不穏状態を呈する初対面の精神疾患患者に対する入院時の対応プロセス

The Process of Hospitalization for Psychiatric Patients Presenting with Restlessness for the First Time

要旨

　目的：不穏状態を呈し，精神科病院に入院となった初対面の患者に対する，精神科看護師の入院時の対応プロセスを明らかにすることを目的とした．

　方法：修正版グラウンデッド・セオリー・アプローチを用いた探索的質的研究であり，精神科看護師12名を対象に半構造化面接を実施した．

　結果：不穏状態を呈する初対面の精神疾患患者に対する看護師の入院時の対応は，【脅かさない接近】から始まり，【患者が体験している世界のイメージ】をしながら，患者に【味方であるという認識の促進】を図るプロセスであった．また，このプロセスは【味方であり続けるためのセルフマネジメント】が支えており，さらに【通じ合う感性を探る姿勢】という看護師の信念が基盤になっていた．

　結論：精神科看護師は患者と通じ合える感性があるという信念があり，入院時から私はあなたの味方であるというメッセージを患者に送り続けることが重要であることが示唆された．

　Purpose: The purpose of this study was to clarify psychiatric nurses' involvement with to patients who they had met for the first time and who were in a restless state when admitted to a psychiatric hospital at the time of admission.

　Methods: This is an exploratory and qualitative study using a modified grounded theory approach in which semi-structured interviews were conducted with 12 psychiatric nurses.

　Results: Nurses' involvement to hospitalized psychiatric patients exhibiting restlessness were as follows: They used a [non-threatening approach] and were part of a process of [helping patients realize they were their allies] while [imagining the world experienced by patients]. In addition, the process was supported by [self-management to remain an ally] and was based on nurses' beliefs of [trying to understand one another].

　Conclusion: Psychiatric nurses believe that they have the sensitivity to communicate with patients, and the results suggest that it is important for nurses to continue sending the message that they are on the patients' side starting at the time of hospitalization.