PICUにおいて生命の危機状態にある子どもと家族のふれあいを促すための看護実践

Nursing Practices in Pediatric Intensive Care Unit to Promote Interaction Between Children With Life-Threatening Conditions and Their Family Members

要旨

　目的：本研究は，PICUにおいて生命の危機状態にある子どもと家族のふれあいを促すための看護実践について明らかにすることを目的とした．

　方法：PICUにて5年以上臨床経験のある看護師10名に半構造化インタビューを行い，質的記述的に分析した．

　結果：看護実践は，【面会前に備える】という準備段階から始まっており，【子どもと家族が会う場面を支える】【家族が子どもと関わりともに過ごせる時間をつくる】という身体接触を含むふれあいを促す介入が示された．さらに，【子どものことや看護師の思考を家族に伝える】【子どもと家族のことを知る】という心理面に焦点をあてた介入も見出され，多岐に渡る内容で構成された．

　結論：PICUにおけるふれあいを促すための看護実践とは，身体接触を促すことに留まらず，家族の心理に寄り添い，必要な情報を伝え，ニーズを把握することも含まれた．これは，心の通い合いがあってこそふれあいが成り立つことを示す知見であると考える．

　Objectives: The present study aimed to elucidate nursing practices in Pediatric Intensive Care Units(PICU)that promote interaction between children with life-threatening conditions and their family members.

　Methods: Semi-structured interviews of 10 nurses with at least 5 years of clinical experience in PICU were conducted, and their responses were qualitatively analyzed using a descriptive approach.

　Results: Intervention found in settings that promote physical contact started from the preparatory stage, such as "preparing before meeting," and included "supporting the child and their family meetings" and "arranging time for family members to be involved and spend time with their child." Furthermore, an intervention that focused on psychological aspects, such as "extending support to the family about the child and nurse's thoughts" and "getting to know the child and their family members," was also found, showing the variety of nursing practices.

　Conclusions: Nursing practices that promote interaction in the PICU promote physical contact and include psychologically connecting with the family, communicating important information, and ascertaining their needs. We believe this finding demonstrates that emotional communication is useful for establishing interaction.