2021 Fiscal Year Final Research Report

Development of a practical program on understanding patients experiencing delirium and their nurses

Research Project

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Project/Area Number	18K10655
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 58080:Gerontological nursing and community health nursing-related
Research Institution	Tokyo Women's Medical University
Principal Investigator	Yamauchi Noriko 東京女子医科大学, 看護学部, 臨床講師 (10517436)
Co-Investigator(Kenkyū-buntansha)	田中美恵子東京女子医科大学, 看護学部, 教授 (10171802) 小泉雅子東京女子医科大学, 看護学部, 准教授 (20727606) 安田妙子東京女子医科大学, 看護学部, 臨床講師 (50382429)
Project Period (FY)	2018-04-01 – 2022-03-31
Keywords	せん妄 / ケア / 看護 / 経験 / 現象学
Outline of Final Research Achievements	To clarify the experiences of patients with delirium and their nurses, and to identify how care unfolds between them. Taking an ontological perspective, we performed participant observation in care settings and conducted supplemental unstructured interviews with 5 older adults with delirium and 16 nurses involved in their care. The analysis was guided by Benner’s interpretive phenomenology method. Events between patients and nurses comprised three core-themes; imprisonment in suffering in the “here and now,” fulfillment and release in the “here and now,” and foundation of perception and behavior ;and 15 themes that fall within them. It is important that nurses work with patients to satisfy their needs and desires “here and now” to create a sense of certainty, and that they understand the conditions, sensations, and feelings of themselves and their patients as reflections of one another.
Free Research Field	精神看護
Academic Significance and Societal Importance of the Research Achievements	せん妄患者の安寧は、疾患の回復とともに、その時々の状況や看護からも影響を受けていることは確かである。しかしながら、看護師は、自分が行ったケアが患者の安寧にどのように関わり、あるいは関わらなかったのかについてよくわからずにいる。本研究では、現象学的アプローチを用いて、看護の場面において、普段は自覚されることないレベルの意識や身体の動きにまで遡って、ケアがどのように成り立つのかについて、その一部を明らかにした。これまで主流としてきた医学モデルに基づくせん妄のアセスメントやケアとは異なる独自の視点から、患者を安寧へと導くケアの知見と示唆を得たと考える。