小児集中治療室 (PICU) に入室している鎮静下の幼児の表情を捉えたケア  [in Japanese] Nursing care based on facial expressions of infants under sedation in pediatric intensive care units  [in Japanese]

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Abstract

<p> 目的 : 看護師がPICUに入室している鎮静下の幼児の表情をどのように捉え、ケアに生かしているのかを明らかにすることである。</p><p> 研究方法 : Leiningerの民族看護学を用いた。研究参加者は、看護師8名と一般情報提供者の幼児と家族9組、医師5名とした。</p><p> 結果 : 1. 「険しい」 表情が続く時は、眠れない原因があると推測し、鎮静深度を見極めていた。2. 目を閉じていても口を動かす表情の時は、計画外抜管の可能性を予測し呼吸の安定を維持させていた。3. 鎮静薬中止後、3時間経過しても 「うつろな」 表情の時は、病態の悪化があると予測し急激な悪化を防ぐ対応につなげていた。4. 覚醒しても 「ぐったり」 で 「辛そうな」 表情の時は、呼吸や循環の影響を予測し安静にさせるケアを優先させていた。</p><p> 考察 : 鎮静下において、眉間や目元口元のわずかな表情の変化を捉えて、今後起こり得る異変を予測し今必要なケアを見極めていたと考える。</p>

<p> Purpose: To demonstrate how nurses observe and utilize the facial expressions of infants in the PICU under sedation for caregiving purposes.</p><p> Method: Leininger's Transcultural Nursing Theory was applied. The study infants comprised eight nurses in addition to general information providers comprising nine families with infants and five doctors.</p><p> Results: 1. If a "grim" expression persisted, nurses tried to identify the most suitable depth of sedation to address possible causes of sleeplessness. 2. If the infant's eyes were closed but the mouth was moving, nurses tried to maintain the infant's breathing stability while anticipating a possible unplanned extubation. 3. If an "empty gaze" was present three hours after coming off sedative medication, nurses anticipated a worsening of clinical condition and responded to prevent acute deterioration. 4. If the expression was "limp" and "with signs of distress" after being awakened, nurses anticipated impact in the area of breathing and circulation, and prioritized the maintenance of restfulness.</p><p> Discussion: During sedation, nurses watch for subtle changes in expression in the area between the eyebrows, or near the eyes, and the mouth, to anticipate a possible abnormality in the coming hours and determine the care needed at that time.</p>

Journal

  • Journal of Japanese Society of Child Health Nursing

    Journal of Japanese Society of Child Health Nursing 26(0), 166-172, 2017

    Japanese Society of Child Health Nursing

Codes

  • NII Article ID (NAID)
    130006230341
  • NII NACSIS-CAT ID (NCID)
    AA11583347
  • Text Lang
    JPN
  • ISSN
    1344-9923
  • NDL Article ID
    028820883
  • NDL Call No.
    Z19-B293
  • Data Source
    NDL  J-STAGE 
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