Establishing a practice guide for visualizing and sharing musculoskeletal nursing: Assessment perspectives of postoperative excretory care for patients with proximal femur fractures viewed through nurses’ narratives
This study aimed to establish a practice guide for visualizing and sharing assessment perspectives in musculoskeletal nursing according to the results of interviews with nurses regarding postoperative excretory care for patients with proximal femur fractures. The contents corresponding to the nurses...
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| Published in | Journal of Japan Society for Musculoskeletal Nursing Vol. 20; pp. 67 - 74 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japan Society for Musculoskeletal Nursing
28.02.2025
日本運動器看護学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2186-635X 2435-001X |
| DOI | 10.34324/jsmn.20.0_67 |
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| Abstract | This study aimed to establish a practice guide for visualizing and sharing assessment perspectives in musculoskeletal nursing according to the results of interviews with nurses regarding postoperative excretory care for patients with proximal femur fractures. The contents corresponding to the nurses' assessment perspectives from the coded and categorized data were extracted, classified, and organized based on commonality and similarity and further illustrated as a framework for practice guides. The 44 perspectives on excretory care assessment were organized into five categories: general condition, pain, motivation, muscle strength/body movement, and cognitive ability/comprehension. Pain and motivation were key factors in assessing a patient' s ability to move. Further, the entire movement was evaluated from both muscular/physical and cognitive/comprehension aspects to ensure safe movements in the toilet. The drafted practice guide included nurses' discursive reasoning, which is challenging to verbalize in daily practice. Thus, this draft is considered an effective teaching tool that represents practical nursing knowledge. |
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| AbstractList | This study aimed to establish a practice guide for visualizing and sharing assessment perspectives in musculoskeletal nursing according to the results of interviews with nurses regarding postoperative excretory care for patients with proximal femur fractures. The contents corresponding to the nurses' assessment perspectives from the coded and categorized data were extracted, classified, and organized based on commonality and similarity and further illustrated as a framework for practice guides. The 44 perspectives on excretory care assessment were organized into five categories: general condition, pain, motivation, muscle strength/body movement, and cognitive ability/comprehension. Pain and motivation were key factors in assessing a patient' s ability to move. Further, the entire movement was evaluated from both muscular/physical and cognitive/comprehension aspects to ensure safe movements in the toilet. The drafted practice guide included nurses' discursive reasoning, which is challenging to verbalize in daily practice. Thus, this draft is considered an effective teaching tool that represents practical nursing knowledge. This study aimed to establish a practice guide