精神状態の急性増悪により入院を要した人の家族の体験—自分の‘家族’の具合が急に悪くなった時

Experiences of Families with Members who Required Hospitalization Due to Acute Exacerbation of a Mental Condition in Japan: When “My Family” Suddenly Became Ill

要旨

　目的：我が国の精神科救急における家族への看護に示唆を得るため，精神状態の急性増悪により入院を要した人の家族の体験について，家族の視点から記述する．

　方法：精神状態の急性増悪により精神科救急入院料病棟に入院した人の家族6名に非構造化インタビューを行い，Riessmanのナラティヴ研究法テーマ分析を用いて分析した．

　結果：【‘家族’がつながりようのない人になってしまった】【このままでは‘家族’を死なせてしまう】【逃げ出したいのに逃げ出せない】【助けられ方が分からない】【‘家族’が精神異常者になってしまった】【なぜ‘家族’が病気になってしまったのか】【自分の日常を生きられない】の7つのテーマを見出した．

　結論：急性増悪への対応に縛りつけられる家族を支える早期介入サービスを拡充する必要がある．看護には，入院した人とのつながりの回復を家族と共に模索する支援，家族が抱えているしかない困難を分かろうとする支援，家族の後悔や自責の念に配慮し，家族自身の日常に目を向けた支援が求められていることが示唆された．

　Purpose: The purpose of this study was to describe from a family perspective the experiences of families with members who required hospitalization due to acute exacerbation of a mental condition in Japan. It thereby aims to obtain suggestions for family nursing care in psychiatric emergencies.

　Method: Unstructured interviews were conducted with six family members of people admitted to a domestic emergency psychiatric inpatient unit due to an acute exacerbation of a mental condition. The responses were analyzed using the thematic approach of Riessman's narrative research.

　Results: Seven themes were identified: “He/she has become someone I can no longer have a human connection with”; “If I don't save my family, he/she will die”; “I want to get out of this situation, but I can't”; “I don't know how we can be saved”; “My family has gone insane”; “Why did ‘my family’ become ill?”; and “I can't live my own daily life”.

　Conclusion: The results of this study suggest a need for the expansion of early intervention services to support families who have been forced to deal with their family members' mental health issues. In addition, nursing services should strive to work with families who have lost connections with their family members in hospitals. The difficulties that family members are forced to endure must be listened to, and they should receive support that focuses on their daily lives, while considering their feelings of regret and remorse.