脳血管疾患を発症し,緊急入院となった成人期患者の家族の体験―緊急入院時,一般病棟転棟時,急性期病院退院時の三時期に焦点をあてて―

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  • ノウ ケッカン シッカン オ ハッショウ シ,キンキュウ ニュウイン ト ナッタ セイジンキ カンジャ ノ カゾク ノ タイケン : キンキュウ ニュウインジ,イッパン ビョウトウテントウジ,キュウセイキ ビョウイン タイインジ ノ サン ジキ ニ ショウテン オ アテテ
  • Experiences of Family Members of Urgently Hospitalized Patients with Cerebrovascular Disease During Three Periods: Upon Urgent Hospitalization, Upon Transfer to a General Ward, and Upon Discharge after Urgent Hospitalization

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目的:脳血管疾患を発症し,緊急入院となった成人期患者家族の体験を明らかにし,その特徴を踏まえた看護実践への示唆を得る. 方法:脳血管疾患を発症し,緊急入院となった成人期患者家族6名に研究同意を得て面接調査を行った.面接内容を対象者が述べた言葉のみでなく,観察された反応,表情,態度等のメッセージも文字化して,Krippendorff, Kの内容分析法を用いて分析した. 結果・考察:三時期の家族の体験を表す27のカテゴリを形成した.緊急入院時には【配偶者の生命の危機に対する衝撃】,一般病棟転棟時には【配偶者の病状変化に対する継続的懸念】,急性期病院退院時には【退院・転院に向けた心身の準備状態の確立の実感】など,三時期で特有の体験をしていた. 結論:家族の体験の特徴を踏まえ,緊急入院時は家族が過酷な状況を乗り越えられるような支援,一般病棟転棟時には感情の揺れに配慮した支援,急性期病院退院時には発達段階を考慮した具体的支援の必要性が示唆された.

Purpose: To elucidate the experiences of family members of adults who were urgently hospitalized due to cerebrovascular disease and to obtain insights into nursing practice based on the characteristics of such experiences. Methods: An interview survey was conducted with six family members who agreed to participate in the research. The data were analyzed using Krippendorff’s method of content analysis. Not only words, but also the observed reactions, expressions and manners expressed by family members during the interviews were analyzed. Results: A total of 27 categories were generated for the following three periods: 1) when patients were urgently hospitalized, 2) when patients were transferred to a general ward, and 3) when patients were discharged after urgent hospitalization. The participants had experiences specific to each period, such as‘ feeling shocked and relieved by the spouse being alive’ upon urgent hospitalization,‘ expectations for recovery and worries for disease progression’ upon transfer to a general ward, and‘ being ready to provide support again’ upon discharge after urgent hospitalization. Conclusions: The characteristics of experiences faced by the participants suggest the necessity of the following support strategies: support for family members to overcome critical situations upon immediate hospitalization, support that considers emotional changes upon transfer to a general ward, and support specific to disease progression level upon discharge after immediate hospitalization.

原著

群馬県立県民健康科学大学紀要15, 13-29. (2020)

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