精神状態の急性増悪に直面した家族の体験に関する文献検討

Literature Review of Family Experiences of People with Mental Health Crises

要旨

　目的：精神状態の急性増悪に直面した家族の体験について，文献から明らかにし，看護実践と研究への示唆を得る．

　方法：医学中央雑誌，PubMed，CINAHLを用いて，精神状態の急性増悪に直面した家族の体験について論じられている原著論文を抽出した．メタエスノグラフィーを参考に各論文を比較検討し，家族の体験を明らかにした．

　結果：7論文を比較検討した結果，家族の体験には，「対応を要する事態であると気づく」「あらゆる手を尽くす」「必要なケアを受けられず苦悩する」「高い（低い）専門家たちの対応の質に触れる」「ケアから排除される」「医療従事者の対応によって苦悩する」があった．

　結論：精神的・身体的打撃に晒されながら必要な支援を受けられずにいる家族に対して，国内でも早期介入サービスの構築が望まれる．また，看護師は，家族が自信を持って精神状態が悪化した人に関われるよう，必要な情報を互いに共有し合う姿勢を持つ必要がある．国内でも同様の研究をしていく必要がある．

　Objective: To elucidate the experiences of the families of people who have experienced mental health crises, and to obtain suggestions for nursing practice and research through a review of the literature.

　Method: Using Ichu-shi web databases, PubMed, and CINAHL, the authors extracted original papers that discuss such family experiences, and compared them with reference to metaethnography.

　Results: Comparison among seven papers identified the following six family experiences: “Realization that the situation needs to be dealt with,” “Doing everything possible,” “Suffering from being unable to receive the necessary care,” “Finding out the high (low) quality of professionals response,” “Exclusion from care,” and “Suffering after receiving necessary care.”

　Conclusion: Early intervention services need to be established in Japan for families who are exposed to shock and physical battering but are unable to receive the necessary support. It is also necessary for nurses to be open to sharing necessary information with families so that they can be confidently involved in the care of the family member with mental illness. There are no studies discussing this theme available in Japan.