2018 Fiscal Year Final Research Report

The use of "Patient Record "for psychiatric nursing practice and its therapeutic effects

Research Project

PDF

Project/Area Number	16K15975
Research Category	Grant-in-Aid for Challenging Exploratory Research
Allocation Type	Multi-year Fund
Research Field	Gerontological nursing
Research Institution	The Japanese Red Cross Toyota College of Nursing
Principal Investigator	TSUBONOUCHI Chizuru 日本赤十字豊田看護大学, 看護学部, 助教 (90449497)
Co-Investigator(Kenkyū-buntansha)	古澤亜矢子日本福祉大学, 看護学部, 准教授 (20341977) 野村直樹名古屋市立大学, 大学院人間文化研究科, 教授 (80264745)
Research Collaborator	KINOSHITA Yuriko ODA Yoshiko
Project Period (FY)	2016-04-01 – 2019-03-31
Keywords	「患者カルテ」 / 協働するナラティヴ / ポリフォニー / 対話的アプローチ / 無知の姿勢 / 家族支援 / 説明モデル / 精神科看護
Outline of Final Research Achievements	Outpatients of schizophrenia and mood disorder visiting the university hospital were interviewed by nurses to produce a record (Patient Record, PR) of their everyday life, suffering, and prospects of improvement. The results: ① PR became “a place to come back” for each patient. ② The patients felt accepted and supported by medical staff. Writing PR together with the nurse contributed to their improvement. ③ The patients acquired own guideline for coping with problems. Joint Meetings (JM) were held afterward for the patient, family, and medical staff, using contents of PR. JM offered a chance for participants to exchange opinions about their problems in a collaborative air.　Through JM, we researchers learned to keep a suitable distance with patient's family and the importance of finding strength of patients to enhance their social ties.
Free Research Field	精神看護学
Academic Significance and Societal Importance of the Research Achievements	学術的意義：ナラティヴ（語り）の研究を進める一環として、精神科看護において記述とは何かということを再考し、新たな記述形式を提案できたこと。この記述形式は、対話型の記録の取り方であり、患者と看護師が共同で一つの文書を作成していくプロセスの開発である。社会的意義：看護師にとっての新たな看護技術の開発を意味する。医療記録の著者は医療者だが、「患者カルテ」の著者は患者と看護師であり、看護師に特化した技術として看護師の専門領域を確保した。また、患者にとっては自らの声、意見、想いを対話を通して表出できる治療空間を作り上げることができた。