2012 Fiscal Year Final Research Report
Building a model for a support methodology based on expertise acquired during provision of palliative care
| Project/Area Number |
21390586
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Clinical nursing
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| Research Institution | Japanese Red Cross College of Nursing |
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Principal Investigator |
MORITA Minako 日本赤十字看護大学, 看護学部, 教授 (50288065)
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| Co-Investigator(Kenkyū-buntansha) |
YOSHIDA Mituko 日本赤十字看護大学, 看護学部, 准教授 (80308288)
OKUHARA Hidemori 静岡県立大学, 看護学部, 准教授 (60288066)
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| Co-Investigator(Renkei-kenkyūsha) |
HUKUI Satomi 首都大学東京, 健康福祉学部, 准教授 (20436885)
TANAKA Takami 日本赤十字看護大学, 看護学部, 講師 (60336716)
SINDOU Etuko 慶応大学, 看護学部, 准教授 (20310245)
HIGUTI Yosie 日本赤十字看護大学, 看護学部, 講師 (00460098)
ADACHI Yuko 日本赤十字学園, 学事課長 (70248970)
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| Project Period (FY) |
2009 – 2012
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| Keywords | 緩和ケア / がん / 実践知 / 援助方法 |
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| Research Abstract |
The purpose of this study was to develop a model for care methodology by analyzing the experience of nurses, specifically the clinical wisdom acquired during the provision of palliative care, and using it to improve the overall process. Taking our cue from Benner’s methods of studying clinical wisdom (1999/2005), we interviewed 20 nurses with three or more years of experience of providing palliative care. The characteristics of the nurses’ judgments and actions were analyzed in relation to 30 episodes that were reconstructed as narratives and given themes, then categorized according to their characteristics into the following nine major themes: judgment on pain/suffering and coping with it; conflict regarding sedation; continence support to protect the patient’s dignity; care that responds to the patient’s wishes; palliative care carried out using teamwork; care for the patient’s mental suffering; deathwatch; challenges faced by family carers; and the need for nurses to understand and respond to the wishes of home-cared patients and their families. The 30 episodes were categorized and organized according to their major themes, then compiled into a collection of cases, based on which we discussed support methodology from four viewpoints and obtained suggestions for practical application. The four viewpoints were (1) the relationship between nurses’ past practical experience and their attitudes to nursing, (2) how nurses understood patients and their families, (3) characteristics of practical judgments that are made considering what will happen next and how these judgments are acted on, and (4) the clinical wisdom both needed and acquired during the practice of team medicine.
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