ハイリスク治療計画への意思決定における子どもの参加を巡る親の考え方 : 造血幹細胞移植事例を通して  [in Japanese]

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Abstract

ハイリスク治療計画の意思決定への子どもの参加については親が大きく関与しているにも関わらず、親の考え方に焦点をあてた研究報告は少ない。本研究ではハイリスク治療としての造血幹細胞移植を巡る親の考え方を調査し記述する事を目的とした質的・帰納的研究を行った。過去2年以内に造血幹細胞移植を受けた1歳から15歳までの14人の小児患者の親を対象に半構成的面接を行い、分析した。その結果、ハイリスク治療計画としての造血幹細胞移植の意思決定における子どもの参加を巡る親の考え方は、子ども側の要素として「参加能力の見極め」「参加を巡る子どもの反応の予測」、親側の要素として「移植への親の受けとめ」「親の対応力の予想」「親の責務」が考慮され、「子どもの参加を巡る親の決意-代理意思決定、誘導的承諾、本人に委ねる」が導き出された。これらを共感的に理解し、親の決意を尊重するとともに対応力を高める支援の必要性が示唆された。

Parents have a great influence on their children's participation in a decision making process when a high risk treatment plan will be selected, however, there have been few reports focusing on parental ideas. Fifteen children aged between 1 and 15 years had received hematopoiesis stem cell transplantation within the past 2 years, while their parents became the subjects of this study. Semi-structural interviews with the parents were performed and analyzed through a qualitative, inductive research which described the parents' thoughts about stem cell transplantation as high risk treatment. The results show that the parents considered two aspects; the elements on the children's side were "participating ability" and "predicted reaction on the process", and those on the parents' side were "appreciation of the treatment method", "expected responsiveness" and "parental responsibility". Respecting the parents' intentions, it is important to understand these factors empathically, and support may be needed to enhance their ability to confront such difficulties.

Journal

  • Journal of Japanese Society of Child Health Nursing

    Journal of Japanese Society of Child Health Nursing 11(1), 8-14, 2002

    Japanese Society of Child Health Nursing

References:  9

Cited by:  1

Codes

  • NII Article ID (NAID)
    110007461624
  • NII NACSIS-CAT ID (NCID)
    AA11583347
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    1344-9923
  • NDL Article ID
    6114543
  • NDL Source Classification
    ZS47(科学技術--医学--治療医学・看護学・漢方医学) // ZS32(科学技術--医学--小児科学・先天異常・奇形)
  • NDL Call No.
    Z19-B293
  • Data Source
    CJP  CJPref  NDL  NII-ELS  J-STAGE 
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