦᕱ࡞ᕣ࠿࠵

┘ධ࡙࡞࠽࠷࡙㸡ࠔᚪこᛮࡡヾㆉࠕ࠿ࠔᐁ᪃≟Ἓࠕࡻࡽࡵ

ࡾ࠾㸡0DQQ:KLWQH\ࡡ8᳠ᏽࢅ⾔ࡖࡒ㸝⾪㸩㸡⾪㸪㸞㸣᭯ណ࡞㧏࠾ࡖࡒ㸝S㸱㸞㸣ࡱࡒ㸡ࠖථ㝌᪡᭿ࡡ㏝㝌ࠈࠔᚪこᛮࡡヾㆉࠕ࡚ࡢ㸡ࠖථ㝌᪡᭿ࡡ㏝㝌ㄢᩒࡡᚪㄢᩒࡡᚪこᛮࡡ࢓ࢬࢪ࣒ࣤࢹࠗ
ࠖථ㝌᪡᭿ࡡᅂᚗᚃ

こᛮࡡ࢓ࢬࢪ࣒ࣤࢹࠗ
ࠖථ㝌᪡᭿ࡡᅂᚗᚃࡡ⒢㣬ሔ

ࡡ⒢㣬ሔᡜࡡ࢓ࢬࢪ࣒ࣤࢹࠗࡡ㸧㡧┘ࡢ㸡ࠔᐁ᪃≟Ἓࠕ

ᡜࡡ࢓ࢬࢪ࣒ࣤࢹࠗࠖ௒㆜ಕ㝜ࡡᚪこᛮ࡞ࡗ࠷࡙ࡡ

ࡡᖲᆍⅤ࠿఩ࡂ㸡ࠖᐓᒁࡡᵋ㏸ࡷపᏩ⎌ሾࡡᢍᥩࠗ

࢓ࢬࢪ࣒ࣤࢹࠗࠖ௒㆜ಕ㝜࠿ᚪこ࡛ࡈࡿࡾ᫤ࡡ⏞ㄫ㸫

岩手看護学会誌/Journal of Iwate Society of Nursing Science. Vol.6, No.2, 2012⾪ࠈ⑋Ჯࡡ≁ᚡ࡞ࡻࡾ㧏㱃ᝀ⩽ࡡ┫㆜㡧┘ࡡᚋⅤ㸝ᐁ᪃≟Ἓ㸞ࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈᖲᆍsᵾ‵೩ᕣ㸝Ⅴ㸞ࠈ㡧┘␊ྒࢪࢠ࣭ࣛࢼࣤࢡᐁ᪃㡧ࠈࠈ┘᭯↋㸝㹣㸲㸞 㸝㹣㸲㸞㹥ೋ㏝㝌ㄢᩒ࡞ᑍ௴ࡌࡾ⫃ဤࡡ㒼⨠᭯↋㸝㹣㸲㸞 㸝㹣㸲㸞

㌷㝌ᙟᘟ
㹥ೋ

᛬ᛮ᭿⑋Ჯ ះᛮ᭿⑋Ჯ
㸝㹣㸲㸞 㸝㹣㸲㸞㹥ೋ ථ㝌᪡᭿ࡡ㏝㝌ㄢᩒࡡᚪ こᛮࡡ࢓ࢬࢪ࣒ࣤࢹ

s s

  s s

  s s  ථ㝌᪡᭿ࡡᅂᚗᚃࡡ⒢㣬
 ሔᡜࡡ࢓ࢬࢪ࣒ࣤࢹ

s s

  s s

  s s  ථ㝌୯࡞$'/࠿࡜ࡡࡻ࠹
s s ࡞ን໩ࡊ࡙࠷ࡂ࠾ࡡ஢ῼ

  s s

  s s ௒㆜ಕ㝜ࡡᚪこᛮ࡞ࡗ࠷ ࡙ࡡ࢓ࢬࢪ࣒ࣤࢹ

s s

  s s

s s ௒㆜ಕ㝜࠿ᚪこ࡛ࡈࡿࡾ ᫤ࡡ⏞ㄫ࡫ࡡ㛭ࢂࡽs s

  s s

s s ᝀ⩽࠿࡜ࡡࡻ࠹࡝⏍Ὡࢅ ᭻ࢆ࡚࠷ࡾࡡ࠾ࡡ☔ヾs s

  s s

 

s s ᝀ⩽ࡡࡆࡿ࠾ࡼࡡ⒢㣬࡞ 㛭ࡌࡾᛦ࠷ࡡ☔ヾs s

  s s

 

s s ᐓ᪐ᵋᠺࡡᢍᥩ

s s

  s s

s s ᐓ᪐ࡡ௒㆜ງࡡᢍᥩ

s s   s s

s s

 ᐓᒁࡡᵋ㏸ࡷపᏩ⎌ሾࡡ ᢍᥩ

s s

  s s

 

s s  ᐓ᪐ࡡࡆࡿ࠾ࡼࡡ⒢㣬࡞ 㛭ࡌࡾᕵ᭻ࡡ☔ヾs s   s s

s s

 ⤊ῥງࡡᢍᥩ

s s   s s

s s  ࣭࢞ࣂ࣭ࢮࣤ࠿ᶭ⬗ࡌࡾ ࡻ࠹࡝഼ࡀ࠾ࡄ

s s   s s

s s Sೋ㸯0DQQ:KLWQH\ࡡ8᳠ᏽ㸰 㸡S㸱


ࠈ

ࠈ

ࠈ



ࠈ

࡫ࡡ㛭ࢂࡽࠗ
ࠖᐓ᪐ᵋᠺࡡᢍᥩࠗ
ࠖᐓ᪐ࡡ௒㆜ງࡡ࣒ࣤࢹࠗࠖ௒㆜ಕ㝜࠿ᚪこ࡛ࡈࡿࡾ᫤ࡡ⏞ㄫ࡫ࡡ㛭ᢍᥩࠗࠖᐓᒁࡡᵋ㏸ࡷపᏩ⎌ሾࡡᢍᥩࠗࡡ㸬㡧┘࡞ࢂࡽࠗࡡ㸧㡧┘࡞࠽࠷࡙㸡ះᛮ᭿⑋Ჯ࡞ໂຸࡌࡾ┫㆜࠽࠷࡙㸡ࢪࢠ࣭ࣛࢼࣤࢡࢅᐁ᪃ࡊ࡙࠷ࡾ⑋Ჯ࡞ໂຸࡌ

ᖅ㸝௧ୖ㸡ះᛮ᭿⑋Ჯ┫㆜ᖅ࡛ࡌࡾ㸞ࡡ᪁࠿᭯ណ࡞㧏ࡾ┫㆜ᖅ㸝௧ୖ㸡ࢪࢠ࣭ࣛࢼࣤࢡᐁ᪃┫㆜ᖅ࡛ࡌࡾ㸞࠾ࡖࡒ㸝S㸱㸞㸣ࡡ᪁࠿᭯ណ࡞㧏࠾ࡖࡒ㸝S㸱㸞㸣ࡱࡒ㸡ࠖථ㝌᪡᭿

ࠈ㸞ಘ㢏ᛮ࣬ᵋᠺᴣᛍጂᙔᛮ

ࡡ㏝㝌ㄢᩒࡡᚪこᛮࡡ࢓ࢬࢪ࣒ࣤࢹࠗࡡࡲ㸡ᑍ௴⫃ဤࠈ㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜࡞ࡗ࠷࡙ࡡ㈹ၡ㡧࠿㒼⨠ࡈࡿ࡙࠷ࡾ⑋㝌࡞ໂຸࡌࡾ┫㆜ᖅ㸝௧ୖ㸡ᑍ௴┘ࡡಘ㢏ᛮ࣬ጂᙔᛮ࡞ࡗ࠷࡙᳠ゞࡊࡒ㸝⾪㸫㸡⾪㸬㸞㸣ಘ⫃ဤ┫㆜ᖅ࡛ࡌࡾ㸞ࡡ᪁࠿᭯ណ࡞㧏࠾ࡖࡒ㸝S㸱㸞㸣㢏ᛮࡢ㸡&URQEDFKࡡȘ౿ᩐࢅịࡴࡒ㸣ࠔᚪこᛮࡡヾㆉࠕ㌷㝌ᙟᘟ࡞ࡗ࠷࡙ࡢ㸡㈹ၡ㡧┘ࡡහᐖ࠾ࡼ᛬ᛮ᭿⑋Ჯ

࡞ࡗ࠷࡙ࡢ㸡ࠔᐁ᪃≟Ἓࠕ࡞ࡗ࠷࡙ࡢ࡚࠵ࡽ㸡࡛ះᛮ᭿⑋Ჯࡡ㸧⩄࡞ฦࡄ࡙ฦᯊࡊࡒ࠿㸡㡧┘ධ࡙ಘ㢏ᛮࡢヾࡴࡼࡿࡒ㸣ጂᙔᛮ࡞ࡗ࠷࡙ࡢ㸡ᵋᠺᴣᛍࡡ

࡞࠽࠷࡙᭯ណᕣ࠿ヾࡴࡼࡿ࡝࠾ࡖࡒ㸣ጂᙔᛮࢅࡲࡾࡒࡴ࡞ᅄᏄฦᯊࢅ⾔ࡖࡒ㸣ᅄᏄฦᯊ࡞࠽

ࠈࠔᐁ᪃≟Ἓࠕ࡚ࡢ㸡㡧┘ධ࡙࡞࠽࠷࡙㸡ࢪࢠ࣭ࣛࡄࡾ᳠ᏽ࡞ࡗ࠷࡙ࡢ㸡ࢦࣤࣈ࡛ࣜᅄᏄฦᯊࡡ㐲ྙᛮࢅࢼࣤࢡᐁ᪃┫㆜ᖅࡡ᪁࠿᭯ណ࡞㧏࠾ࡖࡒ㸝S㸱㸞㸣ᅒࡾ஥๑᳠ᏽ࡛ࡊ࡙㸡.DLVHU0H\HU2ONLQ㸝.02㸞ࡡᵾࡱࡒ㸡ࠖථ㝌᪡᭿ࡡ㏝㝌ㄢᩒࡡᚪこᛮࡡ࢓ࢬࢪ࣒ࣤ

ᮇጂᙔᛮῼᗐ࠽ࡻࡦ%DUWOHWWࡡ⌣㟻ᛮ᳠ᏽࡡᐁ᪃࠿᥆

ࢹࠗࠖථ㝌᪡᭿ࡡᅂᚗᚃࡡ⒢㣬ሔᡜࡡ࢓ࢬࢪ࣒ࣤࢹࠗ

ዜࡈࡿ㸡.02ࡢ㸡ࠔᚪこᛮࡡヾㆉࠕࠔᐁ᪃≟Ἓࠕ࡛ࡵ࡞

ࠖථ㝌୯࡞$'/࠿࡜ࡡࡻ࠹࡞ን໩ࡊ࡙࠷ࡂ࠾ࡡ஢ῼࠗ

࡚࠵ࡖࡒ㸣ࡱࡒ㸡%DUWOHWWࡡ⌣㟻ᛮ᳠ᏽ⤎ᯕࡢ㸡ࠖᝀ⩽࠿࡜ࡡࡻ࠹࡝⏍Ὡࢅ᭻ࢆ࡚࠷ࡾ࠾ࡡ☔ヾࠗࠖࠔᚪこᛮࡡヾㆉࠕࠔᐁ᪃≟Ἓࠕ࡛ࡵ࡞S࡛࡝ࡾࡒࡴ㸡ᝀ⩽ࡡࡆࡿ࠾ࡼࡡ⒢㣬࡞㛭ࡌࡾᛦ࠷ࡡ☔ヾࠗࠖᐓᒁ

ᅄᏄฦᯊࡡ㐲⏕ࡢጂᙔ࡛ึ᩷ࡊࡒ㸣ฦᯊࡢ㸡୹ᅄᏄἪ

ࡡᵋ㏸ࡷపᏩ⎌ሾࡡᢍᥩࠗࡡ㸫㡧┘࡞࠽࠷࡙㸡ᑍ௴⫃࡞ࡻࡾᅄᏄฦᯊࣈ࣏ࣞࢴࢠࢪᅂ㌷ࢅ⾔࠷㸡ࡐࡡ⤎ᯕ㸡ဤ┫㆜ᖅࡡ᪁࠿᭯ណ࡞㧏࠾ࡖࡒ㸝S㸱㸞㸣㌷㝌ᙟᘟᅄᏄㇿⲬࡡ఩࠷㡧┘ࡷ々ᩐࡡᅄᏄ࡞ᅄᏄㇿⲬࡡ㧏࠷㡧࡞ࡗ࠷࡙ࡢ㸡ࠖ௒㆜ಕ㝜ࡡᚪこᛮ࡞ࡗ࠷࡙ࡡ࢓ࢬࢪ

