ターミナル期における自己尊重の障害への介入について―子宮頸癌Ⅲb期再発の47歳の症例を通して

Assist for Patient in the Terminal Condition to Establish Self-concept: Diagnosis Process and Intervention

　心理的・精神的問題の多くは，そこにあることがわかっていながら，うまく表現されずに「不安」などとして介入されることが多いように思われる．特に人生経験の少ない学生にとってはクライエントの置かれた状況をどう表現してよいのか，また，その状況にどう対応すればよいのかわからないことも多い．今回，学生の臨床実習において看護診断を用い，学生とともに根気よく内容を検討していくことによって，ふさわしい診断や介入を選択でき，看護過程全体の中での診断の意義を学ぶことができたと考えた．今後，よりよい指導のために，この学生の行った診断と介入について検討した．

　I have tried to introduce making nursing diagnosis into nursing education program since 3 years ago. At that time, nurse student was allotted to the client with recurrent cervical cancer who were thought to have lowered self-care level and impaired self-concept. Though the student paid her attention only to physical problems of the client at first, she could gradually recognize the client had mental problems as well. However, she did not know how to express what was the client's mental problems and how to manage them. In the training of making nursing diagnosis, she got used to describe and arrange various kinds of mental symptoms and finally she was able to make a correct nurse diagnosis. In this study, I am going to briefly touch on this training process of the nurse, and discuss mental condition of lowered self-care level and impaired self-concept which she mentioned as a diagnosis.