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Japanese

Title 心不全患者のアドバンス・ケア・プランニングの概念分析
Subtitle 総説
Authors 山本美保1), 吉岡さおり2)
Authors (kana)
Organization 1)京都府立医科大学大学院保健看護学研究科博士後期課程, 2)京都府立医科大学大学院保健看護学研究科
Journal 日本看護科学会誌
Volume 40
Number
Page 537-543
Year/Month 2020 /
Article 報告
Publisher 日本看護科学学会
Abstract 「要旨」目的: 心不全患者のアドバンス・ケア・プランニングの概念を明らかにすることである. 方法: Rodgersの概念分析の手法を用いた. 結果: 分析の結果, 7つの属性【希望を持ちながら最悪の事態への備え】【その人の価値の探求】【疾患管理を見据えた生活の編み直し】【病みの軌跡に関する認識を合わせること】【納得したケアゴールに向けた対話】【段階的で継続的な取り組み】【患者の意思をつむいでいくこと】, 4つの先行要件, 4つの帰結が明らかになった. 結論: 本概念は「患者が家族・医療者とともに価値を探求し, 疾患管理のための生活の編み直しをしながら, 最悪の事態への備えとして, 病みの軌跡に関する認識を合わせることや, 納得したケアゴールに向けた対話を繰り返し, 患者の意思をつむいでいくプロセス」と定義した. 本概念は心不全の臨床経過の特徴を反映し, 慢性疾患のセルフマネジメントの要素を含むことが示唆された.
Practice 看護学
Keywords 心不全, アドバンス・ケア・プランニング, 概念分析, heart failure, advance care planning, concept analysis

English

Title Concept Analysis of Advance Care Planning for Patients with Heart Failure
Subtitle
Authors Miho Yamamoto1), Saori Yoshioka2)
Authors (kana)
Organization 1)Doctoral Course, Graduate School of Nursing for Health Care Science, Kyoto Prefectural University of Medicine, 2)Graduate School of Nursing for Health Care Science, Kyoto Prefectural University of Medicine
Journal Journal of Japan Academy of Nursing Science
Volume 40
Number
Page 537-543
Year/Month 2020 /
Article Report
Publisher Japan Academy of Nursing Science
Abstract [Abstract] Objective: To clarify the concept of advance care planning (ACP) for patients with heart failure. Method: The concept analysis method described by Rodgers. Results: The following seven attributes were identified: "hoping for the best but preparing for the worst," "exploration of personal values," "life restructuring from the perspective of disease management, " "sharing recognition of the patient's illness trajectory, " "dialogue toward satisfactory care goals," "step-by-step and continuous efforts," and "sharing patient hopes." In addition, four antecedents and four consequences were identified. Conclusion: ACP in patients with heart failure was defined as a process to prepare for the worst, share recognition of the illness's trajectory, conduct dialogues toward satisfactory care goals, and share patient hopes, while exploring personal values and restructuring life from the perspective of disease management together with family and medical staff. These findings suggested that the concepts of ACP for patients with heart failure reflected the clinical course of the disease, and that self-management of chronic disease was included in the attributes.
Practice Nursing
Keywords heart failure, advance care planning, concept analysis
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