災害看護実践行動をもとにした災害看護教育プログラム開発のための基礎的研究〜災害看護実践経験を持つ看護者の語りの分析

A basic study toward the development of educational programs for disaster nursing based on practical behavior in the field: analysis of narratives provided by nurses engaged in disaster work

要約

　本研究は、災害看護教育プログラムの開発に向けて、求められる教育内容を具体的な行動レベルで明らかにするために、災害看護実践行動の検討を行うことを目的とするものである。そのため、被災地の病院で災害看護実践に携わった看護者の経験から災害看護実践行動を抽出し検討を行った。阪神・淡路大震災（1995年）以降、被災地で災害看護実践を行った40名の看護者を対象に、急性期から亜急性期の活動体験の中で、1）災害時に成果を上げた行動、2）災害時に成果を上げることが困難だったこと又は出来なかったことを語ってもらったところ、豊かな内容の語りを得ることが出来た。研究デザインは因子探索型質的研究であり、解釈学的アプローチを用い分析を行った。得られたカテゴリーからは看護管理者、病棟・外来看護師、支援看護師が、それぞれの役割のもと、災害時に懸命に働く姿が浮き彫りになった。また、多様で特徴的な看護実践行動からは、役割ごとの個別性や共通性、役割を超えた共通性が明らかになった。災害看護教育プログラムの開発に欠かせない具体的で貴重な行動を得ることが出来た。

Abstract

　The purpose of this study was to examine disaster nursing practices for clarification of the content required on a specific behavioral level to develop educational programs for such work. Disaster nursing practices were identified from the experiences of nurses who had worked in disaster areas at the acute or sub-acute stage. A total of 40 nurses,including nurse-directors,staff nurses who had worked for hospitals in disaster areas,and nurses dispatched to provide disaster relief services,were interviewed in regard to their effective behavior and practical difficulties experienced through natural disasters and work in relation to mass casualty events since the Hanshin-Awaji Earthquake of 1995. Nurses recounted their experiences as storytellers,creating a rich source of narratives on the subject. An exploratory study based on descriptive qualitative design was conducted,and the narratives were analyzed using the interpretive phenomenological method. The themes and sub-themes found highlighted that all interviewees had played significant roles in unusual disaster situations and during the critical phase of disasters. These outcomes served to elucidate the characteristics and commonalities of practical behavior in disaster nursing in relation to and beyond individual roles. Information on the specific valuable types of behavior identified is expected to be beneficial in the development of disaster education programs.