@article{oai:kansai-u.repo.nii.ac.jp:00011916,
 author = {室谷, 牧子 and 佐瀬, 美恵子 and 外堀, 佳代 and 黒田, 研二},
 journal = {人間健康研究科論集},
 month = {Mar},
 note = {地域包括ケアに関わる専門職の参加のもと、インシデント・プロセス法を用いた多職種による事例検討会を開催した。介護支援専門員が支援上困難を感じる事例の特徴、当日の参加者のアセスメント及びグループワークで抽出された課題と課題解決法の提案について、記録の内容分析を行った。目的は、本人の自立支援と尊厳保持を中心に据えたケアマネジメント展開への提言を行うことである。分析の結果、以下の点が明らかになった。支援困難事例の特徴として「認知症」「家族に課題」「医療」「介護上の課題」がキーワードとして抽出された。支援が困難となる背景はこれらの要素単体ではなく、複数が絡み合い困難さが増している。同居家族の影響も受ける。地域包括ケアの構成要素を意識したアセスメントでは「本人の思い」と「インフォーマルサポート」の情報・分析の不足が認められた。抽出された課題としては、「本人の思いの把握」「地域との関わり・支援体制」「連携」のいずれもが不十分であることが指摘された。提案された解決策は、「本人の思い・ストレングスの把握」「地域ケア会議等を活用し支援体制を構築する」「地域とつながりをもつ」ことであった。以上から、あらかじめ支援困難事例の特徴を理解し、初動時から支援体制を強化し、困難化を予防する仕組みが重要であることが確認できた。そのためには本人や地域のストレングスが十分発揮できるよう、本人の生活機能や能力を評価し、地域の情報を有効に活用することが求められる。これらを学際的チームアプローチにより、PDCA(Plan-Do-Check-Action)サイクルに基づき展開することで、本人の自立支援と尊厳を守る支援が期待される。, We held case study meetings using the incident-process method, in which multidisciplinary professions working in community-based care participated. A content analysis was performed concerning characteristics of cases that the care manager in charge felt difficult to support, assessment by participants of the meetings, and problems and problem-solving proposals that the participants generated at the meeting. This study aimed to make recommendations for the development of care management based on the core values of protecting client's dignity and supporting their independence. The results of the analysis revealed the following points. The difficult to support cases were characterized by several keywords, including "Dementia," "Family Issues," "Medical Treatment," and "Support Issues". Difficulty was not caused by these simple factors but was intertwined due to these factors. It was also affected by cohabiting family members. In the assessment based on the constituent elements of community-based care, there was a paucity of information regarding "the client's wishes" and "informal care support." Further, it was pointed out in the group works that the extracted tasks were insufficient for "grasping personal thoughts" "relationship with the community / support system" and "cooperation". The proposed solution was "to grasp personal thought and strengths," "to build a support system utilizing community care meetings" and "to have a connection with the community". As indicated above, the characteristics of cases where support was difficult were reconfirmed, as was the importance of strengthening the support system from the initial stage and having a system in place to prevent cases becoming difficult to care for. Thus, it is important to adequately understand client and community strengths, evaluate the client's functional capacity, and effectively utilize community information. By practicing these based on the Plan-Do-Check-Action (PDCA) cycle through an interdisciplinary team approach, it is expected that care which supports individuals' dignity and independence will be realized.},
 pages = {3--28},
 title = {多職種事例検討会における支援困難事例の分析 : 学際的アセスメントとストレングスに配慮した課題解決策},
 volume = {1},
 year = {2018}
}