┘ࢅ㝎࠷࡙㸡ࠔᚪこᛮࡡヾㆉࠕࠔᐁ᪃≟Ἓࠕ࡛ࡵ࡞㸧ࡗ㸬

岩手看護学会誌/Journal of Iwate Society of Nursing Science. Vol.6, No.2, 2012⾪ࠈ㧏㱃ᝀ⩽ࡡ┫㆜ࡡࠔᚪこᛮࡡヾㆉࠕ࡞㛭ࡌࡾ㡧┘ࡡᅄᏄฦᯊ⤎ᯕ ࠈ➠ᅄᏄ㸝㡧┘㸞࠘ᐓᗖ⫴ᬊ࣬ᐓ᪐ᶭ⬗ࡡビ౮࡛ᐓ᪐࣬ᝀ⩽ࡡᕵ᭻☔ヾ࠙Ș㸲 ᐓ᪐ࡡࡆࡿ࠾ࡼࡡ⒢㣬࡞㛭ࡌࡾᕵ᭻ࡡ☔ヾ ᐓ᪐ᵋᠺࡡᢍᥩ ᐓ᪐ࡡ௒㆜ງࡡᢍᥩ ࣭࢞ࣂ࣭ࢮࣤ࠿ᶭ⬗ࡌࡾࡻ࠹࡝഼ࡀ࠾ࡄ ⤊ῥງࡡᢍᥩ 
ᐓᒁࡡᵋ㏸ࡷపᏩ⎌ሾࡡᢍᥩ ᝀ⩽ࡡࡆࡿ࠾ࡼࡡ⒢㣬࡞㛭ࡌࡾᛦ࠷ࡡ☔ヾ➠ᅄᏄ㸝㡧┘㸞࠘㏝㝌ㄢᩒࠉ௒㆜ಕ㝜ࡡึ᩷࠙Ș㸲 ථ㝌᪡᭿ࡡ㏝㝌ㄢᩒࡡᚪこᛮࡡ࢓ࢬࢪ࣒ࣤࢹ ථ㝌᪡᭿ࡡᅂᚗᚃࡡ⒢㣬ሔᡜࡡ࢓ࢬࢪ࣒ࣤࢹ ௒㆜ಕ㝜ࡡᚪこᛮ࡞ࡗ࠷࡙ࡡ࢓ࢬࢪ࣒ࣤࢹ ௒㆜ಕ㝜࠿ᚪこ࡛ึ᩷ࡈࡿࡾ᫤ࡡ⏞ㄫ࡫ࡡ㛭ࢂࡽ㝎አࡊࡒ㡧┘ ᝀ⩽࠿࡜ࡡࡻ࠹࡝⏍Ὡࢅ᭻ࢆ࡚࠷ࡾࡡ࠾ࡡ☔ヾ ථ㝌୯࡞$'/࠿࡜ࡡࡻ࠹࡞ን໩ࡊ࡙࠷ࡂ࠾ࡡ஢ῼ

ᅄᏄㇿⲬ㔖
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ᅂ㌷ᚃࡡㇿⲬ㔖ᖲ᪁࿰ᐞ୙⋙㸝㸚㸞⣴✒ᐞ୙⋙㸝㸚㸞ᖲᆍೋ

1㸲㸡ᅄᏄ᢫ฝἪ㸯୹ᅄᏄἪࠈᅂ㌷Ἢ㸯.DLVHUࡡḿぜ໩ࢅఔ࠹ࣈ࣏ࣞࢴࢠࢪἪ

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⾪ࠈ㧏㱃ᝀ⩽ࡡ┫㆜ࡡࠔᐁ᪃≟Ἓࠕ࡞㛭ࡌࡾ㡧┘ࡡᅄᏄฦᯊ⤎ᯕ
㡧┘␊ྒ

㡧ࠈࠈ┘

➠ᅄᏄ㸝㡧┘㸞࠘ᐓᗖ⫴ᬊ࣬ᐓ᪐ᶭ⬗ࡡビ౮࡛ᐓ᪐࣬ᝀ⩽ࡡᕵ᭻☔ヾ࠙Ș㸲 ᐓ᪐ࡡࡆࡿ࠾ࡼࡡ⒢㣬࡞㛭ࡌࡾᕵ᭻ࡡ☔ヾ ᐓ᪐ᵋᠺࡡᢍᥩ ᐓ᪐ࡡ௒㆜ງࡡᢍᥩ ⤊ῥງࡡᢍᥩ ࣭࢞ࣂ࣭ࢮࣤ࠿ᶭ⬗ࡌࡾࡻ࠹࡝഼ࡀ࠾ࡄ ᝀ⩽࠿࡜ࡡࡻ࠹࡝⏍Ὡࢅ᭻ࢆ࡚࠷ࡾࡡ࠾ࡡ☔ヾ ᝀ⩽ࡡࡆࡿ࠾ࡼࡡ⒢㣬࡞㛭ࡌࡾᛦ࠷ࡡ☔ヾ 
ᐓᒁࡡᵋ㏸ࡷపᏩ⎌ሾࡡᢍᥩ
➠ᅄᏄ㸝㡧┘㸞࠘㏝㝌ㄢᩒࠉ௒㆜ಕ㝜ࡡึ᩷࠙Ș㸲 ථ㝌᪡᭿ࡡᅂᚗᚃࡡ⒢㣬ሔᡜࡡ࢓ࢬࢪ࣒ࣤࢹ ථ㝌᪡᭿ࡡ㏝㝌ㄢᩒࡡᚪこᛮࡡ࢓ࢬࢪ࣒ࣤࢹ ௒㆜ಕ㝜ࡡᚪこᛮ࡞ࡗ࠷࡙ࡡ࢓ࢬࢪ࣒ࣤࢹ ථ㝌୯࡞$'/࠿࡜ࡡࡻ࠹࡞ን໩ࡊ࡙࠷ࡂ࠾ࡡ஢ῼ
㝎አࡊࡒ㡧┘ ௒㆜ಕ㝜࠿ᚪこ࡛ึ᩷ࡈࡿࡾ᫤ࡡ⏞ㄫ࡫ࡡ㛭ࢂࡽ
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1㸲㸡ᅄᏄ᢫ฝἪ㸯୹ᅄᏄἪࠈᅂ㌷Ἢ㸯.DLVHUࡡḿぜ໩ࢅఔ࠹ࣈ࣏ࣞࢴࢠࢪἪ

ࡡᅄᏄ࠿᢫ฝࡈࡿࡒ㸣ࠔᚪこᛮࡡヾㆉࠕࡡ➠㸦ᅄᏄࡢ㸡㏝㝌ㄢᩒࡡᚪこᛮࡡ࢓ࢬࢪ࣒ࣤࢹࠗ
ࠖථ㝌᪡᭿ࡡᅂ

ࠖᐓ᪐ࡡࡆࡿ࠾ࡼࡡ⒢㣬࡞㛭ࡌࡾᕵ᭻ࡡ☔ヾࠗࠖᚗᚃࡡ⒢㣬ሔᡜࡡ࢓ࢬࢪ࣒ࣤࢹࠗࠖ௒㆜ಕ㝜ࡡᚪこᐓ᪐ᵋᠺࡡᢍᥩࠗ
ࠖᐓ᪐ࡡ௒㆜ງࡡᢍᥩࠗ
ࠖ࣭࢞

ᛮ࡞ࡗ࠷࡙ࡡ࢓ࢬࢪ࣒ࣤࢹࠗࠖ௒㆜ಕ㝜࠿ᚪこ࡛ึࣂ࣭ࢮࣤ࠿ᶭ⬗ࡌࡾࡻ࠹࡝഼ࡀ࠾ࡄࠗ
ࠖ⤊ῥງࡡᢍ

᩷ࡈࡿࡾ᫤ࡡ⏞ㄫ࡫ࡡ㛭ࢂࡽࠗࡡ㸩㡧┘࠾ࡼᵋᠺࡈࡿ

ᥩࠗࠖᐓᒁࡡᵋ㏸ࡷపᏩ⎌ሾࡡᢍᥩࠗ
ࠖᝀ⩽ࡡࡆ

ࡾࡆ࡛࠾ࡼ㸡
࠘㏝㝌ㄢᩒ㸡௒㆜ಕ㝜ࡡึ࡛᩷࠙ゆ㔐ࡊࡿ࠾ࡼࡡ⒢㣬࡞㛭ࡌࡾᛦ࠷ࠗࡡ㸬㡧┘࠾ࡼᵋᠺࡈࡿࡾ

ࡒ㸣ࠔᐁ᪃≟Ἓࠕࡡ➠㸦ᅄᏄࡢ㸡ࠖᐓ᪐ࡡࡆࡿ࠾ࡼࡡ

ࡆ࡛࠾ࡼ㸡࠘ᐓᗖ⫴ᬊ࣬ᐓ᪐ᶭ⬗ࡡビ౮࡛ᐓ᪐࣬ᝀ⩽⒢㣬࡞㛭ࡌࡾᕵ᭻ࡡ☔ヾࠗࠖᐓ᪐ᵋᠺࡡᢍᥩࠗ
ࠖᐓࡡᕵ᭻☔ヾ࡛࠙ゆ㔐ࡊࡒ㸣➠㸧ᅄᏄࡢ㸡ࠖථ㝌᪡᭿ࡡ᪐ࡡ௒㆜ງࡡᢍᥩࠗ
ࠖ⤊ῥງࡡᢍᥩࠗ
ࠖ࣭࢞ࣂ࣭

㸭

岩手看護学会誌/Journal of Iwate Society of Nursing Science. Vol.6, No.2, 2012⾪ࠈ⑋Ჯࡡ≁ᚡ࡞ࡻࡾᅄᏄฦᯊ⤎ᯕࡡᚋⅤ㸯ࠔᚪこᛮࡡヾㆉࠕ࡛ࠔᐁ᪃≟Ἓࠕࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈࠈᖲᆍsᵾ‵೩ᕣ㸝Ⅴ㸞ࠈࢪࢠ࣭ࣛࢼࣤࢡᐁ᪃㡧ࠈࠈ┘᭯↋㸝㹣㸲㸞 㸝㹣㸲㸞ᚪこᛮࡡヾㆉ
࠘ᐓᗖ⫴ᬊ࣬ᐓ᪐ᶭ⬗ࡡビ౮s s
ࠈࠈ࡛ᐓ᪐࣬ᝀ⩽ࡡᕵ᭻☔ヾ࠙࠘㏝㝌ㄢᩒ㸡௒㆜ಕ㝜ࡡึ᩷࠙s sᐁ᪃≟Ἓ࠘ᐓᗖ⫴ᬊ࣬ᐓ᪐ᶭ⬗ࡡビ౮s s
ࠈࠈ࡛ᐓ᪐࣬ᝀ⩽ࡡᕵ᭻☔ヾ࠙

㹥ೋ



㏝㝌ㄢᩒ࡞ᑍ௴ࡌࡾ⫃ဤࡡ㒼⨠᭯↋㸝㹣㸲㸞 㸝㹣㸲㸞

㌷㝌ᙟᘟ
㹥ೋ

᛬ᛮ᭿⑋Ჯ ះᛮ᭿⑋Ჯ
㸝㹣㸲㸞 㸝㹣㸲㸞㹥ೋs s

s s

  s s

s s

  s s

  s s ࠘㏝㝌ㄢᩒ㸡௒㆜ಕ㝜ࡡึ᩷࠙s s   s s

  s s



Sೋ㸯0DQQ:KLWQH\ࡡ8᳠ᏽ㸰 㸡S㸱ࢮࣤ࠿ᶭ⬗ࡌࡾࡻ࠹࡝഼ࡀ࠾ࡄࠗ
ࠖᝀ⩽࠿࡜ࡡࡻ࠹

㒼⨠ࡈࡿ࡙࠷࡝࠷⑋㝌࡞ໂຸࡌࡾ┫㆜ᖅ㸝௧ୖ㸡ᑍ௴࡝⏍Ὡࢅ᭻ࢆ࡚࠷ࡾࡡ࠾ࡡ☔ヾࠗࠖᝀ⩽ࡡࡆࡿ࠾ࡼ

⫃ဤ୘ᅹ┫㆜ᖅ࡛ࡌࡾ㸞ࡡᐁ᪃ࡻࡽࡵ᭯ណ࡞㧏࠾ࡖࡒ㸣

ࡡ⒢㣬࡞㛭ࡌࡾᛦ࠷ࡡ☔ヾࠗࠖᐓᒁࡡᵋ㏸ࡷపᏩ⎌ࠈ㌷㝌ᙟᘟࡡ㐢࠷࡚ࡢ㸡ࠔᚪこᛮࡡヾㆉࠕࠔᐁ᪃≟Ἓࠕ

ሾࡡᢍᥩࠗࡡ㸭㡧┘࠾ࡼᵋᠺࡈࡿࡾࡆ࡛࠾ࡼ㸡࠘ᐓᗖ࡛ࡵ࡞᭯ណᕣࢅヾࡴ࡝࠾ࡖࡒ㸣⫴ᬊ࣬ᐓ᪐ᶭ⬗ࡡビ౮࡛ᐓ᪐࣬ᝀ⩽ࡡᕵ᭻☔ヾ࡛࠙ゆ㔐ࡊࡒ㸣➠㸧ᅄᏄࡢ㸡ࠖථ㝌᪡᭿ࡡᅂᚗᚃࡡ⒢㣬ሔϫ㸣⩻ᐳᡜࡡ࢓ࢬࢪ࣒ࣤࢹࠗ
ࠖථ㝌᪡᭿ࡡ㏝㝌ㄢᩒࡡᚪこᛮ㸣㧏㱃ᝀ⩽࡞ᑊࡌࡾ㏝㝌ᚃࡡ⏍Ὡࢅず㏳ࡊࡒ┫㆜ࡡࡡ࢓ࢬࢪ࣒ࣤࢹࠗࠖ௒㆜ಕ㝜ࡡᚪこᛮ࡞ࡗ࠷࡙ࡡ࢓ࠈࠔᚪこᛮࡡヾㆉࠕ࡛ࠔᐁ᪃≟Ἓࠕࢬࢪ࣒ࣤࢹࠗ
ࠖථ㝌୯࡞$'/࠿࡜ࡡࡻ࠹࡞ን໩ࡊ࡙࠷

