Development of a qualitative assessment indicators of end-of-life care for patients with chronic heart failure

Research Project

Project/Area Number	16K20778
Research Category	Grant-in-Aid for Young Scientists (B)
Allocation Type	Multi-year Fund
Research Field	Clinical nursing
Research Institution	University of Human Environments
Principal Investigator	Obayashi Mina 人間環境大学, 看護学部, 講師 (80590009)
Project Period (FY)	2016-04-01 – 2020-03-31
Project Status	Completed (Fiscal Year 2019)
Budget Amount *help	¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000) Fiscal Year 2018: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000) Fiscal Year 2017: ¥520,000 (Direct Cost: ¥400,000、Indirect Cost: ¥120,000) Fiscal Year 2016: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywords	慢性心不全 / 末期・終末期ケア / 末期終末期 / 指標開発 / 末期 / 終末期 / 緩和 / 慢性期看護
Outline of Final Research Achievements	In this study, we developed 68 qualitative assessment indicators of end-of-life care for patients with chronic heart failure through a Delphi survey to specialized nurses. Using the indicators, we conducted a survey for nurses working in cardiology departments nationwide about the implementation status of care and examined the validity of the indicators. As a result, we found that nurses are taking time for bedside care every day in order to alleviate the suffering of patients, while being busy and having difficulty securing time. In addition, we consider that the presence of an intervention team at the hospital and the experience of participating in training or study sessions helped raise awareness of end-of-life care among nurses and led to higher levels of care implementation. Furthermore, as a result of examining the validity of the indicators, we believe that the validity was confirmed.
Academic Significance and Societal Importance of the Research Achievements	慢性心不全患者に必要な看護ケア全体を網羅した心不全末期・終末期ケアの質評価指標を開発したことにより、指標は看護師のケアの振り返り等に活用できると考える。それにより末期・終末期ケアを意識した看護ケアを提供できること、さらに病棟単位等で不十分なケアの傾向の検討も可能となり、部署全体の課題としての取り組みやその評価における活用もできると考える。さらに今回その指標を用いて全国の循環器科で働く看護師を対象にした実態調査も行ったことにより、ケアの実施状況が確認され、課題を明らかにすることができた。さらに所属機関の介入チームの存在の有無や研修会等の参加経験の有無の重要性が改めて認識できた。