小児がんの子どもと家族に対する症状マネジメント看護援助モデルの構成概念と介入の枠組み  [in Japanese] COMPONENT CONCEPTS AND FRAMEWORK OF NURSING INTERVENTION MODELS OF SYMPTOM MANAGEMENT FOR CHILDREN WITH CANCER AND THEIR FAMILIES  [in Japanese]

Access this Article

Search this Article

Abstract

本研究の目的は,原疾患・治療に起因する症状を体験している小児がんの子どもと家族に対する症状マネジメント看護援助モデルの構成概念と介入の枠組みを明確にすることであった。小児関連病棟/緩和ケア病棟看護師,訪問看護師計13名に,ターミナル期にある小児がんの子どもと家族1事例の想起に基づく半構造的面接を実施し,9つの構成概念とそれらに対応する看護援助を抽出し,以下の3つの介入の枠組みとそれらを構成する看護援助を明確にした。1)[子どもの生活の質の向上を目指した症状コントロール]は,≪症状のモニタリング,及び症状の特性に基づく薬理的・治療的方法の適切かつ積極的な適用≫≪ 症状の増悪・増強要因の除去,及び症状の軽減・緩和要因の導入≫≪ 原疾患・治療に起因する症状に伴う日常生活上の支障の最小限化≫で構成された。2)[子どもの症状マネジメントの促進]は,≪子どもの症状,及び症状緩和に関する認識の獲得・組織化・再組織化の促進≫≪子どもの症状に対する対処の探索・獲得・強化の促進≫≪子どもの症状,及び症状緩和に対する能動的意思活動の喚起と支持≫で構成された。3)[子どもの症状マネジメントに対する家族の応答性の促進]は,≪子どもの症状に対する家族の対処の探索・獲得・強化の促進≫≪子どもの症状,及び症状緩和に関する家族の認識の獲得・組織化・再組織化の促進≫≪子どもの症状の増悪・増強,及び症状の軽減・緩和から生起する家族の感情の表出・喚起・安定化の促進と受容≫で構成された。The purpose of this study was to identify the component concepts and framework of nursing intervention models of symptom management for Japanese children with cancer and their families. Qualitative data was collected fromthirteen nurses practicing in pediatric units, palliative care units, and nursing homes or clinics. Participants were askedto recall one child with terminal stage cancer and their families, and a semi-structured interview was conducted. As aresult, 9 component concepts and 9 nursing intervention modes were extracted from the nurses'narrative stories. The following three nursing intervention models of symptom management for children with cancer and their families andthe components of nursing intervention for each model were obtained: 1) [Controlling unpleasant symptoms cased by disease or oncology therapy aimed to improve quality of life of children with cancer] implied the following : 'Monitoring symptoms and applying adequate and aggressive therapeutic/pharmacological practices in line with symptom characteristics', 'Eliminating/applying exacerbation/alleviation factors effected intensity of symptom distresses', and'Minimizing negative outcomes on daily life caused by symptoms', 2) [Improving symptom management by the child his or herself] implied the following:'Improving the child's acquisition, systematization, and re-systematization of perceptions of symptoms as well as the means to palliate symptoms','Improving the child's inquiry, acquisition, and reinforcement of coping strategies for symptoms ', and 'Rousing and supporting the child's active emotional energy and motivation ',3) [Improving family responses in line with the child's symptom management] implied the following : 'Improving the family's acquisition, systematization, and re-systematization of perceptions of the child's symptoms as well as the means to palliate the child's symptoms','Improving the family's inquiry, acquisition, and reinforcement of coping strategies for child's symptoms or supports their ・・・

Journal

  • 千葉看護学会会誌

    千葉看護学会会誌 13(1), 44-52, 2007-06-30

    千葉看護学会

Codes

  • NII Article ID (NAID)
    120005927775
  • Text Lang
    JPN
  • Article Type
    journal article
  • ISSN
    1344-8846
  • Data Source
    IR 
Page Top