小児がん患者—看護婦関係における看護婦の心理的な距離感の構成因子と意味

Meaning and Factors of Psychological Distancing which Pediatric Oncology Nurses Recognize in Their Interactions with Patients

　本研究では，小児がん患者のケアに携わる看護婦が，子どもとの相互作用の中で認知する心理的な距離感がどのような過程で生じ，どのような意味をもつのかを明らかにすることを目的とした。

　研究方法には帰納的質的なアプローチであるグラウンデッド・セオリーの手法を用いた。データ収集はがんの子どものケアに携わっている看護婦16名に対する面接と，入院中の子どもとのかかわり場面の参加観察によって行なった。

　分析の結果，看護婦の認知する心理的な距離感の構成する因子と〈“気持ちの共有”的な距離感〉，〈“壁”的な距離感〉，〈“巻き込まれ”的な距離感〉，〈“遠のき”的な距離感〉という4つの心理的距離感のタイプが明らかになった。

　さらに，それに基づき心理的な距離感を《個々の対象に対する看護婦のかかわり許容量に比し，どのくらい子どもに対応できているかという感覚》と定義した。

　Recently the therapy for malignancy in children has improved and many more patients are surviving, although malignacy still remains the most common cause of mortality in children over the age of five years. However, as therapy has become more aggressive, suffering and anxiety for these patients has increased, and nurses that work with them face more difficulties.

　The purpose of this study is to describe factors and meaning of psychological distancing which pediatric oncology nurses recognize in their interactions with patients.

　In this study, the grounded theory approach was used. The subjects were sixteen nurses working with patients a flicted with various malignancies.

　They were interviewed, and nurse - patient interactions were observed.

　The results were as follows:

　1. Some factors and four patterns of the psychological distancing were extracted.

　2. The psychological distancing is defined by feelings of limitations to their care capacity which the nurses experienced.