Determining the current state of palliative care in the ICU and ER and the factors that influence the practice of palliative care

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K23190
• 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: Shinshu University
• Principal Investigator: Kato Akane 信州大学, 学術研究院保健学系, 助教 (90883215)
• Project Period (FY): 2020-09-11 – 2024-03-31
• Keywords: 緩和ケア / クリティカルケア / 症状緩和 / 終末期ケア / 意思決定支援

Outline of Final Research Achievements

This study was a cross-sectional research conducted through a questionnaire survey targeting specialist nurses and certified nurses practicing in the critical care domain, focusing on the current status of palliative care. Questionnaires were mailed to 740 randomly selected nurses, and 384 responses (52%) were analyzed as valid. Nurses in the critical care domain felt that care for physical, psychological, social, and spiritual distress was insufficient, and there was a lack of knowledge and skills regarding palliative care. Additionally, symptom screening other than pain and nausea/vomiting was not adequately conducted, and the utilization rate of specialized palliative care, such as palliative care teams, for palliative purposes was low. Furthermore, it was revealed that there was insufficient engagement in family conferences.

Free Research Field

クリティカルケア看護

Academic Significance and Societal Importance of the Research Achievements

国際的に緩和ケアの対象範囲が拡大する中で、日本のクリティカルケア看護における緩和ケアの理解および実践が発展途上であることが明らかとなった。その背景には、クリティカルケアに関わる看護師の知識や技術が不十分であることだけでなく、専門的緩和ケア活用システムのミスマッチや専門的緩和ケアチームとの連携不足などの病院組織や、クリティカルケア領域の慣習などが影響していることも示唆された。今後は、看護師を対象とした教育プログラムの構築や医師との合同ワークショップなど多職種、他領域を交えた教育機会を設ける必要性がある。