エンパワーメント現象を生み出す看護者のこころのケアの特性

Characteristics of Psychosocial Nursing Care: The dimensions of psychosocial nursing care to promote the empowerment among the patients

はじめに

　病む人のこころのケアは，従来，看護者が自らの責務として繰り返し見直し，実践を積み重ねてきた領域である。医療の進歩に伴いキュア偏重となった時代には，看護者は，看護実践の内容を検討し，キュア中心からケア中心へという動きを生みだした。1980年代後半より取り組まれた，Watson^1），Leininger^2），Benner^3），Swanson^4）らのケアリング概念に関する研究や理論の構築は，看護者の専門職としてのケアの再検討として位置づけることができよう。

　わが国においても，萱間^5），菅原^6），上泉^7），添田^8）らにより，精神看護に携わる看護婦，ターミナルケアに関わっている看護婦，ICUの看護婦，小児看護に携わる看護婦のアプローチ技術が抽出され，構造化されている。このように，いくつかの先行研究は見られるが，各専門領域を統合した「こころの看護」のモデルは提示されていない。

　Nurses provide the psychosocial nursing care to promote the patients' empowerment. In spite of recognizing the importance of psychosocial nursing.

　The research reported here is part of a large study designed toexplore the psychosocial nursing intervention strategies. This part of the study is focused on characteristics of psychosocialnursing care as identified by nurses.

　Research design was descriptive and qualitative. Subjects were aconvenient sample of nurses who have more than 5 years experience and agreed to participate in this research. Data wascollected through semistructured interviews. Data was recorded on a tape and transcribed, then analyzed based on Grounded Theory Approach.

　Subjects: the number of subjects were consisted of 39 nurses. The average age and duration of clinical experience was 36.6 years old and 12.6 years.

　Result: sixteen of the characteristics of psychosocial nursing to promote the empowerment among the patients were identified.;

　1) respect the patients' decision making,

　2) clinical judgment from multiple perspectives,

　3) predictability,

　4) flexibility,

　5) classification of the patients by comparison,

　6) monitoring,

　7) relief from reality,

　8) relief from pain and suffering,

　9) enhancement of the patients' ego strength,

　10) nurture of hope,

　11) support individualized daily living styles,

　12) encouragement of the patients'own problem solving abilities,

　13) respect of individuality,

　14) self-utilization,

　15) self-control based on professional identity,

　16) utilization of team power.

　Discussion: Nurses choose from the sixteen dimensions of psychosocial nursing and organizing them in order to stabilizingthe patients' conditions.