for visualizing and sharing assessment perspectives in musculoskeletal nursing according to the results of interviews with nurses regarding postoperative excretory care for patients with proximal femur fractures. The contents corresponding to the nurses' assessment perspectives from the coded and categorized data were extracted, classified, and organized based on commonality and similarity and further illustrated as a framework for practice guides. The 44 perspectives on excretory care assessment were organized into five categories: general condition, pain, motivation, muscle strength/body movement, and cognitive ability/comprehension. Pain and motivation were key factors in assessing a patient' s ability to move. Further, the entire movement was evaluated from both muscular/physical and cognitive/comprehension aspects to ensure safe movements in the toilet. The drafted practice guide included nurses' discursive reasoning, which is challenging to verbalize in daily practice. Thus, this draft is considered an effective teaching tool that represents practical nursing knowledge. 本研究では，「大腿骨近位部骨折患者の術後排泄ケア」に関するインタビュー結果をもとに，運動器看護のアセスメントの視点を可視化して共有するための実践ガイド（素案）の作成を試みた．コード化・カテゴリ化されたデータから，看護師のアセスメントの視点に該当する内容を抽出し，共通性や類似性に沿って分類・整理し，さらに実践ガイドの枠組みとして図示した．44の排泄ケアのアセスメントの視点は，全身状態，疼痛，意欲，筋力・身体の動き，認知力・理解力の5項目に整理された．疼痛と意欲が，患者が“動く”ことを支えるアセスメントの重要な鍵となっていた．また，トイレでの安全な動作の獲得に向けて，動作の全体像を筋力・身体の動きと認知力・理解力の両側からアセスメントしていた．実践ガイド（素案）には，普段の実践では言語化されにくい看護師の説話的推論が含まれ，看護の実践知を反映した意義ある教材となり得ることが示唆された． |
| Author | Nishihara, Sayaka Sano, Kaori Iijima, Yuriko Satoh, Masae Saito, Takako Sasamori, Masako Yanagimoto, Yuko |
| Author_FL | 西原 さやか Sano Kaori 飯島 由理子 笹森 正子 齋藤 貴子 柳本 優子 Satoh Masae |
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| Author_xml | – sequence: 1 fullname: Saito, Takako organization: Department of Nursing, Faculty of Nursing, Japanese Red Cross Akita College of Nursing – sequence: 1 fullname: Sano, Kaori organization: Department of Public Health, Graduate School of Health Sciences, Kobe University – sequence: 1 fullname: Sasamori, Masako organization: Tokyo Sports & Orthopedic Clinic – sequence: 1 fullname: Nishihara, Sayaka organization: Department of Nursing, Graduate School of Medicine, Yokohama City University – sequence: 1 fullname: Satoh, Masae organization: Nursing Course, School of Medicine, Yokohama City University – sequence: 1 fullname: Yanagimoto, Yuko organization: Chiba University Medical School Hospital – sequence: 1 fullname: Iijima, Yuriko organization: Nursing Course, School of Medicine, Yokohama City University |
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| References | 9. 加藤和子，南雲美代子，中村祐子，内田伸樹，片桐智子，原萃子．クリティカルパスを使用した看護活動の実証的研究．山形保健医療研究．2005; 8: 13–23. 22. 松本有希．術後の痛みを体験する患者に対する看護師の臨床判断の要素とその構造．日本看護研究学会雑誌．2023; 46(2): 201–211. 23. 江川幸二．回復意欲を高める看護実践．日本クリティカルケア看護学会誌．2017; 13(1): 19–29. 13. 中山栄純，柳本優子，齋藤貴子，佐野かおり，笹森正子，佐藤政枝，他．運動器看護における「排泄ケア」に対する判断根拠とその影響要因について—大腿骨頚部骨折・術後回復期の援助場面に焦点をあてて—．日本運動器看護学会第20回学術集会抄録集，2020. 11. DiCenso A, Cullum N, Ciliska D. Implementing evidence-based nursing: some misconceptions. Evidence-Based Nursing. 1998; 1(2): 38–40. 15. 齋藤貴子．人工股関節置換術後トイレ歩行自立プロセスにおける看護師の判断要素の抽出と構造化．日本運動器看護学会誌．2014; 9: 38–48. 20. de Kruijf M, Verlinden VJA, Huygen FJPM, Hofman A, van der Geest JN, Uitterlinden AG, et al. Chronic joint pain in the lower body is associated with gait differences independent from radiographic osteoarthritis. Gait & Posture. 