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Japanese

Title 進行がん患者と家族の間での終末期の話し合いを促進するための家族への看護プログラムの開発
Subtitle 原著
Authors 渡邉美和, 増島麻里子
Authors (kana)
Organization 東都大学幕張ヒューマンケア学部看護学科, 千葉大学大学院看護学研究科
Journal 千葉看護学会会誌
Volume 26
Number 1
Page 39-48
Year/Month 2020 / 8
Article 原著
Publisher 千葉看護学会
Abstract がん患者が人生の最期をよりよく過ごすために, 患者が医療者や家族と十分話し合い, 患者の意思を基に終末期の医療・ケアを進めることが重要であるが, わが国ではこのような話し合いが十分に行われていない. 本研究の目的は, 進行がん患者と家族の間での終末期の話し合いを促進するための家族への看護プログラムを開発することである. 【第一段階】がん患者と家族の間での終末期の話し合いに関する問題を明らかにする目的で, 国内外の文献レビューを行った. 和文献6件, 英文献6件を対象として分析を行い, 問題の「発生」は4, 「要因」は10, 「結果」は4のカテゴリーに集約された. 【第二段階】文献レビューの結果と社会的認知理論を基盤にして, 看護プログラムの枠組みを構成し, プログラムで用いる教育的ツールとしての「進行がん患者と家族の間での終末期の話し合いを促進するための家族向けのガイドブック」を作成した. また, ガイドブックの課題を明らかにする目的で, 終末期がん看護のエキスパート看護師を対象にインタビュー調査を実施し, 明らかとなった12の課題を基にガイドブックを修正した. 本研究では, 文献レビューにて明らかになったがん患者の終末期の話し合いに関する問題と社会的認知理論を基盤として, 看護プログラムとガイドブックを考案した. また, エキスパート看護師の意見を基にガイドブックを洗練した. 今後はプログラムを試行しその効果を明らかにする必要がある.
Practice 看護学
Keywords end-of-life discussions, advance care planning, cancer, nursing program

English

Title DEVELOPMENT OF A NURSING PROGRAM FOR FAMILY MEMBERS OF PATIENTS WITH ADVANCED CANCER TO PROMOTE END-OF-LIFE DISCUSSIONS
Subtitle Original Articles
Authors Miwa Watanabe*1, Mariko Masujima*2
Authors (kana)
Organization *1:Tohto University, Makuhari Faculty of Human Care, Department of Nursing, *2:Chiba University, Graduate School of Nursing
Journal Journal of Chiba Academy of Nursing Science
Volume 26
Number 1
Page 39-48
Year/Month 2020 / 8
Article Original article
Publisher Chiba Academy of Nursing Science
Abstract In order for cancer patients to better spend the end of their lives, it is important for patients to thoroughly discuss their wishes with their healthcare providers and their families, and to promote end-of-life care based on the patient's will. However, in Japan, the discussion is not done often enough. The purpose of this study is to develop a nursing program for family members of patients with advanced cancer to promote end-of-life discussions between the patients and the family members. [Phase I] I reviewed domestic and international literature for the purpose of clarifying problems concerning end-of-life discussions between cancer patients and their families. I analyzed six Japanese and six English research articles, and four categories were derived as "Manifestations" of the problem, ten categories were derived as "Determinants" and four categories were derived as "Consequences." [Phase II] Based on the results of Phase I and social cognitive theory, I constructed the framework of the nursing program, and as an educational tool used in the program, "A guidebook for family members of patients with advanced cancer to promote end-of-life discussions." In order to clarify the problems of the "guidebook," an interview survey was conducted for expert end-of-life cancer nurses. The twelve categories were extracted regarding problems in the guide book, then the guidebooks were modified based on the results. The framework of the nursing program and the guidebook were constructed based on the problems about end-of-life discussions of cancer patients identified by literature reviews and social cognitive theory. I also modified the guidebook based on the opinions of expert nurses. In the future, it is necessary to try the program and clarify the effect of the program.
Practice Nursing
Keywords end-of-life discussions, advance care planning, cancer, nursing program
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