術後せん妄を発症した高齢患者の家族の体験

【目的】術後せん妄を発症した高齢患者の家族が患者のせん妄に遭遇することで，どのような体験をしているのかを明らかにし，看護実践への示唆を得る．
【方法】術後せん妄を発症した高齢患者の家族１４名を研究対象とした．家族に対して患者の術後せん妄に関する半構造化インタビューを実施した．参加者ごとに得られたデータのコード，サブカテゴリの生成を行い，サブカテゴリを参加者間で類似比較し，カテゴリを生成した．
【結果】術後せん妄を発症した高齢患者の家族の体験について分析した結果，「ただならぬ様子」，「回復の見通しがみえない不安」，「なんとか助けたい」，「対応を悔やむ」，「思いや対応が通用しない」，「想像したせん妄と現実の相違」，「迷惑をかける申し訳なさ」，「心身の限界」，「医療者との解釈の相違」の９つのカテゴリが生成された．
【結論】術後せん妄を発症した高齢患者の家族は，術後の回復過程で患者の異変に気づき，緊迫した状況に不安を感じながら，患者を助けたいと対応を試み，後悔や周囲への申し訳なさを感じていた．看護師には術後せん妄を発症した高齢患者の家族に対する正確な情報提供や，家族が安心して患者へ対応ができるための支援が必要であることが示唆された．

Objective ： To determine the experiences of family members of older patients who have postoperative delirium and to obtain perspectives for nursing practice.
Methods ： Fourteen family members of older patients with postoperative delirium were included in the study. Semi-structured interviews were conducted with family members. The data obtained from each individual were coded and categorized according to themes. Similarity among participants’ descriptions were identified from which thematic categories were recognized.
Results：The following nine categories of experiences of family members of patients with postoperative delirium were identified : “strange behavior”, “uncertainty about the prospect of recovery”, “desire to be helpful somehow”, “regret over method of handling”, “feelings and actions with no effect”, “disparity between expected and actual delirium”, “apologetic feeling for annoyance to others”, “sense of reaching the physical and mental limit” and “difference in views from medical staff”.
Conclusion ： Family members of older patients exhibiting postoperative delirium exhibited remorse and expressed regret and apology to the neighborhood upon noticing changes in the patient’s behavior during postoperative recovery. They were uneasy under great strain, while also trying to attempt to help the patient. The results suggested that it is necessary for nurses to strive to provide family members of older patients with postoperative delirium with accurate information and support and that it is usual for family members to attempt to ease patient unconventional behaviors.