ࠈ㧏㱃ᝀ⩽࡞ᑊࡌࡾ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜㡧┘ධ࡙ࡂ࠾ࡡ஢ῼࠗࡡ㸩㡧┘࠾ࡼᵋᠺࡈࡿࡾࡆ࡛࠾ࡼ㸡
࠘㏝㝌

࡞࠽࠷࡙㸡
ࠔᚪこᛮࡡヾㆉࠕ࠿ࠔᐁ᪃≟Ἓࠕࡻࡽࡵ᭯ណ

ㄢᩒ㸡௒㆜ಕ㝜ࡡึ࡛᩷࠙ゆ㔐ࡊࡒ㸣࡞㧏࠾ࡖࡒࡆ࡛࠾ࡼ㸡ࠔᚪこᛮࡡヾㆉࠕࡢ㧏࠷࠿㸡᪝ࠈ㸞ᅄᏄฦᯊ⤎ᯕ࡞ࡻࡾ྘⩄ࡡᚋⅤࠍࡡ┫㆜࡚ᐁ㊮ࡊࡀࡿ࡙࠷࡝࠷⌟≟࠿࠵ࡾ࡛⩻࠻ࡼࡿࠈᅄᏄฦᯊࡡ⤎ᯕࢅࡨࡱ࠻㸡ࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃ࡡ

ࡾ㸣ࡱࡒ㸡྘㡧┘ࡡࠔᚪこᛮࡡヾㆉࠕ࡛ࠔᐁ᪃≟Ἓࠕࡡ᭯↋㸡ᑍ௴⫃ဤࡡ㒼⨠ࡡ᭯↋㸡㌷㝌ᙟᘟࡡ㐢࠷࡞࠽࠷

ᖲᆍⅤࢅẒ㍉ࡌࡾ࡛㸡ᴣࡠྜྷࡋࡻ࠹࡝ᚋⅤ㡨న࡛࡝ࡾ࡙ฦᕱ࡞ᕣ࠿࠵ࡾ࠾㸡0DQQ:KLWQH\ࡡ8᳠ᏽࢅ⾔ࡖࡒ࠿㸡㡧┘ࡡ୯࡚㸡ᚋⅤ㡨న࠿ኬࡀࡂ␏࡝ࡾ㡧┘ࡡ㸦

㸝⾪㸭㸞㸣

ࡗ࡞㸡
ࠖථ㝌᪡᭿ࡡᅂᚗᚃࡡ⒢㣬ሔᡜࡡ࢓ࢬࢪ࣒ࣤ

ࠈࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃ࡡ᭯↋࡚ࡢ㸡ࠔᚪこᛮࡡヾㆉࠕࢹࠗ࠿࠵ࡖࡒ㸣ࡆࡿࡢ㸡ࠔᚪこᛮࡡヾㆉࠕࡢࡊ࡙࠷ࡾ

࡞࠽࠷࡙࠘㏝㝌ㄢᩒ㸡௒㆜ಕ㝜ࡡึ࡚᩷࠙᭯ណᕣ㸝S㸱

ࡵࡡࡡࠔᐁ᪃≟Ἓࠕ࠿఩࠷㸣඙⾔◂✪࡚ࡵ㸡㏝㝌࡞ࡳ㸞ࢅヾࡴ㸡ࢪࢠ࣭ࣛࢼࣤࢡᐁ᪃┫㆜ᖅࡡヾㆉ࠿㸡ࡄ࡙ࡡᨥᥴࢅ᪡᭿࡞㛜ጙࡌࡾࡆ࡛࡚㸡ථ㝌ࡡ㛏᭿໩ࢅࢪࢠ࣭ࣛࢼࣤࢡࢅᐁ᪃ࡊ࡙࠷࡝࠷⑋Ჯ࡞ໂຸࡌࡾ┫㆜㜭ࡃࡆ࡛࠿ሒ࿈㸞ࡈࡿࡒࡽ㸡ᝀ⩽⫴ᬊࡵ々㞟࡚࠵ࡾࡆᖅ㸝௧ୖ㸡ࢪࢠ࣭ࣛࢼࣤࢡᮅᐁ᪃┫㆜ᖅ࡛ࡌࡾ㸞ࡡヾ࡛࠾ࡼ㸡々㞟࡝ㄢᩒහᐖ࠿ᚪこ࡛࡝ࡖ࡙ᨥᥴ࡞᫤㛣ࢅㆉࡻࡽࡵ᭯ណ࡞㧏࠾ࡖࡒ㸣ࠔᐁ᪃≟Ἓࠕ࡚ࡢ㸡࠘ᐓᗖ⫴こࡌࡾࡒࡴ㸡᪡᭿࠾ࡼᑊ㇗⩽ࡡ≁ᏽ࡛ᨥᥴࡡᚪこᛮ㸞ᬊ࣬ᐓ᪐ᶭ⬗ࡡビ౮࡛ᐓ᪐࣬ᝀ⩽ࡡᕵ᭻☔ヾ࡛࠙࠘㏝

࠿㏑࡬ࡼࡿ࡙࠷ࡾ㸣ࡱࡒ㸡㏝㝌ᨥᥴ࡞ᑊࡊ࡙ࣀ࢕ࣛࢪ

㝌ㄢᩒ㸡௒㆜ಕ㝜ࡡึ᩷࠙ࡡ࡜ࡔࡼ࡞ࡵ᭯ណᕣ㸝S㸱

ࢠᝀ⩽࡚࠵ࡾ࡛ヾㆉࡊࡒ᫤Ⅴ࡚㸡ิࡴ࡙✒ᴗⓏ࡝ᨥᥴ

㸞ࢅヾࡴ㸡ࢪࢠ࣭ࣛࢼࣤࢡᐁ᪃┫㆜ᖅࡡᐁ᪃࠿㸡࠿㛜ጙࡈࡿ࡙ࡵ㸡ᨥᥴ㛜ጙࡡࢰ࢕࣐ࣤࢡࢅ㏠ࡌ㸞ࡆ࡛ࢪࢠ࣭ࣛࢼࣤࢡᮅᐁ᪃┫㆜ᖅࡡᐁ᪃ࡻࡽࡵ᭯ណ࡞㧏࠾ࡵ㏑࡬ࡼࡿ࡙࠷ࡾ㸣ࠖථ㝌᪡᭿ࡡᅂᚗᚃࡡ⒢㣬ሔᡜࡖࡒ㸣ࡡ࢓ࢬࢪ࣒ࣤࢹࠗࡡࠔᚪこᛮࡡヾㆉࠕࡢࡊ࡙࠷ࡾࡵࡡ

ࠈᑍ௴⫃ဤࡡ㒼⨠ࡡ᭯↋࡚ࡢ㸡ࠔᚪこᛮࡡヾㆉࠕ࡞ࡢࡡࠔᐁ᪃≟Ἓࠕ࠿఩࠷ࡆ࡛࠾ࡼ㸡┫㆜ᖅࡢ㸡ථ㝌᭿㛣᭯ណᕣ࠿ヾࡴࡼࡿ࡝࠾ࡖࡒ㸣ࠔᐁ᪃≟Ἓࠕ࡚ࡢ㸡࠘ᐓᗖ࠿▯⦨ࡊ࡙࠷ࡾ⌟ᅹ㸡㏝㝌ᨥᥴ࠿᪡᭿࠾ࡼᐁ᪃ࡈࡿࡾ

⫴ᬊ࣬ᐓ᪐ᶭ⬗ࡡビ౮࡛ᐓ᪐࣬ᝀ⩽ࡡᕵ᭻☔ヾ࡛࠙࠘㏝ࡆ࡛ࡡ࣒ࣛࢴࢹࡷᚪこᛮࢅ⌦ゆࡊ࡙࠷ࡾ࡛ྜྷ᫤࡞㸡ᅂ㝌ㄢᩒ㸡௒㆜ಕ㝜ࡡึ᩷࠙ࡡ࡜ࡔࡼ࡞ࡵ᭯ណᕣ㸝S㸱ᚗᚃࡡ⒢㣬ሔᡜࡡ࢓ࢬࢪ࣒ࣤࢹࡡᚪこᛮࡵ⌦ゆࡊ࡙࠷㸞ࢅヾࡴ㸡ᑍ௴⫃ဤ┫㆜ᖅࡡᐁ᪃࠿㸡ᑍ௴⫃ဤ࠿ࡾ⌟≟࡚࠵ࡾ㸣ࡱࡒ㸡々ᩐࡡ⑄ᝀࢅᢢ࠻ࡾࡆ࡛࠿ኣ࠷

㸮

岩手看護学会誌/Journal of Iwate Society of Nursing Science. Vol.6, No.2, 2012㧏㱃ᝀ⩽ࡢ㸡$'/ࡡን໩ࡡ஢ῼ࠿㞬ࡊࡂ㸡ಞḿ࠿ᚪこࡼࡿࡾ㸣࡝ࡆ࡛ࡵኣࡂ㸡᪝ࠍࡡኣᚹ࡝┫㆜ࡡ୯࡚㸡᪡᭿࠾ࡼ㏝ࠈ㸞ᅄᏄฦᯊ⤎ᯕ࡞ࡻࡾᅄᏄ࡞ࡗ࠷࡙㝌ᚃࢅずᤛ࠻ࡒ┫㆜ࢅ⾔࠹ࡆ࡛࠿ᅏ㞬࡝≟Ἓ࡞࠵ࡾࡆ

ࠈᅄᏄฦᯊ࡞ࡻࡖ࡙ฦ㢦ࡈࡿࡒ࠘ᐓᗖ⫴ᬊ࣬ᐓ᪐ᶭ⬗࡛࠿⩻࠻ࡼࡿࡾ㸣ࡊ࠾ࡊ㸡㏝㝌ᨥᥴ㛜ጙࡡࢰ࢕࣐ࣤࢡ

ࡡビ౮࡛ᐓ᪐࣬ᝀ⩽ࡡᕵ᭻☔ヾ࡚࠙ࡢ㸡ࠔᚪこᛮࡡヾ

ࢅ㏠ࡈ࡝࠷ࡒࡴ࡞ࡵ㸡᪡᭿࡞࢓ࢬࢪ࣒ࣤࢹࢅ⾔࠷㸡ಞㆉࠕ࡞࠽࠷࡙㸡ࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃ࡡ᭯↋ࡷᑍ௴⫃ḿࡊ࡝࠿ࡼ┫㆜ࡌࡾᚪこ࠿࠵ࡾࡒࡴ㸡ᑍ௴⫃ဤ࠿㒼⨠ဤࡡ㒼⨠ࡡ᭯↋㸡㌷㝌ᙟᘟࡡ㐢࠷࡚㡧┘࡞᭯ណᕣ࠿ヾࡈࡿ࡙࠷ࡾሔྙ࡞ࡢ㸡᪡᭿࡞㏻⤙ࢅཱིࡖ࡙㏻ᦘࢅᐠ࡞

ࡴࡼࡿ࡝࠾ࡖࡒ࠿㸡ࠔᐁ᪃≟Ἓࠕ࡚ࡢࢪࢠ࣭ࣛࢼࣤࢡ

ࡊ࡝࠿ࡼ㸡㧏㱃ᝀ⩽ࡡ≟ឺࢅ⑋Ჯ┫㆜ᖅ࡛භ᭯ࡌࡾᚪᐁ᪃┫㆜ᖅ㸡ᑍ௴⫃ဤ┫㆜ᖅࡡ᪁࠿᭯ណ࡞㧏࠷㸣ࡆࡿこ࠿࠵ࡾ㸣ࡱࡒ㸡ᑍ௴⫃ဤ࠿㒼⨠ࡈࡿ࡙࠷࡝࠷ሔྙ࡞

ࡼࡡࡆ࡛࠾ࡼ㸡⑋Ჯࡡ≁ᚡ࡞㛭ࢂࡼࡍ㸡࡜ࡡ┫㆜ᖅࡵࡢ㸡ථ㏝㝌ࡡㄢᩒࢅ᪝ࠍᐁ㊮ࡊ࡙࠷ࡾ┫㆜ᖅ㛏࡛༝ງࠔᚪこᛮࡡヾㆉࠕࢅ㧏ࡂᣚࡖ࡙࠷ࡾ࡛⩻࠻ࡾࡆ࡛࠿࡚ࡌࡾᚪこ࠿࠵ࡾ࡛⩻࠻ࡾ㸣ࡀࡾ㸣ࡱࡒ㸡⑋Ჯࡡ≁ᚡ࡞㛭౿ࡊ࡙࠷࡝࠷ࡒࡴ㸡㧏㱃㸣⑋Ჯࡡ≁ᚡ࡞ࡻࡾࠔᚪこᛮࡡヾㆉࠕ࡛ࠔᐁ᪃≟Ἓࠕᝀ⩽࡞ྡྷࡀྙ࠹┫㆜ᖅୌெୌெࡡጶເ࠿ཬ᫆ࡈࡿ࡙࠽

