島嶼で活動するナースプラクティショナー教育課程修了者の看護実践

Nursing Practice of Graduates of the Nurse Practitioner Education Course on Islands

要旨

　目的：島嶼で活動するNP教育課程修了者に焦点を当て，彼らが島嶼で実施している看護実践を明らかにする．

　方法：NP教育課程修了者4名に半構造化面接を実施し，質的記述的分析を行なった．

　結果：島嶼で活動するNP教育課程修了者の看護実践として，【島の文化に根ざした個人の価値観を基盤とした看護・医療を実践する】，【治療の選択肢を広げるため島の限られた資源の活用範囲を変革する】，【島民の力を結集してケアを創り出す】，【予防から死に場所まで臨床判断に基づき生活者の視点で支える】実践をしていた．

　結論：島嶼で活動するNP教育課程修了者の看護実践には，ホリスティックな視点を基盤に高度なリーダーシップとコーディネーション，コラボレーションのコンピテンシーが発揮されていた．今後は，NP教育課程修了者の実践がどのように患者・家族に望ましい変化をもたらすのかを評価し，看護実践の成果をより適切に捉えていく．

　Purpose: To examine the nursing practice of graduates of the nurse practitioner education course (the NP education course) on islands.

　Method: Semi structured interviews were conducted with four graduates of the NP education course, and the results were analyzed using a qualitative inductive approach.

　Results: The nursing practice of graduates of the NP education course were induced as follows; [practice nursing and medical care based on individual values rooted in island culture], [transforming the scope of resource utilization on islands with scarce medical resources to expand treatment options], [creating care by gathering the power of the islanders], and [supporting from the dweller's view based on clinical judgment from prevention to place of end of life].

　Conclusion: The nursing practice of graduates of the NP education course on islands was preformed based on a holistic perspective, and, advanced leadership, coordination, and collaboration competency. In the future, it will be necessary to evaluate how the practice of NP educational course graduates brings desired changes to patients and their families, and to assess the results of nursing practice more appropriately.