検査・処置を受ける子どもと医療者のずれ

The Gap Between Health Care Professionals and Children Who Receive Medical Procedures

　検査・処置を受ける子どもと医療者の間にどのようなずれがあるのかを明らかにすることを目的として研究を実施した。研究の主旨を説明し，承諾の得られた2～10歳までの子どもとその処置を担当した医師，看護師17組を研究参加者として，参加観察法と半構成的面接法を用いてデータを収集した。子どもの親からも承諾を得た。データを質的に分析した結果，両者の間に①子どもの能力と医療者の判断のずれ，②子どもの反応と医療者の対応のずれ，③状況の読み取りのずれ，の3つのずれが見いだされた。また，その要因として，医療者側が，処置を早く終わらせたいと思っていること，子どもと体験を共有していないこと，子どもの力を引き出すような関わりをしていないことが考えられた。処置の際に，看護師は子どもに情報を提供し，子どもが自らがんばりたいと思っている気持ちを尊重し，その力を引き出していく関わりをもつ必要があることが示唆された。

　The purpose of this study was to identify the gap between health care professionals and children who receive medical procedures. The participants were seventeen two- to ten-year-old children, physicians and nurses who involved in the procedures. They were informed the purpose of research and agreed to become as participants. Observation and interviews were used for research methods. The data were analyzed qualitatively.

　The gap between health care professionals and children were as follows :

　There was the gap between health care professionalsﾕ judgment of childrenﾕs ability and childrenﾕs actual ability.

　There was the gap between childrenﾕs behavior while they received medical procedures and health care professionalsﾕ responses to that.

　There was the gap in understanding of the situation between children and health care professionals. Because health care professionals performed procedures on their own way, children couldnﾕt understand what would be going on.

　The results showed health care professionalsﾕ lack of ability of imagination and consideration. As health care professionals thought that it was good to finish procedures as fast as possible, they couldnﾕt afford to imagine of childrenﾕs feelings and efforts.

　Nurses need to know childrenﾕs feelings and efforts, so that they can increase childrenﾕs potential and actual ability while children receive medical procedures.