在宅ALS療養者の人工呼吸器をめぐる意思決定支援のあり方に関する看護研究  [in Japanese] Nursing Support for Decision-making of Ventilator Use in Individuals with ALS at Home  [in Japanese]

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Abstract

<B>【目 的】</B> 在宅ALS療養者の人工呼吸器をめぐる意思決定支援における看護研修会を試行し, 参加者の研修会に対する反応, ならびに看護師の立場から意思決定支援における重要事項を明らかにした. <B>【対象・方法】</B> 研修会参加者に対する質問紙調査を行い, データは質的分析した. <B>【結 果】</B> 意思決定支援における必要事項は, [支援者個々に求められるもの]として, タイミングを見計らうなどのアセスメント技術と傾聴や寄り添うといった支援アプローチがあげられ, [支援態勢整備]に関しては, サブサポート態勢, チームワークが見いだされた. <B><B>【結 語】</B></B> 在宅ALS療養者の人工呼吸器をめぐる意思決定支援においては, 通常の在宅療養支援態勢にプラスして, 中心的役割を担う支援者をサポートするサブサポート態勢の2重構造が必要であり, それがアセスメントのための多様な情報収集や支援の方向性の客観視化など支援者個々の力量向上につながることが示唆された.

Based on the results of previous studies, a "workshop for support in decision-making" was organized in trial, and those items that are considered important in nurses' support of ALS patients in decision making were explored. Descriptive and qualitative analysis was conducted on data obtained from questionnaires. Consequently, this study found two areas related to the support of patients in making decisions. The "supports by individuals" included the followings : the assessment skills (determining timing and extensive assessment concerning life activities in general and including families and intra-family relationships) and approach/psychological support techniques (active listening, communication, empathy, understanding of the patient). For "support by the community", organization of a sub-support system (supportive attitude of those offering help and playing the central role), and teamwork (information sharing within the team, cooperation and role assignment) was recognized. These findings indicated that to help patients in their decision-making process, the usual support system for home care patients should be a dual structure reinforced by a sub-support system to help the supporters who play the central role ; and such a structure should lead to improving supports by individuals, such as objective establishment of a direction in support and collection of diverse information for assessment.

Journal

  • The Kitakanto Medical Journal

    The Kitakanto Medical Journal 58(2), 209-216, 2008

    Kitakanto Medical Society

Codes

  • NII Article ID (NAID)
    110006668526
  • NII NACSIS-CAT ID (NCID)
    AN10585677
  • Text Lang
    JPN
  • Article Type
    journal article
  • ISSN
    1343-2826
  • NDL Article ID
    9516399
  • NDL Source Classification
    ZS7(科学技術--医学)
  • NDL Call No.
    Z19-138
  • Data Source
    NDL  NII-ELS  IR  J-STAGE 
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