ࠈࡡ㐢࠷ࡽ㸡㧏㱃໩ࡡຊ㏷ࡷ௒㆜࡞࠽ࡄࡾㅎၡ㢗ࢅᨼវ࡞ࡗ࠾

ࠈ㸞㧏㱃ᝀ⩽࡞ᑊࡌࡾ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜㡧┘ࡲ㸡ᚪこᛮࢅヾㆉࡊ࡝࠿ࡼ┫㆜ࡊ࡙࠷ࡾ࡛ࡵゕ࠻ࡾ㸣ࠈࠈࠈ࡞ࡗ࠷࡙

ཬࡊ࡙ࠔᐁ᪃≟Ἓࠕ࡛࡝ࡾ࡛㸡ᖲᆍⅤࡢࠔᚪこᛮࡡヾࠈࠔᚪこᛮࡡヾㆉࠕࡢ㸡ࠖථ㝌᪡᭿ࡡ㏝㝌ㄢᩒࡡᚪこㆉࠕࡻࡽࡵ఩ࡂ࡝ࡽ㸡ࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃ࡷᑍ௴⫃ᛮࡡ࢓ࢬࢪ࣒ࣤࢹࠗ
ࠖථ㝌᪡᭿ࡡᅂᚗᚃࡡ⒢㣬ሔᡜဤࡡ㒼⨠ࡡ᭯↋࡞ࡻࡖ࡙᭯ណᕣ࠿ヾࡴࡼࡿ࡙࠷ࡾ㸣ࡆࡡ࢓ࢬࢪ࣒ࣤࢹࠗࠖ௒㆜ಕ㝜ࡡᚪこᛮ࡞ࡗ࠷࡙ࡡ࢓

ࡿࡢ㸡⾪㸪࡞♟ࡊ࡙࠷ࡾࡻ࠹࡞㸡ࠖᝀ⩽ࡡࡆࡿ࠾ࡼ

ࢬࢪ࣒ࣤࢹࠗࠖ௒㆜ಕ㝜࠿ᚪこ࡛ࡈࡿࡾ᫤ࡡ⏞ㄫ࡫

ࡡ⒢㣬࡞㛭ࡌࡾᛦ࠷ࡡ☔ヾࠗ࡞࠽࠷࡙ࠔᐁ᪃≟Ἓࠕ࠿ࡡ㛭ࢂࡽࠗࠖᐓ᪐ᵋᠺࡡᢍᥩࠗ
ࠖᐓ᪐ࡡ௒㆜ງࡡᢍ఩࠷ࡆ࡛࠿࠵ࡅࡼࡿࡾ㸣ࡆࡡ⤎ᯕࡢ㸡㏝㝌ㄢᩒ࡞࠽࠷

ᥩࠗࠖᐓᒁࡡᵋ㏸ࡷపᏩ⎌ሾࡡᢍᥩࠗࡡ㸬㡧┘࡚㸡࡙㸡୯ᚨ࡞Ꮛᅹࡌࡾ㧏㱃ᝀ⩽࡞┘ࢅྡྷࡄ࡙⌦ゆࡌࡾᚪࢪࢠ࣭ࣛࢼࣤࢡᮅᐁ᪃┫㆜ᖅ࡛Ẓ㍉ࡊ࡙㸡ࢪࢠ࣭ࣛࢼ

こᛮࢅ♟ြࡊ࡙࠽ࡽ㸡ࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃ࡷᑍ௴⫃ࣤࢡᐁ᪃┫㆜ᖅࡡ᪁࠿ヾㆉ࠿᭯ណ࡞㧏࠾ࡖࡒ㸣ࡊ࠾ဤ࠿㒼⨠ࡈࡿ࡙࠷ࡾࡆ࡛ࡢ㸡┫㆜ᖅࡡࠔᚪこᛮࡡヾㆉࠕࡊ㸡ᑍ௴⫃ဤࡡ㒼⨠ࡡ᭯↋࡚᭯ណᕣ࠿ヾࡴࡼࡿࡒࡡࡢ

࠿ࠔᐁ᪃≟Ἓࠕ࡞ንࢂࡾこᅄ࡞࡝ࡾ࡛⩻࠻ࡼࡿࡾ㸣ࠖථ㝌᪡᭿ࡡ㏝㝌ㄢᩒࡡᚪこᛮࡡ࢓ࢬࢪ࣒ࣤࢹࠗࡡ

ࠈᅄᏄฦᯊ࡞ࡻࡖ࡙ฦ㢦ࡈࡿࡒ࠘㏝㝌ㄢᩒ㸡௒㆜ಕ㝜㸦㡧┘ࡡࡲ࡚㸡ᑍ௴⫃ဤ┫㆜ᖅࡡ᪁࠿ࠔᚪこᛮࡡヾㆉࠕࡡึ࡚᩷࠙ࡢ㸡ࠔᚪこᛮࡡヾㆉࠕ࡞࠽࠷࡙㸡ࢪࢠ࣭ࣛ࠿᭯ណ࡞㧏࠾ࡖࡒ㸣ࡱࡒ㸡㌷㝌ᙟᘟࡡ㐢࠷࡚ࡢ㸡ධ࡙ࢼࣤࢡࢅᐁ᪃ࡊ࡙࠷ࡾ᪁࠿㧏࠷࠿㸡ᑍ௴⫃ဤࡡ㒼⨠ࡷࡡ㡧┘࡚᭯ណᕣ࠿ヾࡴࡼࡿ࡝࠾ࡖࡒ㸣ࡌ࡝ࢂࡔ㸡᭩ࡵ㌷㝌ᙟᘟࡡ㐢࠷࡞࠽࠷࡙㡧┘࡞᭯ណᕣ࠿ヾࡴࡼࡿ࡝࠾

ኣࡂࡡ㡧┘࡚᭯ណᕣ࠿ヾࡴࡼࡿࡒࡡࡢ㸡ࢪࢠ࣭ࣛࢼࣤ

ࡖࡒ㸣ୌ᪁㸡
ࠔᐁ᪃≟Ἓࠕ࡚ࡢ㸡ࢪࢠ࣭ࣛࢼࣤࢡࢅᐁ

ࢡࡡᐁ᪃ࡡ᭯↋࡞ࡻࡾࡵࡡ࡚࠵ࡖࡒ㸣ࡆࡿࡼࡢ㸡ࢪࢠ᪃㸡ᑍ௴⫃ဤ࠿㒼⨠ࡈࡿ࡙࠷ࡾ᪁࠿᭯ណ࡞㧏࠷㸣࠘㏝㸞࣭ࣛࢼࣤࢡ⚂ࡡ᭯ຝᛮ ࡷ㸡ࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃࡞

㝌ㄢᩒ㸡௒㆜ಕ㝜ࡡึ࡚᩷࠙ࡵ㸡඙࡞㏑࡬ࡒࡻ࠹࡞㸡㸞ࡻࡾ┫㆜ᖅ࡫ࡡᩅ⫩ຝᯕ ࠿㏑࡬ࡼࡿ࡙࠷ࡾࡆ࡛࠾ࡼࠔᚪこᛮࡡヾㆉࠕࢅ㧏ࡂᣚࡖ࡙࠷ࡾ࡛⩻࠻ࡾࡆ࡛࠿࡚

ࡵ㸡ࢪࢠ࣭ࣛࢼࣤࢡࢅᐁ᪃ࡌࡾࡆ࡛ࡢ㸡᪝ࠍࡡ┫㆜ࡡࡀࡾࡵࡡࡡ㸡
ࠔᐁ᪃≟Ἓࠕ࡛࡝ࡾ࡛㸡ࢪࢠ࣭ࣛࢼࣤࢡ㈹ࢅ୕ࡅࡾࡆ࡛࡞ࡵࡗ࡝࠿ࡽ㸡ᐁ᪃ࡌࡾࡆ࡛ࡡណ࿝ࡢ

ࡡᐁ᪃ࡷᑍ௴⫃ဤࡡ㒼⨠ࡡ᭯↋࡞ࡻࡖ࡙᭯ណᕣ࠿ヾࡴኬࡀ࠷࡛ゕ࠻ࡾ㸣ࡼࡿ࡙࠷ࡾ㸣ࡊ࠾ࡊ㸡ࠔᚪこᛮࡡヾㆉࠕ࡚㸡ࢪࢠ࣭ࣛࠈࠔᐁ᪃≟Ἓࠕ࡚ࡢ㸡ධ࡙ࡡ㡧┘࡚ࢪࢠ࣭ࣛࢼࣤࢡᐁ

ࢼࣤࢡࡡᐁ᪃࡞࠽࠷࡙㡧┘࡞᭯ណᕣ࠿ヾࡴࡼࡿࡒࡆ࡛᪃┫㆜ᖅࡡ᪁࠿᭯ណ࡞ࠔᐁ᪃≟Ἓࠕ࠿㧏࠾ࡖࡒ㸣ᑍ௴ࡢ㸡࠘ᐓᗖ⫴ᬊ࣬ᐓ᪐ᶭ⬗ࡡビ౮࡛ᐓ᪐࣬ᝀ⩽ࡡᕵ᭻⫃ဤࡡ㒼⨠ࡡ᭯↋࡞࠽࠷࡙㡧┘࡞᭯ណᕣ࠿ヾࡴࡼࡿࡒ☔ヾ࡛࠙␏࡝ࡾ㒂ฦ࡚࠵ࡾ㸣࠘㏝㝌ㄢᩒ㸡௒㆜ಕ㝜ࡡࡡࡢ㸫㡧┘࡚㸡ᑍ௴⫃ဤ┫㆜ᖅࡡ᪁࠿᭯ណ࡞ࠔᐁ᪃≟ึ᩷࠙ࡢ㸡㏝㝌ㄢᩒࡷ௒㆜ಕ㝜࡛࠷ࡖࡒ㧏㱃ᝀ⩽ࢅཱིἛࠕ࠿㧏࠾ࡖࡒ㸣ࡱࡒ㸡㌷㝌ᙟᘟࡡ㐢࠷࡞࠽࠷࡙㡧┘㸞ࡽࡱࡂ♣ఌⓏഁ㟻࡞ࡗ࠷࡙࡚࠵ࡽ㸡ఔࡼ ࡢ㸡⑋Ჯ┫࡞᭯ណᕣ࠿ヾࡴࡼࡿࡒࡡࡢ㸡௒㆜ಕ㝜࡞㛭ࡌࡾ㸧㡧┘㆜ᖅ㛏ࡡヾㆉ࡛ࡊ࡙㸡┫㆜ᖅࡡ♣ఌ㈠″ࡷ௒㆜ಕ㝜➴࡚࠵ࡽ㸡ះᛮ᭿⑋Ჯ┫㆜ᖅࡡ᪁࠿᭯ណ࡞㧏࠾ࡖࡒ㸣ࡆࡡ▩ㆉ୘㊂࠿࠵ࡖࡒࡆ࡛ࢅሒ࿈ࡊ࡙࠷ࡾ࠿㸡ᮇ◂✪࡚ࡆ࡚ࡵ㸡ࢪࢠ࣭ࣛࢼࣤࢡࢅᐁ᪃ࡌࡾࡆ࡛࡛ྜྷ᫤࡞ᑍ௴

ࡢ㸡┫㆜ᖅࡢࢪࢠ࣭ࣛࢼࣤࢡࢅᐁ᪃ࡌࡾࡆ࡛࡚㸡㧏㱃⫃ဤ࠿࠷ࡾࡆ࡛ࡢ㸡┫㆜ᖅ࡫ࡡᩅ⫩ຝᯕ࠿࠵ࡾ࡛⩻࠻ᝀ⩽ࡡ඙ࡡ⏍Ὡࢅず㏳ࡊࡒ㛭ࢂࡽࢅࡊ㸡♣ఌⓏഁ㟻࡞

岩手看護学会誌/Journal of Iwate Society of Nursing Science. Vol.6, No.2, 2012ࡵ࢓ࣤࢷࢻࢅᗀࡂᣚ࡙ࡒ࡛⩻࠻ࡼࡿࡾ㸣ࡊ㸡ࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃࡞ࡗ࠷࡙ࡢ㸡ᝀ⩽ࡡ≟Ἓࢅࠈ௧୕ࡡࡻ࠹࡞㸡㡧┘Ẏ࡞᳠ゞࡊࡒ⤎ᯕ࡛ᅄᏄฦᯊ

ᢍᥩࡊ࡙࠷ࡾ⑋Ჯ┫㆜ᖅ࠿⾔࠹ࡡ࠿ࡨࡈࢂࡊ࠷࡛ࡡず࡞ࡻࡾ㸧ᅄᏄ࡚᳠ゞࡊࡒ⤎ᯕࡡ࠷ࡍࡿ࡞࠽࠷࡙ࡵ㸡ࢪゆ㸞ࡵ࠵ࡽ㸡ࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃ࡢ㸡┫㆜ࡡୌ㒂࡛ࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃ࡡ᭯↋㸡ᑍ௴⫃ဤࡡ㒼⨠ࡡ᭯↋㸡ࡊ࡙⑋Ჯ༟న࡚ᐁ㊮ྊ⬗ࡓ࡛⩻࠻ࡼࡿࡾ㸣ࡈࡼ࡞㸡ࢪ㌷㝌ᙟᘟࡡ㐢࠷࡛࠷࠹⑋Ჯࡡ≁ᚡ࡚ࡢ㸡ࢪࢠ࣭ࣛࢼࣤ

ࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃࡞ࡗ࠷࡙ࡢ㸡㮎ずࡼ㸞࠿㧏㱃ᝀ⩽ࢡࡡᐁ᪃ࡡ᭯↋࡞࠽࠷࡙᭩ࡵኣࡂࡡ㡧┘࡚᭯ណᕣ࠿ヾ

࡞ᑊࡌࡾ㏝㝌ᨥᥴࢪࢠ࣭ࣛࢼࣤࢡ⚂ࢅ㛜Ⓠࡊࡒ࡝࠾ࡴࡼࡿࡒ㸣ࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃࡞ࡻࡽᅹ㝌᪝ᩐ࠿▯࡚㸡㧏㱃ᝀ⩽࡫㏝㝌ᨥᥴࢅࡌࡾ㝷㸡ᐓ᪐௒㆜మโࢅビ㸞⦨ࡊࡒ ࡛ࡡሒ࿈ࡵ࠵ࡾࡒࡴ㸡ᖳࠍᅹ㝌᪝ᩐ࠿▯⦨ࡊ౮ࡌࡾᚪこᛮ࠿࠵ࡽ㸡ࢪࢠ࣭ࣛࢼࣤࢡ㡧┘࡛ࡊ࡙ࡵ㔔࡙࠷ࡾ୯㸡㧏㱃ᝀ⩽ࡡᅹ㝌᪝ᩐ࠿㛏࠷ࡆ࡛࡫ࡡゆỬࡡこ୘ྊḖ࡚࠵ࡾ࡛ሒ࿈ࡈࡿ࡙࠷ࡾ㸣ᅹᏩ࡞࠽࠷࡙ࡢ㸡⣊ཾ࡞࡝ࡾྊ⬗ᛮࡵ࠵ࡾ㸣ࢪࢠ࣭ࣛࢼࣤࢡࢅᐁ᪃ࡌࡾᐓ᪐ࡡ௒㆜ງ࠿㧏㱃⩽ࡡᅹᏩ⏍Ὡࢅ⤽⤾ࡌࡾ㔔こ࡝こࡆ࡛࡚㸡㧏㱃ᝀ⩽ࢅ┫ࡾちⅤ࠿ᙁ໩ࡈࡿࡾ࡛ྜྷ᫤࡞ᐓ

ᅄ࡚࠵ࡽ㸡௒㆜ງࡡ఩ୖ㸞࠿ၡ㢗ちࡈࡿ࡙࠷ࡾ࠾ࡼࡆ

᪐࡫ࡡ┫㆜ࡵඖᐁࡊ㸡┞ᑊⓏ࡞┫㆜ᖅࡡ┫㆜ࡡ㈹ྡྷ୕

ࡐ㸡ちⅤࢅ࠵࡙࡙⏍Ὡࡡㄢᩒࢅࡌࡾࡆ࡛࠿ኬว࡚࠵

࡞ࡵࡗ࡝࠿ࡾ࡛⩻࠻ࡼࡿࡾ㸣ࡾ㸣ࡱࡒ㸡ᮟᮿࡼ㸞ࡢ㸡ථ㝌᫤ࡡࢪࢠ࣭ࣛࢼࣤࢡࡡࡲ

㸣㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜ࡡᙲ๪࡚ࡢ㸡㏝㝌ᨥᥴࡡᚪこ࡝ᑊ㇗⩽ࢅ≁ᏽࡊࡀࡿࡍ㸡ࡐࡡࠈ⑋Ჯ࡞ໂຸࡌࡾ┫㆜ᖅࡡ㧏㱃ᝀ⩽࡞ᑊࡌࡾ㏝㝌ᚃࡡཋᅄ࡛ࡊ࡙㸡ᅹ㝌᪝ᩐ࠿▯࠷ࡒࡴ᝗ሒࡡཱིࡽࡆ࡯ࡊ࠿

⏍Ὡࢅず㏳ࡊࡒ┫㆜ࡡࠔᚪこᛮࡡヾㆉࠕࡢ㧏࠷࠿㸡࠵ࡖࡒྊ⬗ᛮࢅᣞᦤࡊ࡙࠷ࡾ㸣ࡆࡿࡼࡡࡆ࡛࠾ࡼࡵ㸡ࠔᐁ᪃≟Ἓࠕࡢ఩ࡂ㸡᪝ࠍࡡ┫㆜࡚ᐁ㊮ࡊࡀࡿ࡙࠷࡝

ᬉṹ㛭ࢂࡖ࡙࠷ࡾ᫤㛣࠿㛏ࡂᚨ㌗≟ឺࡡን໩ࢅ┘ࡡᙔ࠷⌟≟ࡡྊ⬗ᛮࢅ㏑࡬ࡒ࠿㸡⑋Ჯ┫㆜ᖅࡡᯕࡒࡌᙲ๪

ࡒࡽ࡞ࡊ࡙࠷ࡾ⑋Ჯ┫㆜ᖅ࠿㸡᪝ࠍࡡ㧏㱃ᝀ⩽ࡡ≟ឺࡢࡱࡌࡱࡌኬࡀ࠷࡛⩻࠻ࡾ㸣࡝ࡏ࡝ࡼ㸡⑋Ჯ࡚ᬉṹ࠾ࢅ࢓ࢬࢪ࣒ࣤࢹࡊ࡝࠿ࡼ㛭ࢂࡾࡆ࡛ࡡ㔔こᛮ࠿ኬࡀ࠷

ࡼ㧏㱃ᝀ⩽࡞㛭ࢂࡖ࡙࠷ࡾ┫㆜ᖅࡡびᐳ࡛࢓ࢬࢪ࣒ࣤ

ࡵࡡ࡛⩻࠻ࡾ㸣ࢹࡢ㸡㏝㝌᫤᭿ࢅ㏠ࡈ࡝࠷ࡒࡴ࡞ࡵ㸡㏝㝌ᨥᥴ࠿⾪㟻ࠈ㧏㱃ᝀ⩽ࡡ≁ᚡ࡛ࡊ࡙㸡$'/࠿఩ୖࡊࡷࡌࡂᅂᚗࡊ

໩ࡌࡾ௧๑㸡ࡌ࡝ࢂࡔ⑋Ჯ࡞ථ㝌ࡊࡒ᫤Ⅴ࠾ࡼ࢓ࢬࢪ

࡞ࡂ࠷≁ᚡ࠿࠵ࡽ㸡἖⒢ࢅ⤂࠻ࡒṹ㝭࡚ථ㝌๑ࡡ⏍Ὡ࣒ࣤࢹࡡちⅤࢅᣚࡖ࡙㛭ࢂࡾᚪこᛮ࠿࠵ࡾ࠾ࡼ࡚࠵

ࢪࢰ࢕࡛ࣜ␏࡝ࡾࡆ࡛࠿ኣࡂずࡼࡿࡾ㸣ࡐࡡࡒࡴ㸡ථ㸞ࡾ㸣ᖲ℡ࡼ ࠿㸡಴ࠍࡡ┫㆜ᖅࡡ⏍ὩࡡちⅤ࠾ࡼࡡ࢓㝌᪡᭿࠾ࡼ㏝㝌ᚃࡡ⏍ὩࢅරమⓏ࡞ず㏳ࡊ࡝࠿ࡼ᪝ࠍ

ࢬࢪ࣒ࣤࢹ⬗ງࡡᕣࢅ⿭࠹ࡒࡴ࡞㸡㏝㝌ㄢᩒ┫㆜ᖅ࡛ࡡ┫㆜ࢅᐁ㊮ࡌࡾࡆ࡛㸡ࡈࡼ࡞㸡አᮮ㏳㝌୯ࡡ஢ᏽථ

ྙྜྷ࡚࢓ࢬࢪ࣒ࣤࢹࢅ⾔࠹ᚪこᛮࢅ㏑࡬࡙࠷ࡒࡽ㸡ᑍ㝌࡚࠵ࡿࡣ㸡አᮮ┫㆜ᖅ࡞ࡻࡾୌḗࢪࢠ࣭ࣛࢼࣤࢡࢅ

㛓㒂⨣࠿᪝ᖏⓏ࡞㏝㝌ᨥᥴὩິࢅ⑋Ჯ┫㆜ᖅ࡛ୌ⥬࡞⾔࠷㸡ࡐࡿ࡞⤾࠷࡙⑋Ჯ┫㆜ᖅ࠿ࢪࢠ࣭ࣛࢼࣤࢡࢅᐁ

⾔࠹ࡆ࡛࡚㸡⑋Ჯ┫㆜ᖅࡡ㏝㝌ᨥᥴ࡞㛭ࡌࡾ⬗ງྡྷ୕᪃ࡌࡾࡆ࡛࡚㸡㏝㝌ᨥᥴࡡᚪこ࡝ᝀ⩽࠿⁻ࡿࡾࡆ࡛ࢅ

㸞ࡡྊ⬗ᛮ ࠿♟ြࡈࡿ࡙࠷ࡾࡻ࠹࡞㸡㏝㝌ㄢᩒ࡞ᑍ௴

ᑛ࡝ࡂࡌࡾࡆ࡛࠿㸡௑ᚃࡡㄚ㢗࡛⩻࠻ࡼࡿࡒ㸣ࡡ┫㆜ᖅ࠿࠷ࡾࡆ࡛ࡢ㸡ࡻࡽᗀ࠷ちⅤ࡚ࡡᥴຐ࠿᭿ᙽ

ࠈᅄᏄฦᯊࡡ⤎ᯕ࠾ࡼ㸡㸧ᅄᏄ࠘ᐓᗖ⫴ᬊ࣬ᐓ᪐ᶭ⬗࡚ࡀࡾ㸣ࡊ࠾ࡊ㸡ᑍ௴⫃ဤࡡ☔ಕ࡛⤊ῥⓏ࡝ᢰಕ࠿ㄚ

ࡡビ౮࡛ᐓ᪐࣬ᝀ⩽ࡡᕵ᭻☔ヾ࠙࠘㏝㝌ㄢᩒ㸡௒㆜ಕ㢗࡛࡝ࡾࡒࡴ㸡ࡐࡡᙲ๪ࡡୌ㒂ࢅ㸡ᗀ࠷ちⅤ࡚࡛ࡼ࠻㝜ࡡึ᩷࠙࡞ฦ㢦ࡈࡿࡒ㸣࠘ᐓᗖ⫴ᬊ࣬ᐓ᪐ᶭ⬗ࡡビࡾࡆ࡛࠿ྊ⬗࡝┫㆜ᖅ㛏࡝࡜࡞༝ງࢅ௭ࡃࡆ࡛ࡢ㸡┫౮࡛ᐓ᪐࣬ᝀ⩽ࡡᕵ᭻☔ヾ࠙ࡢ㧏㱃ᝀ⩽ࡡᚨ㌗ࡷ⏍Ὡ

㆜ᖅ಴ࠍெࡡ࢓ࢬࢪ࣒ࣤࢹ⬗ງྡྷ୕ࡡࡒࡴ࡞ࡵ㸡㧏㱃࠽ࡻࡦᐓ᪐࡞ࡗ࠷࡙㸡࠘㏝㝌ㄢᩒ㸡௒㆜ಕ㝜ࡡึ᩷࠙ᝀ⩽ࡡ┫㆜࡞࡛ࡖ࡙ࡵ㔔こ࡚࠵ࡾ㸣≁࡞㧏㱃ᝀ⩽ࡢ㸡ࡢ㧏㱃ᝀ⩽ࢅ࡛ࡽࡱࡂ♣ఌⓏഁ㟻࡞ࡗ࠷࡙ࡡഁ㟻࡚࠵ᑛࡊࡡὩິโ㝀࡚ᐖ᪾࡞$'/࠿఩ୖࡌࡾࡒࡴ㸡㧏㱃ᝀࡾ㸣ࠔᚪこᛮࡡヾㆉࠕࡡࡲ࡝ࡼࡍࠔᐁ᪃≟Ἓࠕ࡞࠽࠷

⩽ࡡን໩ࢅථ㝌᫤࠾ࡼ᪝ࠍ⌦ゆࡊ࡙࠷ࡾ⑋Ჯ┫㆜ᖅࡷ࡙ࡵ㸡᛬ᛮ᭿⑋Ჯ㸡ះᛮ᭿⑋Ჯ࡞㛭ࢂࡼࡍ᭯ណᕣࢅヾ┫㆜ᖅ㛏ࡡᙲ๪ࡢኬࡀ࠷㸣ࡱࡒ㸡ᑍ௴⫃ဤࡡ㒼⨠࡞ࡗࡴ࡝࠾ࡖࡒࡆ࡛ࡢ㸡㧏㱃ᝀ⩽࡛ᐓ᪐࡞ࡗ࠷࡙ࡡ⌦ゆࡢ࠷࡙ࡢ㸡ᑍ௴⫃ဤࡡ☔ಕ࡛⤊ῥⓏ࡝ᢰಕ࠿ㄚ㢗࡛࡝ࡾࡈࡿ࡙࠷ࡾࡊ㸡㏝㝌ᚃࡡ⏍Ὡࢅず㏳ࡊ࡙࠷ࡾ࠾ࡼࡆ

