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共同問題について臨床で共同問題を使用するうえでの課題を検討するために,看護師267名を対象に実態調査を行った.その結果,全対象の65%が臨床で共同問題を使用していた.そして共同問題を使用している者の7割,使用していない者の半数が共同問題を必要と考えていた.共同問題を使用し,かつエキスパート性の認められた分析対象者161名により評価された使用頻度・重要度の高い共同問題は,生命の危機に直結し,臨床領域の各科で共通して生じることの多い病態に関連したものであった.また使用頻度・重要度の低い共同問題は生殖系に関連したものであった.共同問題の使用にあたって,医師とのコンセンサスはほとんど得られていなかった.以上をふまえ,安易に共同問題を使用するのではなく,効果的な看護を患者に提供できる方策を探るために,共同問題を使用するうえでの課題に取り組むと同時に,看護診断の開発に向けた努力の必要性が示唆された.
The state of the use of collaborative problems was investigated in 297 nurses to evaluate issues in the clinical use of collaborative problems. As a result, 65%of the subjects were using collaborative problems clinically, and 70%of those who were using them, and 50%of those who were not considered that the clinical use of collaborative problems was necessary. In 161 subjects who were using collaborative problems and were considered to be experts in their use, collaborative problems that were used frequently and were important were related to conditions that are directly associated with crises of life and frequently occur in all clinical departments regardless of the specialty, and those that were used less frequently and were less important were related to the reproductive system. Collaborative problems must be managed in cooperation with physicians, in principle, but little consensus with physicians was established. These results suggest that exploration of strategies to provide effective nursing to patients based on sufficient understanding of nursing diagnoses and collaborative problems is necessary rather than readily resorting to collaborative problems.
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