終末期肺がん患者・家族の看護に対する看護師の心情

本研究の目的は終末期肺がん患者・家族への看護に対する看護師のネガティブおよびポジティブな感情を含めた心情を明らかにし，肺がん患者・家族の終末期における看護を検討することである．終末期肺がん患者を担当した経験がある看護師２２名に半構造的面接を行い，内容を質的帰納的に分析した．結果，看護師の心情として【肺がん特有の苦悩を取り除けない心苦しさ】【終末期看護に対する自分の技量の不足への不甲斐なさ】【その人の人生最期を支える重圧感】【家族の看取りのプロセスとして心する】【人の最期に関わることへのやりがい】【患者の死を大切に理解したいという切実な思い】の６つのカテゴリーが抽出された．看護師は終末期肺がん患者のケアを行う中で多様な苦悩や治療に対する葛藤を抱えていることが分かった．また患者のみならず，家族をも看護の対象として捉え，その関わりへの困難を抱えていた．看護師は家族が患者の死を自然なものとして捉えることが出来るように関わり，患者が精神的に充実した最期を迎えることが出来るように介入していた．また患者の死の体験は死生観，看護観を深め，看護師の成長につながっていることが分かった．

This study aimed to describe the lived experiences of nurses who cared for patients with cancer and their families during the terminal phase. A semi-structured interview was conducted with twenty-two nurses who cared for patients with cancer at their terminal stage. These interviews were transcribed and analyzed by identifying words, phrases and statements that describe the experiences of the nurses. As a result, the findings of the study discovered the following six thematic categories : Regret for failing to rid of distress peculiar to lung cancer ; Cowardliness for lack of competency in their nursing skills ; Disheartening feeling during the last moments of the patient’s life ; Expressing EOLC process for the family ; Worthiness to be involved during the last moments of the patient’s life ; and Earnest desire to understand the patient’s death. While nurses may have emotional distress and personal conflicts while taking care of patients, particularly those with lung cancer, this study revealed that The nurses’ experiences of caring for patients with lung cancer during the terminal stage is critical to understanding the humanness during the EOLC. As a recommendation from this study, it is important to include the patients’ families in their care. Family participation may lead them to have an easier acceptance of the patients’ death, by focusing on the situation as a natural occurrence, and for the patients to have a good death. Moreover, the experience of the nurses have deepened their views of life and death situations impacting their practice, and enhancing their growth as nurses during EOL.