Japanese

Title	進行期がん患者とのコミュニケーションに関する文献検討
Subtitle	総説
Authors	山下彩友美1), 川崎優子2)
Authors (kana)
Organization	1)兵庫県立大学大学院看護学研究科 博士前期課程 がん看護学専攻, 2)兵庫県立大学看護学部 治療看護学
Journal	兵庫県立大学看護学部・地域ケア開発研究所紀要
Volume	32
Number
Page	29-43
Year/Month	2025 / 3
Article	報告
Publisher	兵庫県立大学看護学部・地域ケア開発研究所
Abstract	「要旨」【目的】国内外のACP実践の研究から, 成人進行がん患者が医療者と医療やケアについて繰り返し話し合うプロセスの中でおこなわれているコミュニケーションの実態を明らかにし, 看護職がコミュニケーションをどのように提供するべきかという実践課題に対しての具体的な方策, 研究においての今後の課題について明らかにすること. 【方法】分析対象は2019年1月から2024年7月までに発表された文献とした. 国内文献は医中誌WEB, 国外文献はCINAHL, MEDLINE Complete, PubMedを用いた. がん, Advance care planning, コミュニケーションをキーワードとし, ハンドサーチにて追加した文献を合わせて16件を分析対象とした. 分析対象の文献から, コミュニケーションについての記述を抽出し, コード化して抽象度を高めてカテゴリーを生成した. 【結果】医療やケアについて繰り返し話し合うプロセスにおけるコミュニケーションにおける内的要素として【伝え方】, 【問い方】, 【情報共有】, 【信頼関係に基づく人間関係】, 【医療者の態度】, 【患者家族の準備状態】, 【タイミングを逃さず開始】, 【継続的な評価】が特定された. 外的要素として【コミュニケーションツールの使用】, 【教育】, 【システムの構築】, 【手段】, 【参加する人の調整】が特定された. 【結論】実践課題への具体的な方策として, 患者家族の今までの意思決定のプロセス・患者の生活における目標・家族への負担に関する考えといった情報の共有, 医療者の態度形成につながる死生を語り合う教育機会, 患者や家族がもつ医療やケアが健康に及ぼす影響についての考えを知る, 患者や家族が自分たちの価値観に気づき表出する各段階での支援や看護師が捉えた患者像に関するフィードバック, ツールやプログラムを活用し患者の懸念を基にした話し合いを診断期から行う, が示唆された. 研究課題として, 調査研究や観察研究を行いコミュニケーションの実態を明らかにする, 診断期や治療期におけるコミュニケーションの障壁や課題を明らかにする, ツールやプログラム使用による介入の信頼性の検討, が示唆された.
Practice	看護学
Keywords	進行がん, コミュニケーション, Advanced cancer, Communication

English

Title	Domestic and International Literature Review on Communication with Advanced Cancer
Subtitle
Authors	Satomi Yamashita1), Yuko Kawasaki2)
Authors (kana)
Organization	1)Cancer Nursing, Master's Program, Graduate School of Nursing Art and Science, University of Hyogo, 2)Clinical Nursing, College of Nursing Art and Science, University of Hyogo
Journal	University of Hyogo College of Nursing Art and Science & Research Institute of Nursing Care for People and Community Bulletin
Volume	32
Number
Page	29-43
Year/Month	2025 / 3
Article	Report
Publisher	University of Hyogo College of Nursing Art and Science & Research Institute of Nursing Care for People and Community
Abstract	[Abstract] [Purpose] Based on domestic and international research on ACP practice, the purpose of this study was to clarify the actual state of communication that takes place in the process of repeated discussions between adult advanced cancer patients and medical professionals about medical care and to obtain concrete suggestions for the practical issue of how nurses should provide communication, and to obtain suggestions for future research issues. [Methods] Documents published from January 2019 to July 2024 were analyzed. Ichushi Web (JAMAS, the Japan Medical Abstracts Society) was used for Japanese publications, whereas CINAHL, MEDLINE Complete, and PubMed were used for foreign studies. The keywords included "cancer, " "advance care planning, " and "communication." Together with additional documents found via hand-searching, the analysis included 16 documents. From the selected documents, statements concerning communication were extracted and encoded, and categories were generated to raise the level of abstraction. [Results] Specified as internal elements for communications in the process of repeated discussions about medical care and care were the following: telling method, asking method, information sharing, human relationship based on a relationship of trust, attitude of healthcare provider, readiness of the patient's family, initiate communication through opportunities, and continuous assessment. Specified as external elements were using communication tools, education, system building, methods, and coordination and adjustments for participants. [Conclusion] Specific measures suggested for addressing practical issues include sharing information such as the patient's family's decision-making process to date, the patient's goals in life, and thoughts about the burden on the family; educational opportunities to discuss life and death which will lead to the formation of medical professionals' attitudes; learning about the thoughts of patients and families about the impact of medical care and care on health; supporting patients and families at each stage to help them become aware of and express their values, as well as feedback to nurses about the image of the patient as they perceive it; and using tools and programs to hold discussions based on the patient's concerns from the diagnosis stage. Suggested research topics include conducting surveys and observational studies, clarifying communication barriers and challenges during the diagnosis and treatment stages, and examining the reliability of interventions using tools and programs.
Practice	Nursing
Keywords	Advanced cancer, Communication

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