終末期がん患者の在宅療養移行支援に対する病棟看護師の役割の認識

Recognition of the Role of General Ward Nurses in Supporting Transition of End-stage Cancer Patients to Home Care Settings

要旨

目的：病棟看護師を対象に面接調査を実施し，終末期がん患者の在宅療養移行支援における看護師の役割の認識を分析することを目的とした．

方法：がん診療連携拠点病院において，終末期がん看護を実践する看護師を対象に半構造化面接を実施し，得られたデータを質的帰納的に分析した．

結果：対象者は臨床経験年数3〜7年の看護師6名であった．分析の結果，終末期がん患者の在宅療養移行支援における役割の認識として，16のカテゴリ，34のサブカテゴリが得られ，カテゴリの特徴から《患者と家族を中心に見据えた看護実践》《関連職種連携力の発揮》《自己の立場を自覚した行動》《役割開発への取り組み》の4つに分類することができた．

結論：終末期がん患者の在宅療養移行支援において病棟看護師は，自己の立場を意識した積極的支援と関連職種連携を重視し，自己の課題を内省して役割を獲得していくことも視野にあることが示唆された．これらの役割の認識と具体的な行動との関連，移行支援に関連する要因について検討していくことが今後の課題である．

Aim: The present study aimed to analyze the recognition by general ward nurses of their role in supporting transition of end-stage cancer patients to home care setting.

Method: Semi-structured interviews were conducted with nurses in designated cancer hospitals, who provided care to end-stage cancer patients, for performing a qualitative and inductive analysis of the obtained data.

Results: Participants were 6 nurses with 3 to 7 years of clinical experience in 2 designated cancer hospitals. Our analysis revealed 16 categories and 34 subcategories of recognition of the role in supporting transition of end-stage cancer patients to home care settings. 4 characteristics were suggested from 16 categories including “nursing practice focusing on patients and their family members,” “using interdisciplinary cooperation skill,” “behaviors on understanding one's nursing role,” and “addressing the role development”.

Conclusion: Such obtained categories suggest that, in supporting the transition of end-stage cancer patients to home care setting, nurses emphasize active support while understanding their role as a nurse and interdisciplinary cooperation, and consider enhancing their role through introspection of own challenges. Our future task is to examine the relationship between such awareness of roles and specific behaviors and factors relating to support for transition.