Professional's explanation on home care and realization of continuation of home living for family carers with end-of-life cancer patients

2018 Fiscal Year Final Research Report

• Project/Area Number: 26870040
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Gerontological nursing; Social welfare and social work studies
• Research Institution: Kitasato University
• Principal Investigator: Chiba Hiroki 北里大学, 医学部, 助教 (90713587)
• Research Collaborator: Moriya Rika ; Onozawa Shigeru ; Tanaka Yuka ; Itio Michiya ; Ogata Tomoaki ; Misawa Jinpei ; Tarasawa Kunio ; Moriya Yukinori
• Project Period (FY): 2014-04-01 – 2019-03-31
• Keywords: 在宅医療 / 訪問看護師 / エンドオブライフケア / 発話 / 在宅末期がん患者 / 家族介護者 / 不安

Outline of Final Research Achievements

We aimed to generate hypotheses about visiting nurses’ conversational structure and quality of explanation to improve end-of-life care quality with terminal cancer patients and their families in home. The research design was a data conversion type of mixed methods study prospective and observational. In the results, the expert visiting nurses tended to ask questions and confirmation of the body and symptoms mainly to the patients for 10 minutes starting the visit. On the other hand, explanations and information on body and symptoms were mainly given to families after 20 minutes of visit, and it was possible to identify a tendency to explain psychological contents to families after 60 minutes. In addition, the contents of psychological and the social system or insurance were communicated with feeling of reassurance. We also could be confirmed that the visiting nurses' conversation contents more matched with families' anxiety, the less the families' anxiety was reduced.

Free Research Field

社会医学

Academic Significance and Societal Importance of the Research Achievements

患者、家族介護者に対する訪問看護師の実際の発話を用いた研究はほとんどなく、実態を理解・解明する点において学術的な意義があると考える。また在宅で患者の介護を担う家族の不安に援助的な会話をもって対応することで、患者や家族の在宅療養生活の安寧につながる。これは患者の希望する場所での生活を支援しやすくなる可能性があり、人生の最終段階における患者の希望を実現するための重要かつ具体的な支援方法解明の１つとなると考える。同時にこの成果は、医療・介護の専門職教育に活用し発展させることが可能であるが、その教育的手法や方策に関する具体策については今後の課題である。