がん患者遺族からみた緩和ケア病棟の療養環境

The Care Environment of the Palliative Care Unit from the Viewpoint of the Cancer Bereaved

要旨

　本研究の目的は、緩和ケア病棟を利用したがん患者の遺族による療養環境に対する評価を調べ、緩和ケア病棟における療養環境がよりよく発展するための示唆を得ることである。1999年に緩和ケア病棟を開設した民間病院において、質問紙を用いた横断的調査を実施した。質問項目は看護師と医師の対応や病棟の施設整備に関する項目等で構成した。遺族117名に質問紙を郵送して配布し、76件を回収した（回収率64.9％）。緩和ケア病棟の増加に対する賛成は90.3％であった。看護師と医師の対応への評価は概ね良好であり、特に「患者の希望をよく理解した対応」への評価が高かった。交通のアクセス、個室、ベッドサイドトイレ、臥位で入れる浴槽等の施設整備について、利便性や患者のQOLを配慮した点が高く評価された。緩和ケア病棟利用満足度は高く、看護師の対応・医師の対応・施設整備に対する評価と各々関連した（P＜.001）。緩和ケア病棟のイメージは良い方に変化し、看護師の対応に関する評価と関連した（P＜.05）。

Abstract

　The purpose of this study is to evaluate the care environment of the Palliative Care Unit(PCU) from the viewpoint of the cancer bereaved, whose family members are hospitalized in a PCU and to develop suggestions for the improvement of the medical care environment in the PCU. A cross-sectional study administered by questionnaire was carried out in a private hospital which opened a PCU in 1999. The questionnaire was composed of items on nurse and doctor attitudes, PCU facilities, etc. Seventy-six out of 117 bereaved responded to the questionnaire by mail(response rate: 64.9％). The proportion of those who supported an increase in the number of PCUs was 90.3％. The cancer bereaved generally positively evaluated attitudes of nurses and doctors in the PCU. Especially positive was the evaluation for the attitude of "adequate empathy for the patient's wishes". Also highly evaluated were accessibility and private room facilities, including bedside toilets, and mechanical baths. Conveniences and considerations of QOL for patients were evaluated highly. Satisfaction with the PCU among the cancer bereaved was associated with positive evaluations for nurse and doctor attitudes and facilities(p＜.001). The image of the PCU among cancer bereaved improved, and was associated with the evaluations of nurse attitudes(p＜.05).