外照射を受けるがん患者に対する放射線療法看護の実践状況

The Present State of Radiation Therapy nursing in Cancer Patients Undergoing External Radiation Therapy

要旨

　本研究の目的は，外照射を受けるがん患者に対する放射線療法看護の実践状況を明らかにすることである．

　放射線療法看護に携わる看護師1,400名にがん放射線療法看護の質評価指標を用いて放射線療法看護の実践状況を問う自記式質問紙調査を実施した．回収数は394名で，すべての項目に記入があった349名を分析対象とした．がん放射線療法看護の質評価指標の信頼性と構成概念妥当性を確認した後，放射線療法看護の構成因子，職位，所属，施設の分類，がん放射線療法看護認定看護師資格の有無による実践状況を分析した．

　結果，安全に照射を受けるケア，納得した治療を意思決定するケア，セルフマネジメントを促進するケアは実践できていたが，がんサバイバーとして生きぬくケアは十分な実践ができていなかった．安全に照射を受けるケア，セルフマネジメントを促進するケアは，病棟に比べ放射線治療部門が有意に高かった（p＜0.01）．すべての因子において，一般看護師に比べがん放射線療法看護認定看護師の実践が有意に高かった（p＜0.01）．

　今後，さらに放射線療法看護の質を高めるためには，がんサバイバーとして生きぬくケアを重点的に教育する必要性が示唆された．また，認定看護師は実践の場で役割モデルを示し，看護師への指導・相談の役割を果たすことで，放射線療法看護の質向上が期待される．

　We sought to clarify the present state of radiation therapy nursing in cancer patients undergoing external radiation therapy.

　We conducted a self-administered questionnaire of 1400 nurses involved in radiation therapy nursing. The nurses were asked to describe present state using the “Cancer Radiation Therapy Nursing Quality Evaluation Index”. We received 394 questionnaire responses and we used 349 fully-completed responses as our analysis set. After confirming the reliability and constructive concept validity of the Cancer Radiation Therapy Nursing Quality Evaluation Index, we used the questionnaire responses to analyze constituent factors, respondents' positions, affiliations, type of facilities, and status of radiation therapy certification.

　Our findings showed that the respondents could provide nursing care conducive to safe radiation therapy, nursing care that helped patients to make satisfactory therapeutic decisions, and nursing care that facilitated patient self-management, but were unable to sufficiently deliver nursing care for improving quality of life of cancer survivors. Nursing care conducive to safe radiation therapy and that facilitated patient self-management was significantly higher among nurses who worked in radiotherapy departments than among those in hospital wards (P<0.01). All of the factors related to the quality of radiation therapy nursing were significantly higher among the Certified Nurse in Radiation Oncology Nursing than among the general nurses (P<0.01).

　Our study findings suggested that in order to improve the quality of radiation therapy nursing, nursing education and training must place a greater emphasis on care to improve the daily life of cancer survivors. The overall quality of radiation therapy nursing is expected to be improved by Certified Nurse in Radiation Oncology Nursing acting as role models for their nursing peers in clinical settings, and guiding and consulting with other nurses.