小児特発性ネフローゼ症候群患者のプライマリナースの薬理学的知識と看護実践状況

The Knowledge of Pharmacology and Nursing Practice for Children with Idiopathic Nephrotic Syndrome

要旨

　目的：小児特発性ネフローゼ症候群（INS）患者のプライマリナース経験がある看護師における，小児INS治療計画に関する知識および看護実践状況とプレドニゾロン（PSL）の添付文書に基づく薬理学的知識の現状を明らかにすることである．

　方法：大学附属病院または地域医療支援病院の小児病棟に在籍している看護師697名に質問紙調査を実施した．

　結果：分析対象者210名を小児INS患者のプライマリナース経験有群と無群に分け比較を行った．治療計画に沿った看護を行っているものは，有群89名（90.8％），無群98名（89.1％）であった．また，併用注意をまったく知らないものは，有群30名（30.6％），無群39名（35.5％）であった．プライマリナース経験の有無により，知識や看護実践状況に有意な差はなかった．

　結論：小児INS患者のプライマリナースは，治療計画は把握していたが，ガイドラインに基づく看護を行っていない可能性がある．また，治療計画と薬理学の知識との乖離が示された．

　Objective: This study was performed to investigate knowledge of nurses with experience in caring for children with idiopathic nephrotic syndrome (INS) about treatment regimens, knowledge of pharmacology based on the package insert for prednisolone, and nursing practice.

　Methods: Six hundred and ninety-seven nurses working at the children's ward in public hospitals and regional support hospitals were asked to enroll in this study.

　Results: We analyzed the responses of 210 out of 226 nurses who consented to the study by comparing knowledge of pharmacology nursing practice between nurses with and without experience in caring for patients with INS. In the group with experience of providing nursing care for patients with INS, 89 (90.8%) provided nursing care according to the plan, whereas 98 (89.1%) provided nursing care according to the plan in the group with no experience. Some nurses did not know all of the precautions for co-administration of prednisolone (experience: [30] 30.6% vs. no experience [39] 35.5%) There was no significant difference between the two groups.

　Conclusion: This study demonstrated that nurses with experience in caring for patients with INS understood treatment plans for individual patients, but they may have not been performing nursing based on relevant guidelines. The results also revealed a gap between their treatment planrelated and pharmacological knowledge.