Development of Analysis and Coordination Tools of Clinical Ethics in Critical Care Medicine
| Project/Area Number |
17K12212
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Clinical nursing
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| Research Institution | Yamaguchi University |
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Principal Investigator |
YAMASE Hiroaki 山口大学, 大学院医学系研究科, 教授 (90279357)
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| Co-Investigator(Kenkyū-buntansha) |
田戸 朝美 山口大学, 大学院医学系研究科, 准教授 (30452642)
山本 小奈実 山口大学, 大学院医学系研究科, 助教 (60574340)
佐伯 京子 山口大学, 大学院医学系研究科, 助教 (60759687)
須田 果穂 山口大学, 大学院医学系研究科, 助手 (60883593)
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| Project Period (FY) |
2017-04-01 – 2022-03-31
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| Project Status |
Completed (Fiscal Year 2021)
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| Budget Amount *help |
¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000)
Fiscal Year 2021: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2020: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2019: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2018: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2017: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
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| Keywords | 臨床倫理 / 倫理分析 / 倫理調整 / 問題志向型システム / 意思決定支援 / クリティカルケア / 意思確認 / 看護学 / 臨床看護学 / 重篤・救急看護学 |
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| Outline of Final Research Achievements |
We have developed ACTce-CCM;Analysis and Coordination Tools of Clinical Ethics in Critical Care Medicine.The preparation process was carried out in four stages:prototype creation,application of prototype version to fictitious cases,clarification based on focus group interviews,and a survey on ethical issues and ethical adjustment.
The completed version of ACTce-CCM consists of information organization and assessment frameworks,problem analysis,integration,problem lists,goals,care practices,and ethical adjustment.There are six frameworks:pathology and treatment,QOL and QOD,patient intention,family psychosocial situation,medical team situation, and the surrounding situation.The problem lists include those related to the patient, the family, and the medical staff.Goals include those of the medical team and the expected outcomes for the patient/family. Care practices and ethical adjustment consist of three aspects:direct patient care,direct family care,and medical team adjustment.
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| Academic Significance and Societal Importance of the Research Achievements |
クリティカルケアでは、DNAR、予期し得ない状況で訪れる突然死、脳死患者からの臓器提供、救えない命への終末期ケア、家族の代理意思決定、医療職が個々に抱く価値観の相違から生じる医療チーム内のコンフリクトなど、さまざまな倫理的問題が生じやすい。本研究ではこうした倫理上の問題について、一連の問題志向型システム（POS）に則って問題解決を支援できる臨床倫理分析・調整システムツールACTce-CCMを開発した。これは、クリティカルケアの臨床実践で活用できるわが国初の臨床倫理分析・調整ツールで、臨床で活用することにより、倫理的問題について実践レベルでの有効な解決をもたらすことができる。
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Report
(6 results)
Research Products
(7 results)
