Development of Nursing decision making support model for patients with chronic respiratory disease during the transitional stage

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K23172
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund
• Review Section: 0908:Society medicine, nursing, and related fields
• Research Institution: Japanese Red Cross College of Nursing
• Principal Investigator: Kawada Terue 日本赤十字看護大学, 看護学部, 准教授 (40438263)
• Project Period (FY): 2020-09-11 – 2023-03-31
• Keywords: 慢性呼吸器疾患 / Advance Care Planning / 意思決定支援 / 熟練看護師

Outline of Final Research Achievements

The purpose of this study was to reveal how expert nurses support patients with chronic respiratory diseases to make their decision　at times of change in their symptoms or need to change their recuperation. Through interviews with experienced nurses, it became clear that “building a relationship of trust by listening particularly about their daily life”,　“creating a basis for the patients and their families to choose”, “seeking the timing of ACP”, “ascertaining the changing situation and support” and “building trust as a team and advance” are the supports provided by the nurses. It revealed that relationship in consideration with the patients’ life background and sense of values support the patients to make their decisions.

Free Research Field

看護学

Academic Significance and Societal Importance of the Research Achievements

2018年に厚生労働省はアドバンス・ケア・プランニングの実践・普及を明文化し、この考え方が社会に認識されるようになった。しかし、最終末期の意思決定に焦点があてられる研究が多く、非がん性疾患のように、長期にわたる経過の中で様々なタイミングで意思決定が必要となる疾患の患者への支援はあまり明らかになっていない。また、慢性疾患を持つ人への支援は看護師も長期的な関わりがある一方で、その役割は明確になっていない。本研究では、看護師は治療方針の決定のみならず、その人が望む生活を支援するための継続的な支援を行っていることが明らかになり、看護師が療養支援を行うことの重要性を示唆する結果であった。