2022 Fiscal Year Final Research Report

Development of a mental care program applying the empathic assistance model practiced by intense care nurses

Research Project

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Project/Area Number	17K12225
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Clinical nursing
Research Institution	Juntendo University
Principal Investigator	Ueno Kyoko 順天堂大学, 医療看護学部, 教授 (50159349)
Co-Investigator(Kenkyū-buntansha)	栗原加代茨城キリスト教大学, 看護学部, 教授 (40382816) 長谷川隆一獨協医科大学, 医学部, 教授 (10301053) 岡本隆寛順天堂大学, 医療看護学部, 先任准教授 (60331394) 阿部美香順天堂大学, 医療看護学部, 助教 (90708992) 宇留野由紀子茨城キリスト教大学, 看護学部, 講師 (30734280) 長津貴子茨城キリスト教大学, 看護学部, 講師 (40824735)
Project Period (FY)	2017-04-01 – 2023-03-31
Keywords	リエゾン精神看護 / ICU看護師 / 精神的ケアプログラム / ポリヴェーガル理論 / 看護師－患者関係 / 共感援助能力
Outline of Final Research Achievements	After a literature study on nursing philosophy and education in critical medicine, we identified policies and values that are normative for nurses’ behavior and issues related to mental care. Next, we conducted a qualitative study of the characteristics of mental health care provided by psychiatric nurses to mentally ill patients on involuntary hospitalization and the practice of Intensive Care Unit nurses'handling of patients to identify requirements for care that can be implemented in the critical care area. Care was designed based on Polyvagal theory. An intervention study of the proposed care was conducted in one High Care Unit. Patients had low K6 scores and no significant differences were found before or after the intervention. The score of the nurses’ ESB16 (empathic support behavior) was significantly higher after the intervention, suggesting the possibility of good social interaction between nurses and patients as a factor that makes patients feel that they are now safe here.
Free Research Field	精神看護学
Academic Significance and Societal Importance of the Research Achievements	国内外においてICUで治療した患者の精神的ダメージが問題となり、重症患者の生存者30～70％に抑うつや不安、PTSD などの発生が指摘された。だが、この領域での効果的な精神的ケアの方法は確立していない。精神看護専門看護師や臨床心理士などの専門家が患者の精神的健康を回復に導くことは期待できるが、専門家は少なく、適時の対応は困難であろう。しかし、ICU看護師が臨床で実施可能な精神的ケアを実施できれば、患者は安全だと体感し、孤独感や恐怖感を凌ぎ、自ら困難を乗り越える精神機能を発揮させることが可能となるだろう。また、真に専門的、治療的な精神的治療やケアが必要な患者を識別することも可能になるだろう。