Japanese

Title	総合周産期母子医療センターの中堅看護師が実践する小児退院支援の現状と課題
Subtitle	研究報告
Authors	茂本咲子1), 田辺満子1), 後藤福美2), 古田晃子2), 若山志ほみ2)
Authors (kana)
Organization	1)岐阜県立看護大学, 2)岐阜県総合医療センター
Journal	看護実践研究学会誌
Volume	3
Number	1
Page	51-61
Year/Month	2022 / 3
Article	報告
Publisher	看護実践研究学会
Abstract	「要旨」本研究の目的は, 総合周産期母子医療センターの中堅看護師が自身の実践を振り返り, どのような思いで小児退院支援に取り組んでいるかを明らかにして, その現状を共同研究者間で共通認識し, 中堅看護師支援の課題を検討することである. NICU/GCU配属4〜7年目の看護師7名を対象に半構成的面接調査を行った後, 共同研究者5名で検討会を行った. 得られたデータを要約し意味内容の類似性に基づき分類した. 小児退院支援に取り組む中堅看護師の思いについて, 【集中治療を要する子どもと家族への関わりに難しさを感じながら, 子どもの安全と家族の苦悩する思いに寄り添い, 愛着形成を促進している】【家族との信頼関係の構築に難しさを感じながら, 家族の話を聞き, 退院に向けての意思決定を支えるようにしている】【子ども・家族・病棟の責務に板挟みを抱えながらも, 先輩に相談しチームで協働して, 院内外多職種と連携するようにしている】等の5カテゴリが明らかになった. 中堅看護師は医療的ケアを必要とする子どもと家族への対応の難しさを実感しながらも, 子どもが自宅に帰れるように家族関係や医療者との認識のずれを調整しようと努力し, 院内外の多職種と連携協働し家族と一緒にケアをしながら成長していることと, 経験を大切に自信をもって退院支援ができるよう, チームでサポートしていく必要があることを共通認識した. 本研究を通して, 中堅看護師が子どもと家族に向き合うなかでの困難感やもがきなどの感情を含めて実践を振り返り, 語ることにより, その感情が内なる動機づけとなり看護実践を支えていることを記述し見える化することができたと考える. 中堅看護師とともに看護実践を振り返る機会をつくることが重要である.
Practice	看護学
Keywords	中堅看護師, 子どもと家族, 退院支援, NICU/GCU, mid-career nurse, child and family, discharge support

English

Title	Current Situations and Issues of Child Discharge Support Practiced by Mid-Career Nurses at General Perinatal Medical Center
Subtitle
Authors	Sakiko Shigemoto1), Michiko Tanabe1), Fukumi Goto2), Akiko Furuta2), Shihomi Wakayama2)
Authors (kana)
Organization	1)Gifu College of Nursing, 2)Gifu Prefectural General Medical Center
Journal	Journal of Academy of Nursing Practice Research
Volume	3
Number	1
Page	51-61
Year/Month	2022 / 3
Article	Report
Publisher	Academy of Nursing Practice Research
Abstract	[Abstract] The purpose of this study is to examine how mid-career nurses feel in child discharge support through the nurses' reflection on their practice in a general perinatal medical center, have a common understanding of the current situation, and consider issues of nurse support. First, semi-structured interviews were conducted with seven mid-career nurses with four to seven years of experience in a neonatal intensive care unit (NICU) and growing care unit (GCU). Next, the five co-researchers held an investigative commission. The data obtained were summarized and classified according to meaning. The mid-career nurses' thoughts were grouped into five categories as follows, "Nurses are close to children's safety and family's afflictions and encourage attachment while finding it difficult to engage with children needing intensive care and their families," "Nurses listen to children's families and support their decision-making for discharge while finding it difficult to build trust with the families," "Nurses consult with senior nurses and collaborate with nursing or medical teams and multiple occupations inside and outside the hospital while they are sandwiched between the responsibilities of children, families, and wards," "Nurses feel confident and rewarded because they can watch children grow and are supported by changes in their family's child-rearing attitude," and "Nurses are working on the self-improvement and the training for juniors while feeling a sense of accomplishment in being able to care for severely ill children." While realizing the difficulty of dealing with children and families who need medical care, mid-career nurses try to coordinate family relationships and differences in awareness with medical professionals so that the children can return home. Nurses can grow professionally when they collaborate with various other professionals inside and outside the hospital, and provide care to the children with their families. We have a common understanding of the necessity for nursing or medical teams to support mid-career nurses so that they can value experience and support discharge with confidence. By reflecting and talking about their practice including the feelings of difficulty and struggle in dealing with children and families, it is possible to describe and visualize that mid-career nurses' feelings are an inner motivation and support their nursing practice. Hence, it is essential to make opportunities to reflect on nursing practices with them.
Practice	Nursing
Keywords	mid-career nurse, child and family, discharge support, NICU/GCU

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