小児在宅療養における親とのパートナーシップに関する訪問看護師の実践：質的研究の文献検討

Visiting-Nurse Practices in Partnership with Parents in Pediatric Home Care: A Review of Qualitative Literature

要旨

　目的：小児在宅療養における親とのパートナーシップに関する訪問看護師の実践を文献検討により明らかにし，看護の示唆を得る．

　方法：PubMed，CINAHL，医学中央雑誌を用い，小児在宅療養における親と訪問看護師のパートナーシップに関する質的研究を検索し，パートナーシップに関する看護実践を抽出して内容分析を行った．

　結果：9文献を分析した結果，〈いつでも親の力になれる訪問看護師の実践〉〈子どもの最善に取り組む三者関係からみた訪問看護師の実践〉〈親と最適な関係を築こうとする訪問看護師の実践〉が抽出された．

　結論：親に寄り添い，子どもの最善を追求し，長期にわたり関係を調整する訪問看護師の具体的実践が明らかとなり，小児在宅療養の特性を理解した上で親と関係を構築する重要性が示唆された．小児在宅療養に関わる訪問看護師に特徴的なパートナーシップの実践を具現化し，評価や教育に活かすツールの検討が必要である．

　Objective: To clarify the practices of visiting nurses regarding partnerships with parents in pediatric home care settings through a review of qualitative literature and to obtain suggestions for nursing care.

　Methods: Original qualitative research articles reporting the partnerships between parents and visiting nurses in pediatric home care were searched on the following databases: PubMed, CINAHL, and the Ichu-shi Web. Data on nursing practices related to partnerships with parents was extracted from the included articles, and content analysis was performed.

　Results: Nine articles were included in this review. Through the analysis, the following themes were extracted: "practices of visiting nurses who can always empower parents," "practices of visiting nurses from the perspective of a tripartite relationship working for the best of the child," and "practices of visiting nurses who try to build optimal relationships with parents."

　Conclusion: Visiting nurses supported the parent's feelings, sought the best for the child, and adjusted the relationship over time. This review suggests the importance of building a relationship with the parents based on an understanding of these characteristics. Therefore, to achieve the best relationship with parents, identifying what visiting nurses are doing to partner with parents and developing a scale to assess and educate visiting nurses about partnership practices are imperative.