࠿㸡ධᅗㄢᰕ࡞ࡻࡾ࡛㸡ᑍ㛓㒂⨣ࢅ᭯ࡊ࡙࠷ࡾ⑋㝌ࡡࡐ㸡㏝㝌ㄢᩒࡷ௒㆜ಕ㝜ࡡึ᩷ࡵᐁ᪃ࡈࡿ࡙࠷ࡾ࡛⩻㸞㸞

㸣ࡆࡿࡼࡡࡆ࡛࠾ࡼ㸡⑋ᗃᩐࡡ࠻ࡼࡿࡾ㸣ୌ᪁㸡ࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃࡛ᑍ௴⫃ဤࡡᑛ࡝࠷⑋㝌࡚ࡢ㸡ᑍ௴⫃ဤࡡ☔ಕ࠿㞬ࡊ࠷ࡆ࡛ࡵ⩻࠻㒼⨠ࡡ᭯↋࡞᭯ណᕣ࠿ヾࡴࡼࡿࡒࡆ࡛ࡢ㸡ࢪࢠ࣭ࣛࢼ

ࡼࡿࡾ㸣௑ᅂࡡ⤎ᯕࢅず࡙ࡵ㸡ࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃

ࣤࢡࡡᐁ᪃࡛ᑍ௴⫃ဤ࠿㒼⨠ࡈࡿ࡙࠷ࡾណ࿝࠿㧏ࡱࡾࡷᑍ௴⫃ဤࡡ㒼⨠ࡢ⣑༖ᩐ࡞࡛࡜ࡱࡖ࡙࠷ࡾ㸣ࡊ࠾࡛ゕ࠻ࡾ㸣ຊ࠻࡙㸡࠘ᐓᗖ⫴ᬊ࣬ᐓ᪐ᶭ⬗ࡡビ౮࡛ᐓ᪁࠿⑋ᗃᩐ࠿ኣ࠷



岩手看護学会誌/Journal of Iwate Society of Nursing Science. Vol.6, No.2, 2012᪐࣬ᝀ⩽ࡡᕵ᭻☔ヾ࠙࠘㏝㝌ㄢᩒ㸡௒㆜ಕ㝜ࡡึ᩷࠙⩻࠻ࡾࡆ࡛࠿࡚ࡀࡾ㸣࡛࠷࠹㸧ࡗࡡちⅤ࡚᭯ណᕣ࠿ヾࡴࡼࡿࡒࡆ࡛㸡㏝㝌ㄢࠈ⑋Ჯࡡ≁ᚡࢅずࡾ࡛㸡ࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃࡞㛭ࡊᩒຊ⟤࡞ࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃ࡷᑍ௴⫃ဤࡡ㒼⨠࠿⟤

࡙ධᅗⓏ࡝ᐁឺࡢ᪺ࡼ࠾࡛࡝ࡖ࡙࠷࡝࠷࠿㸡ὕහࡼ㸞ᏽこ௲࡛࡝ࡖ࡙࠷ࡾࡆ࡛࠾ࡼ㸡㏝㝌ㄢᩒ࡞࠽ࡄࡾࡗ

ࡡ◂✪࡚ࡢ㸡ࢪࢠ࣭ࣛࢼࣤࢡࢨࢪࢷ࣑࠿ࠔ࠵ࡾࠕ࡛ᅂ

ࡡഁ㟻ࡡ㔔こᛮࡵቌࡌ㸣ࡊ࠾ࡊ㸡㧏㱃ᝀ⩽ࡡᚨ㌗ࡷ⏍➽ࡊࡒࡡࡢ㸚࡚࠵ࡖࡒ㸣ᮇ◂✪࡚ࡢ㸡ࢪࢠ࣭ࣛࢼ

Ὡ࠽ࡻࡦᐓ᪐࡞ࡗ࠷࡙ࡢ㸡⑋Ჯ഼࡚ࡂ┫㆜ᖅ࠿᭩ࡵ⌦ࣤࢡࢅᐁ᪃ࡊ࡙࠷ࡾ࡛ᅂ➽ࡊࡒࡡࡢ㸚࡚࠵ࡽ㸡඙ゆࡊ࡙࠷ࡾ࡛⩻࠻ࡼࡿࡾࡒࡴ㸡ུࡄᣚࡔ㧏㱃ᝀ⩽ࡡ┫⾔◂✪࡛Ẓ㍉ࡌࡾ࡛఩࠷㸣ࡊ࠾ࡊ㸡඙⾔◂✪ࡢ㸡࠵ࡾ㆜࡞ࡢ㸡ࡆࡡ㸧ࡗࡡഁ㟻ࢅࡻࡽណㆉࡊ࡝࠿ࡼࡡ┫㆜࠿ᆀᇡ࡞≁ᏽࡈࡿ࡙࠷࡙ẍᩐ࠿ᑛ࡝ࡂ㸡ኣࡂࡡ⑋㝌ࡡᐁ㸞㔔こ࡛⩻࠻ࡼࡿࡾ㸣⨶ࢿㆺࡼ ࡢ㸡ᮇெ࡛ᐓ᪐ࡡᚨ㒼ឺ࠿ཬ᫆ࡈࡿ࡙࠷ࡾࢂࡄ࡚ࡢ࡝࠷㸣ࢪࢠ࣭ࣛࢼࣤࢡࢅ

හᐖ࡞┞㐢࠿࠵ࡾࡆ࡛࠾ࡼ㸡ᮇெ࡛ᐓ᪐ࢅୌమ࡛ࡲ࡝

ᐁ᪃ࡌࡾࡆ࡛࡞ࡻࡽ㸡㝌አ㏻ᦘ࡝࡜㏝㝌ᨥᥴ࠿ᚪこ࡝ࡊ࡙ࡊࡱ࠹ലྡྷ࠿࠵ࡾ࠿㸡୦⩽ࡐࡿࡑࡿ࡫ࡡᚨ㒼࡫ࡡᝀ⩽ࡡᢍᥩࡷᑍ㛓㒂⨣࡛ࡡ㏻ᦘࢅ᪡᭿࠾ࡼᅒࡾࡆ࡛࠿

ᑊᚺࡡᚪこᛮࢅ㏑࡬࡙࠷ࡾ㸣ᮇ◂✪࡚ࡵ㸡ᐓ᪐ࡡࡆࡿ

ྊ⬗࡛࠷࠹ຝᯕࡵሒ࿈㸞㸞ࡈࡿ࡙࠷ࡾࡆ࡛࠾ࡼ㸡ࢪࢠ

࠾ࡼࡡ⒢㣬࡞㛭ࡌࡾᕵ᭻ࡡ☔ヾ࠿㸡ᝀ⩽ࡡࡆࡿ࠾ࡼࡡ

࣭ࣛࢼࣤࢡࡡᐁ᪃࠿ἴཀྵࡌࡾࡆ࡛࠿᭻ࡱࡿࡾ㸣ࡱࡒ㸡⒢㣬࡞㛭ࡌࡾᛦ࠷ࡡ☔ヾࡻࡽࡵ㧏ೋࢅ♟ࡊ࡙࠷ࡒࡒ

ᑍ௴⫃ဤࡡ㒼⨠ࡢ㸡ධᅗⓏ࡞ቌ࠻࡙࠷ࡾ㸞㸞㸣ᮇ◂✪ࡴ㸡㧏㱃ᝀ⩽࡛ᐓ᪐ࡐࡿࡑࡿࡡᛦ࠷ࡷᕵ᭻ࢅ☔ヾࡊ࡝࡚ࡢ㸡ᑍ௴⫃ဤࡡ㒼⨠ࡡ᭯↋ࢅᅂ➽ࡊࡒࡡࡢ྘┫㆜ᖅ࠿ࡼ㛭ࢂࡾࡆ࡛࠿ᚪこ࡚࠵ࡾ㸣ୌ᪁㸡ࠔ㌷㝌ᨥᥴࠕ࠿

࡚࠵ࡽ㸡⑋㝌ࡇ࡛࡞ᅂ➽ࢅịࡴࡒධᅗㄢᰕ࡛ࡡ༟⣟ẒࠔᅹᏩᨥᥴࠕ࡞Ẓ࡬࡙ᝀ⩽ࡷᐓ᪐ࡡ‫‮‬㊂ᗐ࠿఩࠷ࡡ

㍉ࡢ࡚ࡀ࡝࠷ࡵࡡࡡ㸡ᑍ௴⫃ဤ࠿࠷ࡾ࡛ᅂ➽ࡊࡒධᅗࡢ㸡ᝀ⩽ࡷᐓ᪐࡛༈⒢⩽࡛ࡡヾㆉࡡࡍࡿ࠿᥆ᐳࡈࡿ㸡ㄢᰕࡡ⤎ᯕ㸚࡞Ẓ࡬࡙㸚࡛఩࠾ࡖࡒ㸣ධᅗㄢ㸞┘ᵾࢅභ᭯ࡌࡾࡆ࡛ࡡ㔔こᛮ ࠿㏑࡬ࡼࡿ࡙࠷ࡾ㸣㧏ᰕ㸞࡚ࡢ⑋ᗃ࠿ኬࡀ࠷࡮࡜㸡ࡱࡒ᛬ᛮ᭿୯ᚨࡡ⑋㝌ࡷ㱃ᝀ⩽࡛ᐓ᪐ࡐࡿࡑࡿࡡᛦ࠷ࡷᕵ᭻ࢅ☔ヾࡊࡒ࠹࠻㧏ḗᶭ⬗ࡡ༈⒢ᶭ㛭࡞࠽࠷࡙ᑍ௴⫃ဤ࠿࠷ࡾ࡛ሒ࿈ࡈ࡚㸡༈⒢⩽ࡵྜྷࡋ᪁ྡྷࢅྡྷ࠷࡙࠷ࡂࡒࡴ࡞㸡ⓑ࡚භ᭯ࡿ࡙࠷ࡾ㸣ࡊ࠾ࡊ㸡ධᅗㄢᰕ࡛Ẓ㍉ࡊ࡙ᮇ◂✪ࡡ⤎ᯕࡌࡾࡆ࡛࠿ᚪこ࡚࠵ࡾ࡛⩻࠻ࡾ㸣ࡐࡡࡒࡴ㸡ථ㝌᫤࠵࠿఩࠾ࡖࡒࡡࡢ㸡⑋ᗃᩐ࡞㛭ࢂࡼࡍ༝ງࡊ࡙࠷ࡒࡓࡄ

ࡾ࠷ࡢථ㝌᪡᭿࠾ࡼ㸡㧏㱃ᝀ⩽࡛ᐓ᪐ࢅஹ࠻ࡒヨࡊྙࡾ⑋㝌ࡡ┫㆜ᖅࢅᑊ㇗࡛ࡊࡒࡒࡴ㸡⑋ᗃᩐ࠿ᑛ࡝࠷⑋

࠷ࢅࡌࡾࡆ࡛࠿ኬว࡚࠵ࡽ㸡ࡐࡡ㝷㸡௑ᚃࡡᕵ᭻࡝࡜

㝌࠿ධమࡡ༖ᩐࢅ༥ࡴࡾ࡮࡜ኣࡂ㸡⑋ᗃᩐࡷ⑋㝌ࡡᶭࢅ☔ヾࡌࡾᚪこ࠿࠵ࡾ㸣┫㆜ᖅ࠿㸡$'/࠿࡜ࡡࡻ࠹࡞

⬗࠿㛭౿ࡊ࡙࠷ࡾ࡛ࡵ⩻࠻ࡼࡿࡾ㸣ን໩ࡊ࡙࠷ࡂ࠾ࡡ஢ῼࢅࡊ࡝࠿ࡼ㸡࡝࠽࠾ࡗ㧏㱃ᝀ⩽ࠈᮇ◂✪࡚㸡㈹ၡ⣤ࡡ㡧┘ࡢ㸡㧏㱃ᝀ⩽ࢅཱིࡽᕬࡂ⎌࠿࡜ࡡࡻ࠹࡝⏍Ὡࢅ᭻ࢆ࡚࠷ࡾ࠾ࢅ☔ヾࡊ㸡ࡆࡿ࠾ࡼሾࡷ㌷㝌ࡡ≟Ἓࢅ⩻࠻࡙◂✪⩽ࡼ࡚షᠺࡊࡒ࠿㸡

ࡡ⒢㣬࡞㛭ࡌࡾᛦ࠷ࢅᮇெ࠽ࡻࡦᐓ᪐࡛භ࡞භ᭯ࡌࡾ

&URQEDFKࡡȘ౿ᩐ࠿௧୕࡚࠵ࡽ㸡ಘ㢏ᛮ࠿☔ಕࡈࡆ࡛ࡢ㸡ࢼ࣭ࢫ࡞༳ࡊࡒᨥᥴ࡛ࡊ࡙㔔こ࡚࠵ࡾ㸣ࡈࡼࡿ࡙࠷ࡾࡆ࡛࠿☔ヾ࡚ࡀࡒ㸣ࡱࡒ㸡ࢪࢠ࣭ࣛࢼࣤࢡࡡ

࡞㸡ථ㝌୯࠾ࡼ㏝㝌ᚃࡡ⏍Ὡ࡞ࡗ࠷࡙ず㏳ࡊࢅ❟࡙㸡ᐁ᪃ࡷᑍ௴⫃ဤࡡ㒼⨠࠿㸡㏝㝌ㄢᩒຊ⟤ࡡ⟤ᏽこ௲࡛ᮇெ࠽ࡻࡦᐓ᪐ࡡࢼ࣭ࢫ࡞Ἒ࠹ࡻ࠹࡝㛭ࢂࡽ࠿ịࡴࡼ࡝ࡖ࡙࠽ࡽ㸡㸧ᅄᏄ࡛ࡵࠔᐁ᪃≟Ἓࠕ࡞࠽࠷࡙᭯ណᕣ

