AKIKO HAMAUE

【目的】自分の強みに気付き,健康な生活習慣を継続するための自分なりの方法をみつけることを目標とした特定保健指導プログラムを作成し,評価を行った。また,A市における特定保健指導対象者の特徴を明らかにした。【方法】対象者は,全5回からなる特定保健指導新プログラムに参加した住民である。プログラム開始時および終了時に無記名式アンケート調査を実施した。アンケート内容は,基礎情報,生活習慣,SCAQ(Self-Care Agency Questionnaire),プログラムに関する自由記載であった。分析はWilcoxonの符号付き順位検定により実施した。所属大学の研究倫理委員会の承認を得て実施した。【結果】特定保健指導プログラムの対象者329名中,参加者は92名であった。プログラム開始時のアンケート総回答者数は56名で,回収率は60.8%であった。食生活については,「改善するつもりである(概ね6ヵ月以内)」が49.1%と最も多かった。運動習慣についても,「改善するつもりである(概ね6ヵ月以内)」が31.5%と最も多かった。5回すべてに参加したものは14名で,欠損値を除いた11名において,SCAQに有意な改善は認められなかった。食習慣,運動習慣ともに「既に改善に取り組んでいる(6ヵ月未満)」が2名から4名に増えた。変化した理由としては,「今までは自分に甘く改善しようと思わなかったが,なにより意識が変わり,真剣に自分の体のことを考えるようになった」などがあった。また,食習慣,運動習慣ともに「改善することに関心がない」と回答した1名が「改善するつもりである(概ね6ヵ月以内)」に変化した。【結論】食習慣,運動習慣の改善意思については増加傾向がみられたが,分析データ数が少なく,効果を示すことはできなかった。(著者抄録)

The aim of this study is to determine the effect of food consistency on health and related factors among residents in welfare facilities for seniors (n = 227; mean age, 86.2 ± 8.0 years; 78.9% female). Residents who ate regular food had a lower incidence of fever during the 3-month period (p < 0.001) and consumed more calories (1325.97 ± 220.2 kcal) than those who ate chopped (1125.0 ± 256.8 kcal), paste (1122.0 ± 288.5 kcal), and gastric tube food (812.5 ± 150.7 kcal) (p < 0.001). Modifying a resident’s food by making it softer and finer did not reduce the incidence of choking. Logistic regression analysis (backward elimination method) revealed four factors related to eating regular food: vitality index, appetite, number of remaining teeth, and choking frequency. Causal relationships were not obtained because this was a cross-sectional study. The findings of this study suggest that a regular consistency of food positively influences the health of older individuals.

[Objective] More than two decades have passed since the situation-specific theory (SST) was proposed. This literature review analyzes changes in the number of SST-related articles, their contents, methodologies, and sources for the construction. This study aimed to clarify the developing process and prospects in future SST constructions.[Methods] Using the CINAHL, PubMed, and ICHUSHI databases, we searched for papers in English with the key words of "situation-specific theory" and "situation-specific theories" and those words translated in Japanese. Eighty-eight articles were found and screened. At the end, fifty articles were to be reviewed, and they were sorted by year of publication and contents. Additionally, articles reporting SST construction were analyzed for the theory constructing methodologies and sources used for the constructions.[Results] All articles were classified into the following six categories: theory development, concept analysis, clarification of theory sub-concepts, theory testing, research based on theoretical framework, and review/commentary. The number of published articles is increased every year. The review of these articles revealed that constructions of SST were validated and utilized as research frameworks, and SST has been contributing to the construction of knowledge in the field of nursing science. SSTs were constructed in 23 articles, all of which focused on restricted phenomena in particular fields or subjects. The integrative approach was the most commonly employed for construction methods; however, other methods were found in some articles. The sources frequently used for the constructions were preexisting theories, research findings, and literature reviews, whereas practical experiences were rarely used as the sources.[Conclusion] Based on the increase in constructions of STT, utilization of SST as frameworks, and validation of the theory, the awareness of SST will grow in the field of nursing science. As construction methods other than the integrative approach are emerging, additional SSTs should be constructed with a broader range of approaches.