苦痛を伴う検査時の看護師の関わり―話しかける介入と話しかけながらタッチする介入の対比

Nurse Intervention during Painful Investigations：Comparison of Talking versus Talking and Touching

要旨

　目的：検査を受ける患者の心身の苦痛を軽減する方法として，検査中に話しかける介入または話しかけながらタッチする介入で，患者の感じ方や気持ちに違いがあるかを明らかにすることである．

　方法：胃内視鏡検査を受ける入院患者43名を話しかけ群21名と話しかけタッチ群22名に振り分け介入し，気分調査票を用いて検査前と検査中の気持ちを調査し，かつ自由な感想を得た．

　結果：話しかけ群では検査前と検査中の気持ちに差はみられなかったが，話しかけタッチ群では，緊張や気がかりで落ち着かない気持ち（緊張と興奮），沈みがちな気持ち（抑うつ感）がやわらぎ，リラックスする気持ち（爽快感）が高まっていた（いずれもp＜.05）．また，両群とも看護者の介入に対し【苦痛に耐えるための心強い励まし】【身体的緊張の緩和】【精神的緊張のやわらぎと安心感】【自分に向けられた思いやり】を感じていたが，話しかけタッチ群では【親や家族がそばにいるようなぬくもりとやすらぎ】【好意に対するうれしさ】という感想が聞かれた．

　結論：苦痛を伴う検査を受ける患者は，看護者により話しかけられながらタッチされるほうが，より検査を楽に受けられると考えられた．

Abstract

　This study investigated whether nursing intervention by talking, or talking and touching, as a method to reduce the physical and mental discomfort of patients undergoing investigations creating physical discomfort, resulted in differences in their experience and feelings.

　The study divided 43 patients undergoing gastroscopy into 2 groups, one group of 21 patients receiving talk intervention only, and one group of 22 patients receiving talking and touch intervention, with a survey conducted of the patient's emotional state before and during the investigation, and free reporting of the patient's thoughts.

　No difference was found in the emotional state of the talk intervention group before and during investigation, while for the talking and touch group, there was amelioration in their feelings of restlessness (tension and excitement) due to tension and concern, and feeling down (depressed feeling), and an increase in feelings of relaxation (relief) (all p＜.05). In response to nurse intervention, both groups reported feelings of “strong encouragement to help me get through the discomfort”, “relief of physical tension”, “peace of mind and relief of mental tension”, and “kindness directed at me”, but the talking and touching group reported feeling “warmth and peace, like a family member was with me”, and “happiness at the nurse's kindness”. The above results show that talking and touching intervention ameliorates patient discomfort more during investigation.