看護観が体験から発展するまでの看護師の思考のプロセス

How Nurses Develop Their Nursing Philosophy from Their Personal Experiences

要旨

目的：看護観が自己の体験を通して発展するまでの看護師の思考のプロセスを明らかにすること．

方法：看護実践経験5年以上で，看護部長から看護観が確立していると判断された看護師を対象に半構造化面接を実施し，得られたデータは修正版グラウンデッド・セオリー・アプローチを参考に分析した．

結果：17名の面接から8カテゴリーが生成された．看護観の発展には〈自己の看護が揺らぐ体験に直面〉をした看護師が〈体験との向き合い〉により〈自己の看護の考え方の広がり〉を得て〈めざす看護の定まり〉がなされる【看護観形成過程】と，その実現に向け〈看護ケア方法の探索〉をして〈めざす看護を意識した看護ケアの実践〉を行い〈看護ケアの承認による看護への自信〉を得る過程を繰り返し〈体験の積み上げによる看護観の確立〉に至る【看護観確立過程】があった．

結論：体験により内的に形成された看護観を意識した看護ケアの実践の積み重ねで看護観が発展していくことが示された．

Purpose: The research aim was to clarify how nurses develop their nursing philosophy from their nursing practices.

Methods: Semi-structured interviews were conducted with nurses who had at least five years of practical nursing experience and who the Director of Nursing determined had an established nursing philosophy. The obtained data were analyzed using the modified grounded theory approach.

Results: Eight categories emerged from the analyzed interview data of 17 nurses. These were divided into two processes: [Formative Nursing Philosophy] and [Establishment of Nursing Philosophy]. The former process relates to when a nurse who has <experienced fluctuating nursing philosophy> attempts a <confronting his or her experienced fluctuating nursing philosophy>, <expanding his or her nursing ideas> and then <deciding his or her nursing philosophy>. The latter process relates to when a nurse <establishes nursing philosophy through nursing practical experience> by <searching for nursing care methods that suit his or her nursing philosophy>, <experimenting with nursing practices while conscious of his or her nursing philosophy>, and repeatedly obtains <recognition for nursing care>.

Conclusion: These results indicated that the nursing philosophy develops by internal reflection from experience, and by performing nursing practice that is conscious of the formed nursing philosophy.