検査・処置時における子どもの権利擁護に関する小児病棟看護師の働きかけ

A Qualitative Study of Pediatric Unit Nurses' Support for Children's Rights during Medical Examination and Procedures

要旨

　目的：小児病棟看護師が検査・処置時の看護において，子どもの権利擁護のために実践している看護実践プロセスを明らかにする．

　方法：小児病棟経験5年目以上の看護師20名に対し，子どもの権利擁護の場面について半構造化面接調査を行い，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：《子どもが検査・処置に取り組めそうかの見極め》をしながら【子どもが検査・処置になじめるケアの働きかけ】を行っていた．《恐怖心を減らす関わり》や《頑張ろうと揺れる気持ちを待つ》ようにし，子どもが納得して処置に取り組めるようになり〔権利擁護できた関わり〕となった．業務の都合や看護師の捉え方により〔権利擁護できなかった関わり〕となる場合もあった．

　結論：看護師は検査・処置時の状況を多角的に捉えて子どもができそうか見極め，子どもが主体的に検査・処置に取り組みなじめるように看護実践しているプロセスが明らかとなった．

　Purpose: To clarify how pediatric nurses recognize the protection of children's rights during medical examinations and procedures and how they practice nursing for the protection of children's rights.

　Methods: A semi-structured interview was conducted with 20 nurses with five years of experience regarding the practice of protecting children's rights. Data were analyzed using the grounded theory approach.

　Results: The nurses "assessed whether the child was able to undergo the procedure", and "encouraged care that the child would be comfortable with." The nurses tried to "reduce the child's fear" and "wait for the child's wavering feelings of doing their best," which led to "involvement that was able to protect the child's rights." In some cases, in which the nurses were not able to protect the child's rights, depending on how the nurses view the situation.

　Conclusion: During nursing care, the nurses view the child and the situation from various perspectives and adjust to the environment; they respect the child's independence while also pursuing their best interests and adjusting to the situation.