Departmental Bulletin Paper 大学病院精神科病棟の看護師が実践する精神科看護の専門性
The Psychiatric Nursing Specialty of Nurses Working in the Psychiatric Ward of a University Hospital
ダイガクビョウイン セイシンカ ビョウトウ ノ カンゴシ ガ ジッセン スル セイシンカ カンゴ ノ センモンセイ

尾原, 崇仁  ,  岡野, 照美  ,  福本, のりえ  ,  Ohara, Takayoshi  ,  Okano, Terumi  ,  Fukumoto, Norie  ,  オハラ, タカヨシ  ,  オカノ, テルミ  ,  フクモト, ノリエ

24 ( 1 )  , pp.10 - 17 , 2018-03-31 , 大阪大学大学院医学系研究科保健学専攻 , オオサカ ダイガク ダイガクイン イガクケイ ケンキュウカ ホケンガク センコウ
Original Articles
大学病院精神科病棟の看護師が精神科看護の専門性をどのように認識し, 実践しているかを明らかにすることを目的に, 看護師9名に半構造化面接をし, 質的記述的に分析した. 看護師は, 【適切な距離を保ち良好な関係を構築する存在】【多面的な把握による言動の本質を捉えた対応】【看護師の個性・経験知を生かした柔軟な対応】を基盤とし, 【拒否する患者が受け入れやすい介入】【患者の不安定な気持ちの鎮静化】【幻覚・妄想を認めた上で患者の注意を現実に誘導】【精神状態に伴う危機的状況の予防】をし, 患者の将来に向け【患者の力を引きだし自立に繋げる支援】【患者と協働で周囲の支援を得ながら行う退院に向けた調整】を行っていた. また【精神科看護に潜む不明瞭性の自覚】も専門性と認識していた. これらのことから, 不明瞭性を自覚しながらも患者の本質の理解に努め. 患者に応じた看護実践を組み合わせ, その人らしい生活ができるように支援する重要性が示唆された.
The purpose of this study was to clarify the perceptions and practice of the psychiatric nursing specialty among nurses working in the psychiatric ward of a university hospital. Data were collected using semi-structured interviews of 9 psychiatric nurses who had ≥2 years of work experience. Interview data were analyzed using a qualitative descriptive method. The following ten categories were extracted from the analysis: (1) considering ways to become a nurse who can build a good relationship with patients while maintaining an appropriate distance from patients; (2) caring for patients while understanding the spirit of patients’ words and behaviors after considering the patients from various perspective; (3) reacting in a flexible manner by making good use of a nurse’s personality and empirical knowledge; (4) intervening in ways that are easy for patients who do not accept their nursing care plan or the treatment plan; (5) easing the unstable feeling of patients; (6) supporting patients who report experiencing hallucinations or delusions to differentiate them from reality; (7) preventing a crisis associated with psychological factors; (8) helping patients become more independent while bringing out each patient’s full potential; (9) creating a comfortable lifestyle for patients after leaving the hospital by establishing cooperation between the patients and those who provide support for them; and (10) remaining aware that there is uncertainty hidden within psychiatric nursing. These finding suggest that it is important for nurses to understanding the spirit of patients while remaining aware of the uncertainty hidden within psychiatric nursing, using flexible practices, and supporting patients to live their own life.

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