きょうだいを主役にする：小児集中治療室入院児と面会するきょうだいへの働きかけ

Bringing Siblings to the Center: Support for Siblings Visiting Children Hospitalized in the PICU

要旨

目的：きょうだいが小児集中治療室（以下PICU）に入院中の子どもに面会する場で，両親と看護師はきょうだいにどのように関わり，それがきょうだいにどのような影響を及ぼすのかを明らかにする．

方法：A病院PICUで9名のきょうだいが面会する場面の観察と，きょうだいと一緒に面会した4名の母親と1組の両親へのインタビューを実施し，グラウンデッド・セオリー・アプローチを用いて分析した．

結果：両親と看護師による，《患児との対面の促し》《患児への関心につなげる説明》《患児に触れる促し》【きょうだいを主役にする】という一連の働きかけが適切に行われることで，きょうだいに《患児を身近に感じている様子のきょうだい》という変化が生じていた．

結論：きょうだいに《患児を身近に感じる》という変化が生じるためには，看護師が両親と協働してきょうだいの患児への関わりを促し，【きょうだいを主役にする】という働きかけを行うことが重要である．

Purpose: To identify the processes by which parents and nurses can support siblings visiting children hospitalized in the pediatric intensive care unit (PICU), and what kind of change occurred in the siblings through the visits.

Method: We observed nine siblings visiting children hospitalized in the PICU, and performed semi-structured interviews with four mothers and one pair of parents, who accompanied them. The observation and interview data were analyzed using a grounded theory approach.

Results: Parents and nurses supported siblings visiting children hospitalized in the PICU by «prompting them to approach the hospitalized child»«providing explanations to get siblings interested in the hospitalized child»«prompting them to touch the hospitalized child», and [bringing siblings to the center]. Through continued steps of related support, a change occurred in the siblings, specifically that they had a «feeling the hospitalized child was closer».

Conclusion: It is important to cause changes in siblings toward the «feeling the hospitalized children was closer». Nurses should support the siblings, in cooperation with parents, and provide the support that assists in [bringing siblings to the center].