日本のがん看護外来の看護実践の実態

Survey of Actual Conditions of Nursing Practice in Outpatient Cancer Nursing in Japan

要旨

　目的：日本のがん看護外来の具体的な看護実践を明らかにすることである．がん看護外来は，がん患者やその家族等に対し，生活に伴う症状の改善や自己管理の支援等を医師や他職種と連携して看護職が主導して行う外来をさし，がん相談支援センターは除外した．

　方法：がん診療拠点病院等427施設のがん看護外来担当看護師を対象に，がん看護外来の運営状況，看護実践の設問を含めた横断的質問紙調査を行った．倫理審査委員会の承認を得て行った．

　結果：288部の返信からがん看護外来開設がない172部を除き116部を分析した．がん看護外来は，がん看護専門看護師等が担当し，予約制で毎日開催が多かった．看護実践は〔患者・家族の思いの整理支援〕〔課題解決のための他部署との連携〕〔療養生活の支援〕等の6因子が抽出された．

　結論：がん看護外来の具体的な看護実践は，患者・家族の思いの整理支援や課題解決のための他部署との連携等だった．

　Aims: This study aims to clarify the specific nursing practices in outpatient departments of cancer nursing (ODCN) in Japan. ODCN refers to an outpatient department run by nursing staff in collaboration with doctors and other professionals for cancer patients and their families to improve symptoms associated with daily life and support self-management. Cancer consultation support centers were excluded.

　Methods: A cross-sectional questionnaire survey was administered to nurses in charge of ODCN at the 427 designated cancer care hospitals specified by the Ministry of Health, Labor and Welfare. The questionnaire was mailed to each facility's director of nursing with a request for it to be distributed to the nurse in charge of the ODCN. It included questions about the operational status of ODCN, frequency of nursing practices, and awareness of issues. This study was conducted with the approval of the Research Ethics Review Committee.

　Results: Of the 288 questionnaires returned (response rate of 67.4%), 116 were analyzed since 172 facilities do not have an ODCN. The ODCN are operated by qualified nurses, such as CNS in cancer nursing. Many are open daily and see patients by appointment. The ODCN nursing practice scale has a six-factor structure that includes “support for organizing the thoughts of patients and their families,” “cooperation with other departments to solve problems,” and “support for daily life under medical treatment.”

　Conclusion: The specific nursing practices in ODCN included support for organizing the thoughts of patients and their families, and cooperation with other departments to solve problems.