臨床における看護師のプラシーボ与薬の実態に関する全国調査

A questionnaire survey on the use of placebo in clinical practice by nurses in Japan

臨床で働く看護師が治療行為として実施しているプラシーボ与薬の現状を、全国300床以上の病院954施設の病棟看護師を対象とし無記名自記式質問紙にて調査した。回答者の86％が過去に与薬の経験を持ち、約半数がプラシーボ与薬は効果が「とてもある」または「ある」と答えた。「プラシーボ与薬は倫理に反すると思うか」という設問に「反するとは思わない」と答えた者は59％(n=192)であった。プラシーボ与薬後に患者の苦痛が消失した場合「効果があれば真実を告げなくても良い」と答えた者は約60％であった。看護師はプラシーボ与薬に対して道徳的な不確かさを感じてはいるのだが、問題を深く省察するまでには至らず、多忙な業務に埋没していた。

We surveyed the current state of placebo administration by clinical nurses working in Japan using self-written unsigned answer sheets. We sent a questionnaire to 954 hospitals that have over 300 beds, all over the country. Eighty nine percent of the nurses who responded had used a placebo and about half of these nurses (166, 48%) reported that the placebo was effective or very effective. Fifty nine percent of nurses (192) believed the practice to be ethically permissible. When use of placebo was effective in the patient, about 60% was answered as “If it is effective, you may not speak the truth”. We found that nurses' experience influences their ethical attitude. When administering the placebo nurses had feelings that they could be in a moral ambiguity. However, they did not have time to reflect on these feelings as they were buried in their routine work.