A mixed-methods approach to clinical reasoning of nurses regarding the spiritual pain of terminal cancer patients

2019 Fiscal Year Final Research Report

• Project/Area Number: 16K12064
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Clinical nursing
• Research Institution: Yamaguchi University
• Principal Investigator: TANAKA Aiko 山口大学, 大学院医学系研究科, 教授 (10285447)
• Co-Investigator(Kenkyū-buntansha): 後藤 みゆき 純真学園大学, 看護学科, 教授 (30547972) ; 永田 千鶴 山口大学, 大学院医学系研究科, 教授 (50299666)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Keywords: 終末期看護 / がん患者 / 気がかり / スピリチュアルケア / 混合研究法 / 看護師の臨床推論 / 共分散構造分析 / 多母集団同時分析

Outline of Final Research Achievements

The objective of this study was to clarify the actual situation of how nurses involved in terminal cancer care infer the “concerns and true feelings” of their patients and to create a model for clinical reasoning related to these concerns and true feelings. A mixed-methods research design was used. We conducted semi-structured interviews with nurses working in general wards, palliative care wards and home-visit nursing stations. Data were analyzed qualitatively, and a 25-item scale was created. A questionnaire survey using the scale was then conducted among nurses nationwide.
Covariance structure analysis was used to examine the scale from 1864 responses to construct a path model for clinical reasoning. “Basic care” was related to “clinical reasoning”, and “knowledge and communication skill” contributed to that process. Furthermore, a simultaneous multi-population analysis showed no difference in clinical reasoning between the three models.

Free Research Field

臨床看護学

Academic Significance and Societal Importance of the Research Achievements

本研究の結果から、表出困難な終末期がん患者の「気がかりや本当の思い」に対する看護師の臨床推論の過程を導き出し、看護介入への示唆を得る。このことは、患者のスピリチュアルペインの軽減や生活の質の維持向上につながる。