KANGO-KENKYU Volume 40, Issue 2 (April 2007)

Clinical Judgments and Nursing Actions in the Effective Care for Children and Their Families Masako Yoneyama 1 , Tomomi Sato 2 , Miwa Iwasaki 3 , Mayumi Tsutsui 4 , Shiho Nishida 4 , Hiroko Kusayanagi 5 , Miyuki Hirano 6 , Makiko Fukuchi 7 , Ruri Kawana 8 , Daisuke Odaka 9 , Rina Emoto 4 , Naoko Iimura 4 1Kanagawa University of Human Services 2Tokai University 3The University of Tokyo Hospital 4The Japanese Red Cross College of Nursing 5Musashino University 6Kanagawa Children's Medical Center 7Saitama Children's Medical Center 8Showa University 9Musashino Red Cross Hospital Keyword: ケア効果 , 臨床判断 , 子ども , 家族 , エピソードインタビュー , care-outcome , clinical judgment , children and families , episodic interview pp.159-169
Published Date 2007/4/1
DOI https://doi.org/10.11477/mf.1681100136
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 [Purpose] The objective of this study is to describe clinical judgments and nursing actions in the effective care for children and their families.  [Method] Twelve pediatric nurses, all either graduate students or master's degree holders, with five years of clinical experience or more, were participated in this study. They were informed of the purpose and outline of the study and signed in. Flick's episodic interview method was used for the analyses.  [Findings and Discussion] Clinical judgments and nursing actions were categorized into five groups :   1) In the situations where children refused the nursing care, nurses recognized the gaps between adults' perception and their understanding. Nurses tried to find out the reason of the refusal, explore the way that they could cope with, explain their misunderstanding, and confirm their will.   2) In the situations where children and their family were at a loss what to do, nurses judged the most important thing for them as well as for the family. And nurses supported them to find it out and carry it out. Also nurses tried to listen and confirm the restrained feelings of the family, set the necessary steps to realize it, and prompt them to do it.   3) In the situations where children were going to die, nurses recognized that their family would totally regret if they did not face it, and that nurses had to tell the truth to the family. So nurses tried to listen to other nurses' opinions, inform the family of the truth, and set up the final occasion for children and family to spend together.   4) In the situations where children being incapable to communicate were frustrated, nurses recognized that standing up for them would promote their recovery. So nurses observed their condition, seize on the chance to fulfill their demands, and kept evaluating.   5) Even in the situations where nurses felt most difficult nursing case, nurses tried to find out the children's hidden abilities in obscure signs, confirm their responses, and inform it to the other staff.  To accomplish effective nursing actions, nurses need to accumulate and reflect on their experiences through their own narratives.

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40巻2号 (2007年4月)
電子版ISSN 1882-1405 印刷版ISSN 0022-8370 医学書院