意思疎通の図りにくいうつ病患者との接近を続ける精神科看護師の認知，思考，行動のプロセス

Cognitions, Thoughts, and Behavioral Processes through Which Psychiatric Nurses Continue to Approach Depressed Patients who Have Communication Difficulties

要旨

　目的：意思疎通の図りにくいうつ病患者に接近を続ける精神科看護師の認知，思考，行動のプロセスを明らかにする．

　方法：精神科経験3年以上の看護師17名に半構造化面接を行い，修正版グラウンデッド・セオリー・アプローチを用いて分析した．

　結果：看護師は，患者の醸し出す【バリアとの対峙】に至ったとしても，【バリアの内側に届く方法を探す】ことをしていた．看護師はうつ病看護への信念を持ち，患者を【ひとりぼっちにさせたくない】という思いを抱いていたため，患者の【語られない本音に思いを巡らす】ことが出来，【閉ざされた心に続けるノック】をし続けていた．

　結論：うつ病患者に対して看護師は困難感を抱きやすいが，看護師は患者の孤独な心情を捉え，自分の声がきっと患者に届くと信じることで自身の感情をコントロールし，患者に接近をし続けることが出来ていた．

　Purpose: The present study aimed to clarify the cognitions, thoughts, and behavior process applied by nurses to approach depressed patients who have communication difficulties.

　Methods: Data were collected through semi-structured interviews of 17 nurses with >3 years' experience of practicing psychiatric nursing. The data were analyzed using a modified grounded theory approach.

　Results: Based on the nurses' interviews, nurses who continue to be involved with depressed patients, even if they have to confront the barriers created by the patient, they try to find a way to penetrate these barriers. In such a situation, the nurses believed in depression nursing and did not want to leave the patient alone. For this reason, they could ponder on the inexpressible true intentions of the patients and continued to act in ways that allowed the patient to open up to them emotionally.

　Conclusion: Nurses tend to feel helpless toward depressed patients, but they can control their emotions and keep approaching the patient by capturing the patient's feelings of loneliness and believing that their voice will reach the patient.