COVID-19患者の看取りに関する看護師の経験：現象学的アプローチを用いた記述研究

Experiences of nurses caring for patients with COVID-19 during the end-of-life process: A phenomenological approach

　目的：看護師にとってCOVID-19患者の看取りはどのような経験であったのかを明らかにすることを目的とした。

方法：COVID-19患者の看取りを経験した5年以上の臨床経験をもつ看護師3名に非構造化インタビューを行い、現象学的アプローチを用いて分析した。

結果：【看護師としてだけでなく、人としても許せないことをしてしまった後悔を感じる】と振り返りつつ、【経験を積み重ねてきた自分であっても初めての看取りがあることに驚き戸惑（った）】いながら、【作業ではない看護を改めて考える】、【自分の看護の力量を再確認】する機会となっていた。結論：看護師は患者の尊厳を守ることができなかった看取りに後悔と苦痛を感じており、非日常時でも患者の尊厳を守るケアの在り方を考える必要がある。看護の本質を再考する機会となっており、ネガティブな感情と向き合いながら看護師として成長していく経験であることが示唆された。

　Purpose: This study aimed to describe the experiences of nurses caring for patients with COVID-19 during the end-of-life process. Methods: We conducted unstructured interviews with three nurses who had 5 years of clinical experience and cared for patients infected with COVID-19.Their narrated experiences were analyzed using a phenomenological approach. Result: Participants reflected on their regrets, such as “I feel regret for having done something unforgivable, not only as a nurse, but also as a person.” and “I was surprised and perplexed that even I, who had accumulated so much experience, was having end-of-life care for the first time.” The experiences also provided an opportunity for the nurses to “Thinking again about nursing that is not work” and to “reaffirm my strengths as a nurse.” Conclusion: Nurses expressed regrets and distress for being unable to maintain patients’ dignity during the end-of-life care of patients with COVID-19. Therefore, it is necessary to consider the approach to caring for a patient’s dignity even under unusual situations. It was suggested that this experience was also an opportunity for nurses to reconsider the essence of nursing and the importance of recapturing negative emotions, and to grow as a nurse.