病棟看護師の終末期がん患者に対する退院支援の実践自己評価と関連要因の検討

Self-assessment of Implementation of Discharge Support for Terminal Cancer Patients and Related Factors by Ward Nurses

要旨

　目的：病棟看護師の終末期がん患者に対する退院支援実践の自己評価と関連要因を明らかにする．

　方法：地域がん診療連携拠点A病院の病棟看護師473人を対象に，無記名の自記式質問紙調査を実施した．調査内容は，属性，退院支援実践の自己評価とした．

　結果：終末期がん患者退院支援実践経験のある153人を分析対象とした．退院支援実践の自己評価が高かったのは，患者・家族からの情報収集，家族への療養場所の希望確認であり，社会資源の活用，患者への余命の理解の確認は低かった．退院支援実践の自己評価への関連要因は，病棟看護師の退院支援への苦手意識・終末期がん患者を自宅退院につなげた経験・在宅療養後の情報提供を受けた経験・退院支援に関する知識の有無などであった．

　考察：病棟看護師への支援として，退院後の患者の情報提供を受けられるシステム作り，苦手意識の改善への方策，退院支援の学習機会の必要性が示唆された

　Objectives: This study aimed to clarify self-assessment of implementation of discharge support for terminal cancer patients and related factors by ward nurses.

　Methods: We conducted an anonymous self-administered questionnaire survey of 473 ward nurses of a cancer care district liaison hospital A. The survey contents were self-assessment of attributes and implementation of discharge support.

　Results: Responses from 153 nurses who had experiences of implementation of discharge support for terminal cancer patients were analyzed. The items with high self-assessment of implementation of discharge support were information gathering from patients and their families and confirmation of desired care places with families, and those with low self-assessment were use of social resources and confirmation of the understanding of life-expectancy with the patients. Factors related to the self-assessment of implementation of discharge support by ward nurses included their sense of weakness in supporting discharge, experience of leading terminal cancer patients to be discharged at home, experience of receiving information about events after care at home, and presence or absence of knowledge about discharge support.

　Discussion: Creation of a system through which ward nurses can receive information of discharged patients, measures to improve their sense of weakness, and the necessity for chances for them to learn discharge support were suggested to be useful for supporting ward nurses.