日本における看護師の死への態度に関するスコーピングレビュー

A Scoping Review of Nurses' Attitudes to Death in Japan

要旨

　目的：死に逝く患者を看取る上で求められる看護師の死への態度を系統的に明らかにする．

　方法：PRISMA-ScRのガイドラインに従いスコーピングレビューを用い，包含基準は看護師，看取り，死への態度とし，類似性・相違性から帰納的に整理した．

　結果：54文献を採用，看護師の死への態度は【看取るために必要となる基本姿勢】【患者に行うケア行動】【家族に行うケア行動】【患者や家族に共通して行うケア行動】など9つ，影響要因は【死別や看取りにかかわった経験】【死に関する意図的な学習や教育機会】など3つが抽出された．

　結論：看護師の死への態度にはよりよいケアにするための多職種，看護師間連携，患者や家族のニーズを満たすケア行動，看取るために必要な基本姿勢，看取ることで生じる看護師個人の死やケアすることへの思いがあり，看取り経験，学習機会，ケアへの前向きさが影響していた．

　Objective: To systematically clarify attitudes of nurses, who are required to provide mitori care to dying patients, toward death.

　Methods: Following the PRISMA-ScR checklist, the inclusion criteria comprised nurses, mitori care, and attitudes toward death; an inductive approach in organization was implemented from the perspective of similarities and differences.

　Results: Through the use of 54 articles, nine categories pertaining to nurses' attitudes toward death were extracted, including "a basic stance required to provide mitori care", "care-related actions toward patients", "care-related actions toward families" and "care-related actions toward patients and families". Three categories pertaining to influencing factors were extracted, including "experiences related to bereavement or mitori care" and "opportunities to learning and gain education about death".

　Conclusion: Nurses' attitudes toward death included their personal sentiments toward death and care provision by adopting an attitude required to provide mitori care, providing mitori care, implementing care-related actions to fulfil the needs of patients and family members, and collaborating between nurses and multidisciplinary collaboration to provide higher quality care.