介護老人保健施設の看取りにおける看護管理者の実践内容

Efforts made by nurse administrators during end-of-life care at geriatric health service facilities

　本研究の目的は、介護老人保健施設の看取りにおける看護管理者の実践内容を明らかにすることである。看取りを行っている39施設に勤務する看護管理者39名に質問紙調査を実施した。回収数は36（92.3％）で、全てを有効回答として分析した。その結果、看護管理者は、入所者と家族の希望や不安を引き出しながら、いつもの日々が安楽で安全に過ごせるよう、細やかな配慮を行っていた。入所者の経過に伴う家族の揺れる気持ちに寄り添っていた。また、施設のスタッフの葛藤や不安に対する支援を行っていた。看護管理者はスタッフに対し、看取りを通して死生観を深めて欲しいと願っていた。そのためには、デスカンファレンスの実施や思いを語れる場をつくることの必要性が示唆された。

　The purpose of the present study is to clarify the efforts made by nurse administrators during end-of-life care at geriatric health service facilities. A questionnaire survey was provided to 39 nurse administrators working for 39 facilities that provide end-of-life care. A total of 36 valid responses were received (response rate 92.3％) and analyzed. According to the survey results, overall, respondents took meticulous care to ensure that residents live a safe and comfortable daily life, drawing out needs and concerns from residents and their families. The respondents also supported residents' families when they experienced emotional changes associated with the residents' changing health conditions. Furthermore, the respondents helped their facility staff resolve emotional struggles and concerns. Finally, the respondents hoped that their staff would develop their own views of life and death through end-of-life care, which suggested the need to organize death conferences or create other opportunities for their staff to share their thoughts and feelings with colleagues.