2015; 42(3): 354–359. 4. Burgers JS, Anzueto A, Black PN, Cruz AA, Fervers B, Graham ID, et al. Adaptation, evaluation, and updating of guidelines: article 14 in Integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report. Proceedings of the American Thoracic Society. 2012; 9(5): 304–310. 8. 一般社団法人日本クリニカルパス学会．クリニカルパスの普及・体制の現状と課題—第20回（2020年度）アンケート結果から—．日本クリニカルパス学会誌．2021; 23(1): 30–43. 19. Yanardag M, Şimşek TT, Yanardag F. Exploring the relationship of pain, balance, gait function, and quality of life in older adults with hip and knee pain. Pain Management Nursing. 2021; 22(4): 503–508. 5. Chan AK, Baker R, Lam TP, Kwong MB, Chan LW, Hong TT. Strengthening primary care: the role of clinical practice guidelines. Hong Kong Medical Journal. 2010; 16(1): 73–74. 16. 植田綾，辻村真由子，岡本有子，園田芳美，松浦志野，望月由紀，他．排泄ケアにみられる身体性—国内文献に記述された実践事例のメタ統合を通して—．千葉看護学会会誌．2009; 15(1): 68–75. 3. Minds診療ガイドライン作成マニュアル編集委員会．第1章診療ガイドライン総論．Minds診療ガイドライン作成マニュアル2020 ver.3.0. 東京：公益財団法人日本医療機能評価機構EBM医療情報部；2021. 2–8. 18. 日本看護科学学会看護学学術用語検討委員会（第9・10期委員会）．看護学を構成する重要な用語集．2011-6-24．https://www.jans.or.jp/uploads/files/committee/yogoshu.pdf.（参照2024-1-25） 24. 有田直子，中野綾美．血液・腫瘍疾患をもつ青年が親や医療者とともに行う意思決定を支援する看護実践ガイドラインの開発．高知女子大学看護学会誌．2019; 44(2): 44–55. 14. Henderson V，湯槇ます，小玉香津子．看護の基本となるもの（再新装版）．東京：日本看護出版会；2016. 20–22, 46–48. 17. Miller M, Kearney N. Guidelines for clinical practice: development, dissemination and implementation. International Journal of Nursing Studies. 2004; 41(7): 813–821. 6. Harrison MB, Legare F, Graham ID, Fervers B. Adapting clinical practice guidelines to local context and assessing barriers to their use. Canadian Medical Association Journal. 2010; 182(2): e78–e84. 10. Tanner CA. Thinking like a nurse: a research-based model of clinical judgment in nursing. The Journal of Nursing Education. 2006; 45(6): 204–211. 1. 公益財団法人日本医療機能評価機構．Mindsガイドラインライブラリ，診療ガイドラインの定義．2023-12-26．https://minds.jcqhc.or.jp/cpg/about-cpg/definition/.（参照2024-1-8） 12. 齋藤貴子，柳本優子，笹森正子，吉田澄恵，佐藤政枝，佐野かおり，他．運動器看護における「排泄ケア」の実態把握に向けた予備調査—フォーカスグループインタビューによる語りの分析—．日本運動器看護学会第19回学術集会抄録集，2019. 2. Bjartmarz I, Jónsdóttir H, Hafsteinsdóttir TB. Implementation and feasibility of the stroke nursing guideline in the care of patients with stroke: a mixed methods study. BMC Nursing. 2017; 16(1): 72. 7. 一般社団法人日本クリニカルパス学会HP．クリニカルパスの定義．2014年改訂．https://www.jscp.gr.jp/.（参照2024-1-8） 21. Murata S, Doi T, Sawa R, Nakamura R, Isa T, Ebina A, et al. Association between objectively measured physical activity and the number of chronic musculoskeletal pain sites in community-dwelling older adults. Pain Medicine. 2019; 20(4): 717–723. |
| References_xml | – reference: 9. 加藤和子，南雲美代子，中村祐子，内田伸樹，片桐智子，原萃子．クリティカルパスを使用した看護活動の実証的研究．山形保健医療研究．2005; 8: 13–23. – reference: 10. Tanner CA. Thinking like a nurse: a research-based model of clinical judgment in nursing. The Journal of Nursing Education. 2006; 45(6): 204–211. – reference: 24. 有田直子，中野綾美．血液・腫瘍疾患をもつ青年が親や医療者とともに行う意思決定を支援する看護実践ガイドラインの開発．高知女子大学看護学会誌．2019; 44(2): 44–55. – reference: 17. Miller M, Kearney N. Guidelines for clinical practice: development, dissemination and implementation. International Journal of Nursing Studies. 2004; 41(7): 813–821. – reference: 13. 中山栄純，柳本優子，齋藤貴子，佐野かおり，笹森正子，佐藤政枝，他．運動器看護における「排泄ケア」に対する判断根拠とその影響要因について—大腿骨頚部骨折・術後回復期の援助場面に焦点をあてて—．