Jonsen 4分割表を用いた同種造血幹細胞移植の意思決定期カンファレンスが看護師の思いやケアに与えた影響要因  [in Japanese] The influence on nurses of case conferences regarding allotransplant decision-making patients using the Jonsen four-quadrant approach  [in Japanese]

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Author(s)

    • 横田 宜子 YOKOTA Noriko
    • 国際医療福祉大学大学院 医療福祉学研究科 保健医療学専攻 看護学分野 修士課程 (現職)医療法人 原三信病院 看護部 Division of Nursing, Master's Program in Health Sciences, Graduate School of Health and Welfare Sciences, International University of Health and Welfare (Present office)Nursing Department, Harasanshin Hospital
    • 小田 正枝 ODA Masae
    • 国際医療福祉大学大学院 Graduate School of Health and Welfare Sciences, International University of Health and Welfare

Abstract

患者を多角的に分析できるJonsen 4分割表を用いた同種造血幹細胞移植(移植)の意思決定期カンファレンスが,意思決定を支援する看護師に与えた影響について検討した.看護師8名にカンファレンスが意思決定を支援する看護師の思いやケアに与えた影響について半構成的面接を行い,質的記述的にデータ分析した.≪意思決定の過程を理解する重要性の認識≫≪意思を支援するケアへの変化≫≪意思決定に関わることで得る達成感≫≪高リスクな治療であることの再認識≫のカテゴリーが抽出された.カンファレンスは,看護師の意思決定を支援する上でのゆらぎを解消することはできなかったが,Jonsen 4分割表を用いることは,患者の意思決定過程について,患者の意向やQOLなどをバランス良く熟考するきっかけになっていた.看護師は,病気を治したいという患者の希望を知ることで,前向きな気持ちで意思決定を支えられるようになる可能性がある.

The aim of this study was to identify factors that influence nurses who support patients in allogeneic hematopoietic stem cell transplantation decision-making generated by case conferences. We brought up problems regarding allotransplant decision-making at the conference using the Jonsen four-quadrant approach, which provided an opportunity to consider each patient from several viewpoints. We conducted semi-structured interviews with eight nurses who support patients in allotransplant decision-making. The nurses were interviewed regarding the fluctuations in their feelings and the care they provided. The data from these interviews were analyzed qualitatively and descriptively. We classified the data into four categories: importance of knowledge about the decision-making process; changes in their decision-making support; their sense of accomplishment following the decision-making process; and their perception of the life-threatening risk of transplantation for each patient. Although the conferences did not completely overcome the nurses' fluctuating feelings regarding their support in the decision-making process, the nurses had the opportunity to consider the process in depth from well-balanced viewpoints such as patient preference and quality of life. Knowledge about patients' hopes for a cure may help nurses provide better support to patients' for allotransplant decision-making.

Journal

  • 国際医療福祉大学学会誌

    国際医療福祉大学学会誌 19(1), 9-15, 2014

    International University of Health and Welfare

Codes

  • NII Article ID (NAID)
    110009661007
  • NII NACSIS-CAT ID (NCID)
    AA12537130
  • Text Lang
    JPN
  • Article Type
    journal article
  • Journal Type
    大学紀要
  • ISSN
    2186-3652
  • NDL Article ID
    025331479
  • NDL Call No.
    Z19-B929
  • Data Source
    NDL  NII-ELS  IR 
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