ICU緊急入室患者の家族員の情緒的反応に関する研究

A Study on the Emotional Responses of the Families of ICU Patients on Emergency Admissions

要旨

　本研究の目的は，ICUに緊急入室した患者の家族員が表す情緒的反応を明らかにし，家族員が状況に適切に対応できるための看護援助のあり方を検討することである．ICUに緊急入室した患者の家族員8名を対象に，情緒的反応に関する内容について半構成的面接と参加観察による調査を行い，質的帰納的に分析し，以下を明らかにした．

　ICU緊急入室患者の家族員の情緒的反応は，【先の見通しが立たない】，【医療者を信頼する】，【支えられている】，【負担に感じる】，【患者を守りたい】など，17の主題にまとめられた．さらに，その意味の性質から，『回復の期待』，『医療への信頼』，『独りではない自分』，『課せられている自己』，『家族の絆』の5つの情緒的反応の本質が抽出された．

　家族員が状況に適切に対応できるための看護援助のあり方は，家族員が回復の期待を持ち続けることができる援助，家族員が医療への信頼を実感できる援助，家族員が周囲の支援を効果的に使うことができる援助，家族員が看病を長期的視野に入れることができる援助である．

Abstract

　The purpose of this study is to clarify the emotional responses of the families of patients who are suddenly admitted to the ICU. Further,we considered the best nursing approach for helping the families cope with the situation. Eight subjects, whose family members were suddenly admitted to the ICU, participated in this investigation.We conducted semi-structured interviews and used participant observation to collect data on the emotional responses of subjects. We analyzed this data using qualitative induction.

　The emotional responses of the subjects were categorized into 17 themes. These included ‘concern regarding unpredictability’, ‘dependence on medical staff’, ‘being supported’, ‘burdensomeness’, ‘wish to protect a patient’. Upon considering the deepest meaning of the abovementioned responses,we could finally determine their roots as being：“expectation of recovery”, “reliance on medicine”, “not feeling alone”, “duty and responsibility”, and “familial ties”.

　In summary, the nursing support required for helping the families of ICU patients cope with the situation involved the following：providing reaffirmation for the family's constant expectation of the patient's recovery, facilitating their realization that reliable medicine was available, ensuring that various aids were easily accessible to them, and encouraging their acceptance of long-term care.