看護師の視点からとらえた輸液療法が患者の療養生活行動を妨げるプロセス  [in Japanese] Obstruction of daily activities in patients undergoing fluid therapy：nurses’ perceptions  [in Japanese]

 はじめに：輸液療法は効果や安全を優先して実施される一方，患者はさまざまな我慢を強いられる．今回，輸液中の患者の療養生活行動がどのように妨げられているのかを明らかにした．<Br> 方法：2013年７～８月に一大学病院に勤務する看護師14名を対象に，輸液療法による患者の離床の妨げとその要因，離床促進の工夫についてフォーカス･グループ・インタビューを行い，語りをグラウンデッド・セオリー法を援用し，継続比較分析を行った．<Br> 結果：対象者の語りから６個の【カテゴリ】が生成され，療養生活行動の妨げにいたるつぎのプロセスが明らかとなった．１）【輸液の投与条件】や【輸液投与デバイス】は，特定の【患者の状況】や【療養環境】下で，【療養生活行動への諦め】を引き起こす．２）【療養生活行動の妨げ】は【療養生活行動への諦め】を引き起こし，【療養生活行動への諦め】は【療養生活行動の妨げ】を引き起こす，双方向の関係があった．<Br> 結論：療養生活行動の妨げを予防するためには，輸液療法中の環境や患者の状態だけでなく，療養生活行動への諦めに対するアプローチが必要である．

 Purpose：Fluid therapy is chosen for its good effect and reliable patient safety. However, patients receiving it often have to endure various inconveniences. This study aimed to examine how patients’ daily activities are hindered while undergoing fluid therapy.<Br> Methods：Focus group interviews were conducted on two groups of nurses（14 nurses in total）working at a university hospital in July and August 2013. They were interviewed regarding the difficulties patients undergoing fluid therapy experience when leaving the bed, the cause of such difficulties, and what efforts nurses are performing to facilitate bed leaving. Their comments were sorted into categories using a constant comparative method of the grounded theory approach.<Br> Results：Comments were sorted into six categories, which revealed the following process：1）The［transfusion condition］and［transfusion device］triggered a［sense of helplessness towards daily activities during treatment］under certain［patient conditions］and［treatment environments］. 2）［Obstacles to daily activities during treatment］and［sense of helplessness towards daily activities during treatment］mutually triggered each other.<Br> Conclusions：In order to prevent obstruction of daily activities during fluid therapy, approaches to mitigate the sense of helplessness towards daily activities, along with approaches to improve the fluid therapy environment and patients' conditions, are required.