日本運動器看護学会第20回学術集会抄録集，2020. – reference: 22. 松本有希．術後の痛みを体験する患者に対する看護師の臨床判断の要素とその構造．日本看護研究学会雑誌．2023; 46(2): 201–211. – reference: 3. Minds診療ガイドライン作成マニュアル編集委員会．第1章診療ガイドライン総論．Minds診療ガイドライン作成マニュアル2020 ver.3.0. 東京：公益財団法人日本医療機能評価機構EBM医療情報部；2021. 2–8. – reference: 14. Henderson V，湯槇ます，小玉香津子．看護の基本となるもの（再新装版）．東京：日本看護出版会；2016. 20–22, 46–48. – reference: 23. 江川幸二．回復意欲を高める看護実践．日本クリティカルケア看護学会誌．2017; 13(1): 19–29. – reference: 1. 公益財団法人日本医療機能評価機構．Mindsガイドラインライブラリ，診療ガイドラインの定義．2023-12-26．https://minds.jcqhc.or.jp/cpg/about-cpg/definition/.（参照2024-1-8） – reference: 2. Bjartmarz I, Jónsdóttir H, Hafsteinsdóttir TB. Implementation and feasibility of the stroke nursing guideline in the care of patients with stroke: a mixed methods study. BMC Nursing. 2017; 16(1): 72. – reference: 5. Chan AK, Baker R, Lam TP, Kwong MB, Chan LW, Hong TT. Strengthening primary care: the role of clinical practice guidelines. Hong Kong Medical Journal. 2010; 16(1): 73–74. – reference: 12. 齋藤貴子，柳本優子，笹森正子，吉田澄恵，佐藤政枝，佐野かおり，他．運動器看護における「排泄ケア」の実態把握に向けた予備調査—フォーカスグループインタビューによる語りの分析—．日本運動器看護学会第19回学術集会抄録集，2019. – reference: 19. Yanardag M, Şimşek TT, Yanardag F. Exploring the relationship of pain, balance, gait function, and quality of life in older adults with hip and knee pain. Pain Management Nursing. 2021; 22(4): 503–508. – reference: 21. Murata S, Doi T, Sawa R, Nakamura R, Isa T, Ebina A, et al. Association between objectively measured physical activity and the number of chronic musculoskeletal pain sites in community-dwelling older adults. Pain Medicine. 2019; 20(4): 717–723. – reference: 8. 一般社団法人日本クリニカルパス学会．クリニカルパスの普及・体制の現状と課題—第20回（2020年度）アンケート結果から—．日本クリニカルパス学会誌．2021; 23(1): 30–43. – reference: 20. de Kruijf M, Verlinden VJA, Huygen FJPM, Hofman A, van der Geest JN, Uitterlinden AG, et al. Chronic joint pain in the lower body is associated with gait differences independent from radiographic osteoarthritis. Gait & Posture. 2015; 42(3): 354–359. – reference: 15. 齋藤貴子．人工股関節置換術後トイレ歩行自立プロセスにおける看護師の判断要素の抽出と構造化．日本運動器看護学会誌．2014; 9: 38–48. – reference: 7. 一般社団法人日本クリニカルパス学会HP．クリニカルパスの定義．2014年改訂．https://www.jscp.gr.jp/.（参照2024-1-8） – reference: 16. 植田綾，辻村真由子，岡本有子，園田芳美，松浦志野，望月由紀，他．排泄ケアにみられる身体性—国内文献に記述された実践事例のメタ統合を通して—．千葉看護学会会誌．2009; 15(1): 68–75. – reference: 4. Burgers JS, Anzueto A, Black PN, Cruz AA, Fervers B, Graham ID, et al. Adaptation, evaluation, and updating of guidelines: article 14 in Integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report. Proceedings of the American Thoracic Society. 2012; 9(5): 304–310. – reference: 11. DiCenso A, Cullum N, Ciliska D. Implementing evidence-based nursing: some misconceptions. Evidence-Based Nursing. 1998; 1(2): 38–40. – reference: 6. Harrison MB, Legare F, Graham ID, Fervers B. Adapting clinical practice guidelines to local context and assessing barriers to their use. Canadian Medical Association Journal. 2010; 182(2): e78–e84. – reference: 18. 日本看護科学学会看護学学術用語検討委員会（第9・10期委員会）．看護学を構成する重要な用語集．2011-6-24．https://www.jans.or.jp/uploads/files/committee/yogoshu.pdf.（参照2024-1-25） |
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| Title | Establishing a practice guide for visualizing and sharing musculoskeletal nursing: Assessment perspectives of postoperative excretory care for patients with proximal femur fractures viewed through nurses’ narratives |
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