一般病棟での臨床経験を有する看護師が緩和ケア病棟に配属されて2年未満に経験する心理的負担と対処

The Characteristics of Psychosocial Burden and Coping among Palliative Care Nurses in Less than 2 Years Who Have Clinical Experiences

要旨

目的：一般病棟で臨床経験を有する看護師が，初めて緩和ケア病棟に配属された後，2年未満に感じる心理的負担と対処の特徴について明らかにする．

方法：質的記述的研究方法とし，半構成的インタビュー法を用い，得られたデータを質的帰納的に分析した．

結果：7名の緩和ケア病棟看護師の個別分析結果を統合し，4段階の分析過程を経て，心理的負担は8の上位カテゴリーに集約され，心理的負担への対処は9の上位カテゴリーに集約された．

結論：1）緩和ケア病棟看護師が配属後2年未満に感じる心理的負担の特徴は，【自分の経験がゼロになったような無力感と戸惑い】が中核となり，三層に構造化され，この中で，心理的負担は看護経験を重ねる過程で変化していたが，その一方で経験を重ねても抱き続ける心理的負担もあることが明らかになった．2）心理的負担に対して，看護経験を重ねる過程で後ろ向きの対処から前向きな対処へと変化しており，これらの変化に影響を与える要因には，緩和ケア病棟看護師のレジリアンスが関係していると考えられた．

Purpose: The purpose of this study was to clarify the characteristics of psychosocial burden and coping among nurses with clinical experience in a general hospital assigned to the palliative care ward for the first time within 2 years.

Methods: A qualitative, descriptive study method using semi-structured interviews was adopted. The obtained data ware analyzed qualitatively and inductively.

Results: Individual analysis results of seven nurses in the palliative care ward were integrated, and the psychosocial burden was consolidated into eight categories through a four-stage analysis process. Coping with psychosocial burden was also consolidated into nine categories.

Conclusion: Core characteristics of psychosocial burden reported by nurses assigned to the palliative care ward were 1) “Feelings of confusion and helplessness as if one had zero experience.” This and similar experiences were then structured into three layers. While psychosocial burden changed with years of nursing experience, it was revealed that nurses experienced psychosocial burden that continued even after gaining more experience. 2) The coping process of nurses changed from negative coping with their psychosocial burden to positive coping on gaining more experience. The resilience of nurses in the palliative care ward is thought to be related to this change in process.