intervention study to evaluate the effectiveness of"collaborative model for disclosure of bad news to share decision making"and its practical use

Research Project

Project/Area Number	15K11626
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Clinical nursing
Research Institution	Oita University
Principal Investigator	teramachi yoshiko 大分大学, 医学部, 教授 (70315323)
Co-Investigator(Kenkyū-buntansha)	鈴木志津枝神戸市看護大学, 看護学部, 教授 (00149709) 植田喜久子日本赤十字広島看護大学, 看護学部, 教授 (40253067) 東清巳熊本大学, 大学院生命科学研究部(保), 教授 (90295113) 橋本理恵子大分大学, 医学部, 助教 (90761130) 大野夏稀大分大学, 医学部, 助教 (20818596)
Project Period (FY)	2015-04-01 – 2020-03-31
Project Status	Completed (Fiscal Year 2019)
Budget Amount *help	¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000) Fiscal Year 2018: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000) Fiscal Year 2017: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000) Fiscal Year 2016: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000) Fiscal Year 2015: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywords	意思決定支援 / 悪い知らせ / インフォームド・コンセント / 協働 / チーム医療 / 協働モデル / 有用性 / 実用性 / 合意意思決定
Outline of Final Research Achievements	The purpose of this study is to clarify the effectiveness of “collaborative model for disclosure of bad news to share decision making” and to reveal the issues for its practical use. A semi-structured interview with 12 nurses at 2 facilities was conducted to fulfill the purpose. We concluded that this model could raise nurses’ awareness about persons and processes necessary for decision making, roles of nurses and team medical care. In addition, this model could be an evidence-based background for predictive and intentional approaches. For practical use of this model, the following issues should be resolved: (1) how to train nurses to use it, (2) how to improve a protocol and strategy, (3) how to make nurses aware of its importance, (3) how to standardize the practical clinical ability of supporting decision making, (4) how to improve collaboration of nurses and doctors.
Academic Significance and Societal Importance of the Research Achievements	本研究により、【悪い知らせを伝え意思決定する協働モデル】の有用性が明らかになった。今後、実用化に向けた課題に取り組むことにより、本モデルが臨床現場で活用されれば、現場の看護師の意思決定支援がエビデンスに基づく、質の高いものとなる。このことにより、悪い知らせを伝えられた患者や家族と医療者の合意意思決定がよりよいものとなることを保証し、患者・家族のＱＯＬを高めることに貢献できる。