特別養護老人ホームにおける食支援の実態と看護職の役割

The purpose of this study was to elucidate the conditions of mealtime assistance in intensive- care nursing homes for the elderly in Tottori prefecture and to examine the roles of nursing professionals. A questionnaire survey was conducted on managers and staff of 14 facilities from which consents were obtained. The analyzed subjects were 89 staff members of 12 facilities that responded. Comprehensive skills of mealtime assistance (5 categories, 21 items) were analyzed using (1) descriptive statistics on the type of work mainly performed and type of work preferably performed by certain professionals and (2) text-mining on the anxiety/burden of mealtime assistance. Caregiving was selected in 20 items for the main work performed. The following professionals were selected as those who should preferably perform certain care: nursing professionals performing care directly/immediately affecting lives, “observation of respiratory status”; rehabilitation professionals performing care for “posture maintenance and device use”; and nutrition professionals performing care related to “selection of food form” and “observation of nutritional status.” Mealtime anxiety/burden involved difficulty of determining swallowing status, aspiration, and choking. There was an expectation on nursing professionals, regarding their roles, to advise from a medical perspective based on their observations and assessment of patients’ respiratory and swallowing statuses.