精神科看護師の患者看護師関係における共感体験

Empathy Experienced by Psychiatric Nurses through the Patient-Nurse Relationship

要旨

目的：精神科看護師が日常的な看護実践の中で意識的あるいは無意識的に経験している患者看護師関係における共感体験の特徴を明らかにすることである．

方法：精神科看護経験を5年以上有する看護師30名を対象として非構造的面接を実施した．面接では関係性が深化し印象に残っている事例とのかかわりについて語ってもらい，Bennerの解釈的現象学に依拠して解釈した．

結果：精神科看護師の患者看護師関係における共感体験として，4つのテーマが解釈された．「患者との関係性への関心と患者理解に向かう欲動」「患者と看護師の人間性や生活史が影響しあう」というテーマには，看護師が患者にコミットメントし，患者の負の感情や苦悩を緩和したいという看護師の願望が現れていた．また「ケアの効果の現れで体験する確かに通じ合えた感覚」「時空を超えた一生の絆」というテーマには，患者と看護師が通じ合え，両者の間で喜び，感動，驚きなどの感情体験や安心感，満足感が共有されたことが現れていた．

結論：精神科看護師の患者看護師関係における共感体験は，ケアの一場面を取り出して説明できる現象を超えたものであり，日常のケアの連なりの中や両者の生きる時間が影響しあう中で体験されることが考えられた．

Purpose: This study aimed to elucidate the characteristics of conscious and unconscious empathy that psychiatric nurses experience through their patient-nurse relationships in daily nursing practice.

Methods: Unstructured interviews were conducted with 30 psychiatric nurses who had ≥5 years of work experience. Nurses described relationships with patients that had deepened and left an impression on them. The data were analyzed within the framework of Benner's interpretive phenomenology.

Results: Analysis on empathetic experiences of psychiatric nurses within their patient-nurse relationships interpreted 4 themes. The first 2 themes, concern about their relationship with patients and instinctual drive for understanding the patients and mutual effect between personality characteristics and life histories of patients and nurses, demonstrate nurses' commitment and desire to relieve patients' pain and negative feelings. The second 2 themes, feeling of a genuine connection with patients as confirmed through therapeutic effect and a lifelong bond surpassing time and space, demonstrate mutual understanding, sharing of joyous, tender, and unexpected moments, and feelings of security and satisfaction between nurses and patients.

Conclusion: These findings suggest that empathy experienced by psychiatric nurses through the patient-nurse relationship is a phenomenon that cannot be explained by only one particular scenario of nursing care, and is rather an experience acquired through the association between everyday nursing care and the time that nurses and patients are living in.