ラオス人民民主共和国の中核病院における看護実践の変化—アクションリサーチを用いて

The Changes in Nursing Practice in the Central Hospital in Lao People's Democratic Republic: Action Research Study

要旨

目的：ラオス中核病院で働く看護師の臨床判断の特徴から，看護実践の課題を抽出し，課題への取り組みを実践するアクションリサーチ（以後ARと表記）を通して，看護実践がどのように変化したのかについて，終了時の臨床判断の特徴から明らかにし，AR過程で看護実践に変化をもたらした要因について検討する．

方法：研究協力看護師17名とARグループを作り，3段階のAR過程をとった．AR開始前・終了時に研究協力者に対し，実践したケアについて半構造化面接を行い，データをタナーの臨床判断モデルを利用して質的分析を行い，会議記録を内容分析した．

結果：臨床判断の特徴から，4つの看護実践課題を抽出した．AR過程によって，パターン化した看護師の臨床判断の特徴は，個の患者へ焦点化され，看護実践の変化をもたらした．

結論：AR過程を通して，看護実践に変化が認められ，2つの変化要因が認められた．

Aim: This study aimed to identify the challenges of Laotian nursing practice from the characteristics of nurses' clinical judgment and through Action Research (AR) in order to improve nursing practice, identify how their nursing practices have changed from the characteristics of nurses' clinical judgement at the end of AR and discuss the factors of changes of nursing practice.

Method: An AR group of 17 nurses (research cooperators) was created that underwent three stages in the process of AR. We conducted semi-structured interviews before and after AR with the research cooperators about the nursing practice they performed and conducted a qualitative analysis of the interview data using Tanner's clinical judgment model. The records of meetings organized in the process of AR were analyzed qualitatively.

Results: We identified 4 challenges of nursing practice, and through the process of AR, found that research cooperators' characteristics of clinical judgment have shifted from being fixed to focusing on individual patients, and their nursing practices have changed.

Conclusion: Through the process of AR, we found that their nursing practices have changed and there were two factors of the changes.