ࡿࡾ㸣ࡐࡡࡒࡴ㸡⑋Ჯࡡ≁ᚡ࡞㛭ࢂࡼࡍ㸡㧏㱃ᝀ⩽࡞ࢅヾࡴ㸡࡝࠽࠾ࡗ㌷㝌ᙟᘟ࡚᭯ណᕣ࠿ヾࡴࡼࡿ࡝࠾ࡖ

ᦘࢂࡾ┫㆜ᖅ࠿᪝ࠍࡡ┫㆜࡚࠘ᐓᗖ⫴ᬊ࣬ᐓ᪐ᶭ⬗ࡡࡒࡆ࡛ࡢ㸡㈹ၡ㡧┘ࡡጂᙔᛮ࠿☔ヾ࡚ࡀࡒ࡛ࡵ⩻࠻ࡼビ౮࡛ᐓ᪐࣬ᝀ⩽ࡡᕵ᭻☔ヾ࠙ࢅᐁ㊮ࡌࡾࡆ࡛࠿㸡ᙁࡿࡾ㸣ࡐࡡୌ᪁࡚㸡ᅄᏄฦᯊࢅࡊࡒ᫤࡞㸡ᅄᏄㇿⲬ㔖ࡂ᭻ࡱࡿࡾ㸣

࠿ᑚࡈ࠾ࡖࡒࡽ஦㔔ㇿⲬ࠿࠾࠾ࡖ࡙ࡊࡱࡖࡒ㡧┘࠿࠵㸣ㄢᰕᑊ㇗⩽࠽ࡻࡦᑵᗐࡡጂᙔᛮ

ࡖࡒ㸣ࡆࡡࡆ࡛࠾ࡼ㸡㡧┘හᐖࢅず├ࡌࡆ࡛ࡵᚪこ࡚ࠈᮇ◂✪ࡡㄢᰕᑊ㇗⩽ࢅ᪝ᮇ┫㆜༝ఌ࡚ࡡ┫㆜⫃ဤᐁ࠵ࡾ࡛⩻࠻ࡾ㸣㸞ឺㄢᰕ⤎ᯕ ࡛Ẓ㍉ࡌࡾ࡛㸡⏠ዥẒࡢ࡮࡯ྜྷࡋ࡚࠵ࡖ
ࡒ㸣ࡊ࠾ࡊ㸡ᮇ◂✪࡚ࡢṋ௥௧ୖࡡᑊ㇗⩽࠿ᑛ࡝ࡂϬ㸣⤎ㄵṋ௥௧୕ࡡᑊ㇗⩽࠿ኣ࠾ࡖࡒࡒࡴ㸡ᖲᆍᖳ㱃ࡵ㧏࠷ࠈ⑋㝌࡞ໂຸࡌࡾ┫㆜ᖅࡡ㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊലྡྷ࡞࠵ࡖࡒ㸣┫㆜ᖅ⤊㥺ᖳᩐࡢ㸡㸪ᖳ௧୕ᖳᮅ‫‮‬ࡒ┫㆜㡧┘࡞ᑊࡌࡾࠔᚪこᛮࡡヾㆉࠕ࡛ࠔᐁ᪃≟Ἓࠕ࠽ࡻࡦᖳ௧୕࠿ኣ࠾ࡖࡒ㸣ࡆࡿࡼࡡࡆ࡛࠾ࡼ㸡ᮇ◂ࢅㄢᰕࡊ㸡⑋Ჯࡡ≁ᚡࡇ࡛࡞ฦᯊࡊࡒ⤎ᯕ㸡௧ୖࡡࡆ✪ࡡ⤎ᯕࡢ㸡┫㆜ᖅ⤊㥺࠿㸪ᖳ௧୕ࡡ୯ᇻ௧୕ࡡ┫㆜࡛࠿᪺ࡼ࠾࡛࡝ࡖࡒ㸣ᖅࡡࠔᚪこᛮࡡヾㆉࠕ࡛ࠔᐁ᪃≟Ἓࠕࢅཬ᫆ࡊ࡙࠷ࡾ࡛

㸣㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜㡧┘࡞࠽࠷࡙㸡

岩手看護学会誌/Journal of Iwate Society of Nursing Science. Vol.6, No.2, 2012࡛ࡡ㏻ᦘ࡞ࡵ┘ࢅྡྷࡄ㸡ࡈࡱࡉࡱ࡝ぽᗐ࠾ࡼ㧏㱃ᝀ⩽ࠈධ࡙ࡡ㡧┘࡚ࠔᚪこᛮࡡヾㆉࠕ࠿ࠔᐁ᪃≟Ἓࠕࡻࡽ᭯ࡡ┫㆜࡞ࡗ࠷࡙᳠ゞࢅ㔔ࡠ࡙࠷ࡂᚪこ࠿࠵ࡾ㸣ណ࡞㧏࠾ࡖࡒ㸣㸣㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜ࡡ྘㡧┘ࡡࠔᚪこᛮࡡヾㆉࠕ࡛ࠔᐁ᪃≟Ἓࠕࡢ㸡ࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃

ㅨ㎙ࡡ᭯↋࡞࠽࠷࡙᭩ࡵኣࡂࡡ㡧┘࡚᭯ណᕣ࠿ヾࡴࡼ ኬን࠽ᚹࡊ࠷୯㸡ᮇ◂✪ࡡㄢᰕ࡞༝ງࡊ࡙ࡂࡓࡈࡖ

ࡿ㸡ḗ࠷࡚ᑍ௴⫃ဤࡡ㒼⨠ࡡ᭯↋࡞࠽࠷࡙ኣ࠾ࡖࡒ┫㆜㒂㛏ᵕ㸡⥪┫㆜ᖅ㛏ᵕ㸡┫㆜ᖅࡡⓑᵕ࡞῕ㅨ⏞ࡒ㸣ࡊ୕ࡅࡱࡌ㸣࡝࠽㸡ᮇ◂✪ࡡୌ㒂ࡢ㸡➠㸨ᅂᒷᡥ┫㆜㸣㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜㡧┘ࡡ࠹ࡔ㸡ᏕఌᏕ⾙㞗ఌ࡞࠽࠷࡙Ⓠ⾪ࡊࡒ㸣ࠔᐁ᪃≟Ἓࠕ࡚ࡢ㸫㡧┘࡞࠽࠷࡙ᑍ௴⫃ဤࡡ㒼⨠ࡡ᭯↋࡚᭯ណᕣ࠿ヾࡴࡼࡿࡒࡒࡴ㸡ᑍ௴⫃ဤ࠿㒼⨠ࡈᘤ⏕ᩝ⊡ࡿ࡙࠷ࡾࡆ࡛ࡢ㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜ࡡ㸦㸞ΰỀᡛᯖ㸡Ꮽ஬᪺Ꮔ㸣㧏㱃㛏᭿ථ㝌ᝀ⩽ࡡ㏝㝌࡞

ᐁ㊮ࡡࡒࡴ࡞ࡵ᭻ࡱࡊ࠷࡛⩻࠻ࡾ㸣ࡊ࠾ࡊ㸡⑋ᗃᩐྡྷࡄ࡙ࡡᨥᥴࢨࢪࢷ࣑ࡡᚪこᛮ㸢㏝㝌ࢅᅏ㞬࡞ࡌࡡᑛ࡝࠷⑋㝌࡚ࡢ㸡ᑍ௴⫃ဤࡡ☔ಕ࡛⤊ῥⓏ࡝ᢰಕ

ࡾၡ㢗࡛ᨥᥴࢨࢪࢷ࣑㸢㸣୔㔔┫㆜Ꮥヽ㸰࠿ㄚ㢗࡛࡝ࡾ㸣㸯㸣㸧㸞㏝㝌ᝀ⩽ࡡᖲᆍᅹ㝌᪝ᩐ➴㸣ཉ⏍ຘ഼┤㸰㸣ࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃ࡢ㸡ᑍ௴⫃ဤࡡ㒼⨠ࡻࡽࡵኣࡂࡡ㡧┘࡚᭯ណᕣࢅヾࡴ࡙࠽ࡽ㸡┫㆜ࡡୌ㒂࡛ࡊࠈࠈᖳ᭮᪝ࠈKWWSZZZPKOZJRMSWRXNHL࡙⑋Ჯ༟న࡚┫㆜ᖅ࡞ࡻࡾᐁ㊮࠿ྊ⬗࡚࠵ࡾࡒࡴ㸡

ࠈࠈVDLNLQKZNDQMDGOSGI㸣ࢪࢠ࣭ࣛࢼࣤࢡࡡᐁ᪃ណ⩇ࡢኬࡀ࠷࡛⩻࠻ࡾ㸣ࢪࢠ

㸨㸞0DU\'1D\ORU'RURWK\%URRWHQ5REHUWD࣭ࣛࢼࣤࢡࢅᐁ᪃ࡌࡾࡆ࡛࡚㸡㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅ

ࠈࠈ&DPSEHOO%DUEDUD6-DFREVHQ0DWK\'0H]H\HWDO㸣

ず㏳ࡊࡒ┫㆜ࡡちⅤ࠿ᙁ໩ࡈࡿࡾ࡛ྜྷ᫤࡞ᐓ᪐࡫ࡡ┫㆜ࡵඖᐁࡊ㸡┫㆜ࡡ㈹ྡྷ୕࡞ࡵࡗ࡝࠿ࡾ࡛⩻࠻ࡼ

ࠈࠈ&RPSUHKHQVLYH 'LVFKDUJH 3ODQQLQJ DQG +RPHࡿࡒ㸣ࠈࠈ)ROORZXS RI +RVSLWDOL]HG (OGHUV㸣-$0$㸰㸝㸞㸯㸣㸣㧏㱃ᝀ⩽ࡡ㏝㝌ᚃࢅず㏳ࡊࡒ┫㆜㡧┘ࡢ㸡࠘ᐓᗖ⫴ᬊ࣬ᐓ᪐ᶭ⬗ࡡビ౮࡛ᐓ᪐࣬ᝀ⩽ࡡᕵ᭻☔ヾ࠙㸩㸞(YDQV5/+HQGLVNV5'(YDOXDWLQJ+RVSLWDO࠘㏝㝌ㄢᩒ㸡௒㆜ಕ㝜ࡡึ᩷࠙ࡡ㸧ᅄᏄᵋ㏸࡚࠵ࡖ

'LVFKDUJH3ODQQLQJ㸯$5DQGRPL]HG&OLQLFDOࡒ㸣ࡐࡡࡒࡴ㸡⑋Ჯ഼࡚ࡂ┫㆜ᖅࡢ㸡ࡆࡿࡼ㸧ࡗࡡ

7ULDO0HGLFDO&DUH㸰㸝㸞㸯㸣ഁ㟻ࢅࡻࡽណㆉࡊ࡝࠿ࡼ┫㆜ࡌࡾࡆ࡛࠿㔔こ࡚࠵ࡾ㸪㸞⩹ெ┫㆜ࡡᑍ㛓┫㆜ᖅⓇ㘋⩽ୌぬ㸣┫㆜༝ఌ࣭࣑࣌
࣭࣋ࢩ㸰ᖳ㸧᭮᪝㸣KWWSZZZQXUVHRUMS࡛⩻࠻ࡼࡿࡒ㸣ࠈࠈLQGH[KWPO㸣㸫㸞⨶ࢿㆺ᩺Ꮔ㸡ᮙᮇḿᏄ㸡⚗ᔪ㱗Ꮔ㸡ᑚᮿඁ⣎㸣᪃࠽ࢂࡽ࡞ ⑋Ჯ࡚ᐁ㝷࡞഼࠷࡙࠷ࡾ┫㆜ᖅࡢ㸡㧏㱃ᝀ⩽ࡡ㏝㝌

シ⒢㣬࡫⛛⾔ࡊࡒ⬳༛୯ᝀ⩽ࡡ㏝㝌᫤≟Ἓ࡛㏝㝌ᚃࡡ⏍Ὡࢅず㏳ࡊࡒ┫㆜࡞࠽࠷࡙㸡ࠔᐁ᪃≟Ἓࠕ࡞Ẓ๑ࡡᚨ㒼㸣㡨ኮᇸ༈Ꮥ㸰㸝㸞㸯㸣࡬࡙ࠔᚪこᛮࡡヾㆉࠕࡢ㧏࠷࠿ࡐࡿࢅᐁ㊮ࡊࡀࡿ࡙࠷

