Japanese

Title	手術室入室時における患者の体験
Subtitle	原著
Authors	渡邊幸裕1, 中村泰子1, 古島幸江2
Authors (kana)
Organization	1JA北海道厚生連旭川厚生病院手術室, 2自治医科大学看護学部
Journal	日本手術医学会誌
Volume	43
Number	1
Page	82-89
Year/Month	2022 / 2
Article	原著
Publisher	日本手術医学会
Abstract	要旨:本研究は, 手術室に入室してきた患者の体験を明らかにし, 手術室入室時における看護実践への示唆を得ることを目的とした. 全身麻酔下で手術を受けた患者10名に半構造化面接を実施し, Thinking At the Edgeの手法を用いて質的に分析した. 結果, 手術室入室時の体験は【レールに乗せられた私はいったいどこに連れて行かれるのか気持ちが張り詰める】【イメージしていた手術室と実際の手術室に対するギャップに戸惑う】【見えた聞こえたもの全てが自分のからだが切られることを連想させて生々しい】【すべてを委ねる人にきちんと挨拶をしたいがそういう感じじゃない】【医療者に身を任せて微動だにしないことに精一杯だ】【次々と指示された自分がやること以外は耳に入ってこない】【なんとなく音楽が聞こえてきたような気がする】【麻酔前に看護師が傍で手を握ってくれて励まされた】【先生がずっと傍にいて声をかけてくれて自分は大丈夫だと思えた】【自分で決めて納得してきたから自分から歩みを進める】という10パターンが抽出された. 手術室入室時における患者の体験の特徴は, 視覚や聴覚, 肌からの触覚を通して様々なものを知覚しており, 医療者に言われるがまま, されるがままという体験をしていた. さらに, 自分がおかれた状況について現実的に認識し, 手術に関連する恐怖や手術の成功を切に願う期待などの多様な要因によって, ネガティブな感情とポジティブな感情が交錯した体験をしていたことが考えられた. そのため手術室入室時における看護実践は, 手術室看護師は患者に忙しさを知覚させないこと, 手術室入室時に行うべき確認行為や身体的準備について患者が自分に必要なことだと理解し納得したうえで参画できるよう支援する必要がある. また, 感覚を通して知覚したものすべてが手術を受けるというリアルなイメージを喚起させていたため, 患者の視覚範囲やセンシティブになっている感覚をふまえた環境整備が必要である.
Practice	臨床医学：外科系
Keywords	手術患者, 手術室入室時, 体験, 手術看護

English

Title	The experience of a patient entering the operating room
Subtitle
Authors	Yukihiro Watanabe1, Yasuko Nakamura1, Sachie Furushima2
Authors (kana)
Organization	1Asahikawa-Kosei General Hospital, 2Jichi Medical University School of Nursing
Journal	Journal of Japanese Association for Operating Room Technology
Volume	43
Number	1
Page	82-89
Year/Month	2022 / 2
Article	Original article
Publisher	Japanese Association for Operative Medicine
Abstract	[Abstract] The purpose of this study was to clarify the experiences of patients entering the operating room and to obtain suggestions for nursing practice when entering the operating room. Semi-structured interviews were conducted with 10 patients who underwent surgery under general anesthesia and were qualitatively analyzed using the Thinking At the Edge method. The results showed that the patients' experiences upon entering the operating room were as follows : "I was put on a rail, and I felt tense, wondering where I was being taken," "I was confused by the gap between my image of the operating room and the actual operating room," "Everything I saw and heard reminded me of the incision on my body, and it was very graphic." [I want to greet the person who will be entrusting me with everything, but that is not allowed] [I'm doing my best to leave myself in the hands of the medical staff and not move an inch] [I can't hear anything other than what I'm being instructed to do one after another] [I feel like I'm hearing music] [Before the anesthesia, a nurse held my hand and encouraged me I was encouraged by the nurse who held my hand before the anesthesia], [I felt that I would be all right because the doctor was by my side all the time and talked to me], and [I decided on my own and was convinced, so I proceeded on my own]. The characteristics of the experiences of the patients who entered the operating room were that they perceived various things through their sense of sight and hearing and their sense of touch from their skin, and that they experienced things as they were told by the medical staff and as they were done. In addition, they were aware of their situation realistically and experienced a mixture of negative and positive emotions due to various factors such as fear of the surgery and hope for the success of the surgery. Therefore, in nursing practice at the time of entering the operating room, operating room nurses need to prevent patients from perceiving busyness, and support patients to understand and participate in the confirmation actions and physical preparations that should be made at the time of entering the operating room. In addition, since everything perceived through the senses evokes a realistic image of undergoing surgery, it is necessary to create an environment that takes into account the patient's visual range and sensory sensitivities.
Practice	Clinical surgery
Keywords

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