Nursing Support for Decision-making of Ventilator Use in Individuals with ALS at Home

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  • 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
  • ザイタク ALS リョウヨウシャ ノ ジンコウ コキュウキ オ メグル イシ ケッテイ シエン ノ アリカタ ニ カンスル カンゴ ケンキュウ

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Abstract

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.

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