㸬㸞Ễ⏛ᬓᏄ㸡ᮟᔪᖶ௥㸣㧏㱃⩽ࡡ㏝㝌ᨥᥴ㸣᪝ᮇ⩹࡝࠷⌟≟࠿࠵ࡾ࡛⩻࠻ࡼࡿࡒ㸣ࡐࡡࡒࡴ㸡㧏㱃ᝀ⩽࡛ᖳ༈Ꮥఌ㞟ヽ㸰㸝㸞㸯㸣㛭ࢂࡖ࡙࠷ࡾ᫤㛣࠿㛏ࡂᚨ㌗≟ឺࡡን໩ࢅ┘ࡡᙔࡒࡽ㸭㸞ᡖᮟࡥ࠾ࡽ㸡Ễ⏛ᬓᏄ㸡ᮟᔪᖶ௥㸣ୌ⯙⑋Ჯ࠾ࡼ࡞ࡊ࡙࠷ࡾ⑋Ჯ┫㆜ᖅ࠿㸡᪝ࠍࡡ㧏㱃ᝀ⩽ࡡ≟ឺࢅ࢓⮤Ꮹ㏝㝌ࡌࡾこ௒㆜㧏㱃ᝀ⩽࡫ࡡ㏝㝌ᨥᥴ࡞ᚪこࢬࢪ࣒ࣤࢹࡊ࡝࠿ࡼ㛭ࢂࡾࡆ࡛ࡡ㔔こᛮ࠿♟ြࡈࡿ࡝こ⣪ࡡฦᯊ㏛㊟ㄢᰕ࡞ࡻࡾビ౮࠾ࡼ㸣᪝ᮇᆀࡒ㸣ࡱࡒ㸡ࢪࢠ࣭ࣛࢼࣤࢡࢅᐁ᪃ࡌࡾࡆ࡛࡚㸡㧏㱃ᝀᇡ┫㆜Ꮥఌヽ㸰㸝㸞㸯㸣⩽ࢅ┫ࡾちⅤ࠿ᙁ໩ࡈࡿࡾ࡛ྜྷ᫤࡞㸡ᐓ᪐࡫ࡡ┫㆜ࡵ㸮㸞▴ᶣ㯖㔓㸡≹㔕Ⰳኯ㸡け⃕⨶㈏Ꮔ㸡ᖲᒜ᭰Ꮔ㸣⒢ඖᐁࡊ㸡┞ᑊⓏ࡞┫㆜ᖅࡡ┫㆜ࡡ㈹ྡྷ୕࡞ࡵࡗ࡝࠿ࡾ

㣬ᆵ⑋Ჯ࡞ථ㝌୯ࡡ㧏㱃⩽ࡡ㐘ິᶭ⬗࣬⢥♼ᶭ⬗࡛⩻࠻ࡼࡿࡒ㸣ࡆࡡࡆ࡛࠾ࡼ㸡ථ㝌᪡᭿࠾ࡼ㏝㝌ᚃࡡ࡞㛭ࡌࡾㄢᰕ㸣⸓㔕Ꮥ㝌⣎こ㸰㸯㸣⏍ὩࢅරమⓏ࡞ず㏳ࡊࡒ┫㆜ᐁ㊮࠿㸡௑ᚃࡡㄚ㢗࡛⩻㸞ᴃᮇ㡨Ꮔ㸡ᕖᓧᾀ஦㸣‫‮‬㊂ᗐㄢᰕ࡞ࡻࡾ㏝㝌ᨥᥴ㸞࠻ࡼࡿࡒ㸣඙⾔◂✪࡚ᅹᏩᨥᥴࡡ๪ྙࡵኣ࠷ ࡆ࡛࠾ࡡビ౮㸣᪝ᮇ༈⒢࣏ࢾࢩ࣒ࣤࢹᏕఌ㞟ヽ㸰ࡼ㸡௑ᚃࡢ㸡⑋㝌㛣ࡡ㏻ᦘ࡞࡛࡜ࡱࡼࡍ㸡⑋㝌࡛ᅹᏩ㸝㸞㸯㸣

岩手看護学会誌/Journal of Iwate Society of Nursing Science. Vol.6, No.2, 2012ᐁឺㄢᰕሒ࿈᭡㸣㸣㸣㸞㮎ずᑠᕤ㸡ᮟᔪᖶ௥㸡㫵⩒◂஦㸡ኬහᑔ⩇㸣㏝㝌ᅏ㞬࠿஢ῼࡈࡿࡒ㧏㱃ථ㝌ᝀ⩽࡞ᑊࡌࡾ᪡᭿㏝㝌㸞᲻㘵♰Ꮔ㸡ኬ➁ࡱࡽᏄ㸡㉝㛣᪺Ꮔ㸡㕝ᮄ⫩Ꮔ㸡ఫᨥᥴࡡຝᯕ࡞㛭ࡌࡾ◂✪≁ᏽᶭ⬗⑋㝌⩹ᖳ⑋⛁⸠༐ྍࠈ௙㸣᛬ᛮ᭿⑋㝌࡞࠽ࡄࡾ᪡᭿㏝㝌ᨥᥴࢅ࡞࠽ࡄࡾ‵ᐁ㥺◂✪㸣⑋㝌⟮⌦㸰㸝㸞㸯

┘Ⓩ࡛ࡊࡒࢪࢠ࣭ࣛࢼࣤࢡ⚂ࡡᑙථ㸣᪝ᮇᅹᏩࢢ

㸣

࢓Ꮥఌヽ㸰㸝㸞㸯㸣㸞㮎ずᑠᕤ㸡ዚཋⰶᏄ㸡Ꮽ㐡ዼᏄ㸡ὰ㔕ᘧᜠ㸡ఫ⸠㸞㮎ずᑠᕤ㸡ᮟᔪᖶ௥㸣㧏㱃ᝀ⩽࡞ᑊࡌࡾ㏝㝌ᨥᥴ⏜౅㸣ኬᏕ⑋㝌࡞࠽ࡄࡾᨭゖ∟㏝㝌ᨥᥴࢪࢠ࣭ࣛ

ࢪࢠ࣭ࣛࢼࣤࢡ⚂ࡡ㛜Ⓠ㸝➠ୌሒ㸞㸣⑋㝌⟮⌦ࢼࣤࢡ⚂ࡡጂᙔᛮࡡ᳠チ㸣┫㆜⥪ྙ⛁Ꮥ◂✪ఌヽ㸰㸝㸞㸯㸣㸞᩺⏛㟴Ờ㸣ᩝ⊡ᢊ㘋࡞࠽ࡄࡾ᪝ᮇࡡᐓ᪐௒㆜⩽ࢅ㸰㸝㸞㸯㸣ᑊ㇗࡛ࡌࡾ┫㆜◂✪ࡡິྡྷ࡛ㄚ㢗㸣ᒜᲅኬᏕ┫㆜㸞Ễ⏛ᬓᏄ㸡ᮟᔪᖶ௥㸣㏝㝌ᨥᥴࡡ⌟≟࡛ㄚ㢗㸣ಕᏕఌヽ㸰㸝㸞㸯㸣೸ࡡ⛁Ꮥ㸰㸝㸞㸯㸣㸞㮎ずᑠᕤ㸡ᮟᔪᖶ௥㸣㧏㱃ᝀ⩽࡞ᑊࡌࡾ㏝㝌ᨥᥴ㸞ᮟᮿᜠᏄ㸡㧏ᶣ╤Ꮔ㸡㯦⏛ࡴࡃࡲ㸡୯ㆺ஁ᜠ㸣ᅹࢪࢠ࣭ࣛࢼࣤࢡ⚂ࡡ㛜Ⓠ㸝➠஦ሒ㸞㸢ኬᏕ⑋㝌࡞

Ꮹ⒢㣬࡞࠽ࡄࡾ㏝㝌ᣞᑙࡡ᪡᭿໩࡞ྡྷࡄࡒථ㝌᫤࠽ࡄࡾጂᙔᛮࡡ᳠チ㸢㸣⑋㝌⟮⌦㸰㸝㸞㸯ࢪࢠ࣭ࣛࢼࣤࢡ࡞ࡻࡾ┫㆜㸣᪝ᮇᅹᏩࢢ࢓Ꮥఌヽ㸣㸰㸝㸞㸯㸣㸞๑᥎㸞㸞๑᥎㸬㸞

㸞ఔ┷⏜⨶㸡୷ᒱ├Ꮔ㸡ᕖᓞ࿰௥㸡ᑚᮿዼᏄ㸡ఫ⸠㸞๑᥎㸞㸞᪝ᮇ┫㆜༝ఌࠈᨳ➿௺⏤㒂㸣ᖳ┫㆜⫃ဤᐁឺᘧ⨶㸣⑋Ჯ┫㆜ᖅ㛏࠾ࡼࡲࡒ㏝㝌ㄢᩒࡡ⌟≟࡛ㄚㄢᰕ㸣㸣㸣㢗㸣▴ᕖ┫㆜㞟ヽ㸰㸯㸣㸞᲻⏛ய㸡ኮ⩒೸ኯ㑳㸡㯦⏛ᰜྍ㸡᫅ᕖྚක㸡㎯Ⲧ㸞ὕහᚷ‘㸡୷ᒱ├Ꮔ㸡ఔ┷⏜⨶㸡ᕖᓞ࿰௥㸣⑋㝌ᕰࠈ௙㸣㧏㱃⩽࡞ᑊࡌࡾ᪡᭿㏝㝌ᨥᥴࢪࢠ࣭ࣛࢼ

࡞ໂຸࡌࡾ┫㆜ᖅࡡ㏝㝌ㄢᩒὩິࡡᐁឺ࡛ㄚ㢗㸣ࣤࢡࡡ᭯⏕ᛮ㸣᮶᪝ᮇᩒⅇఌヽ㸰㸯▴ᕖ┫㆜㞟ヽ㸰㸯㸣㸞๑᥎㸞㸣㸞๑᥎㸞㸞ᖲ℡⟿Ꮔ㸡ᶣᮇᬓᏄ㸣㧏㱃⩽ࡡ㏝㝌ᨥᥴ࡞࠾࠾ࢂ

㸞᰿ᨼᶖ㸡㧏ᶣࡲࡷᏄ㸡ྎ⏛࿔ᖲ㸣༈⒢ᶭ㛭࡞࠽ࡄࡾ┫㆜ᖅࡡᙲ๪ᆀᇡ࡛ࡡ㏻ᦘࢅ㏳ࡊ࡙㸣┫㆜࣬ࡾ㏝㝌ㄢᩒᑍ㛓⫃㒼⨠ࡡྊ⬗ᛮ࡞㛭ࡌࡾධᅗㄢ

ಕ೸⛁Ꮥ◂✪ヽ㸰㸯㸣ᰕ㸣᪝ᮇ㎨ᮟ༈Ꮥఌ㞟ヽ㸰㸝㸞㸯㸣㸞ᮿỄ⠔ᚷ㸡Ễ⏛ᬓᏄ㸡ᮟᔪᖶ௥㸣≁ᏽᶭ⬗⑋㝌࡞࠽ࡄࡾ⑋Ჯ┫㆜ᖅࡡ㏝㝌ᨥᥴ࡞ࡗ࠷࡙ࡡヾㆉ࠽ࡻ㸞๑᥎㸞ࡦᐁ᪃≟Ἓ㸢㏝㝌ᨥᥴ㒂⨣ࡡ᭯↋࡞ࡻࡾẒ㍉࡞↌㸞๑᥎㸞Ⅴࢅᙔ࡙࡙㸢㸣⑋㝌⟮⌦㸰㸝㸞㸯㸣㸞๑᥎㸞㸞๑᥎㸫㸞
㸝ᖳ㸨᭮᪝ུ௛ࠈᖳ㸭᭮᪝ུ⌦㸞㸞᪝ᮇゴၡ┫㆜ᣲ⮾㈀ᅆ㸣㏝㝌ㄢᩒ┫㆜ᖅ࡞㛭ࡌࡾ

岩手看護学会誌/Journal of Iwate Society of Nursing Science. Vol.6, No.2, 2012

Nurses’ “Recognition of Necessity” and “Condition of
Implementation” of Care that Considers the Lifestyles ofElderly Patients after Discharge—Focus on Ward Characteristics—
Misako Kojima Yukie Watanabe Chiaki Kinouchi  Mutsumi Chida Michiko Ishikawa
1㸞Faculty of Nursing, Iwate Prefectural University2㸞Department of Nursing Sciences, School of Health Sciences, Japan University of Health Sciences
3㸞Former Iwate Prefectural University

Abstract
Objective: To elucidate the “recognition of necessity” and “condition of implementation” of

nursing care that considers the lifestyles of elderly patients after discharge among nurses working
in wards based on the characteristics of the ward and the influence of these characteristics onnurses’ “recognition of necessity” and the “condition of implementation”. Furthermore, thisresearch investigates the role of nursing care that considers the lifestyles of elderly patients after
discharge in care for elderly patients.
Methods: A 13-item self-report questionnaire on nursing care that considers the environment

surrounding elderly patients as well as their lifestyles after discharge was created and conducted
on 1743 nurses at 59 hospitals.
Results: Responses were obtained from 908 nurses㸝52.1%㸞. For all 13 items, scores for“recognition of necessity” were significantly higher than those for “condition of implementation”
㸝p<0.05㸞. In addition, we analyzed the influence of each ward characteristic on the lifestyles of

elderly patients after discharge. As a result, the ward characteristic with the most significant
influence was the practice of screening. The 13 items had a two-factor structure consisting of“assessment of family background and function, and confirmation of the wishes of the family andthe patient” and “discharge planning and intervention for long-term care insurance”. The ward
characteristic with the most significant influence on these factors was also the practice ofscreening.
Conclusion: Implementation of screening, Implementation of screening was thought to not only

was thought to not only strengthen the perspective of caring for elderly patients, but also
contribute to improvements in nursing care by enhancing nursing care for families.

Key words：elderly, recognition, implementation, discharge planning, screening