術後早期の看護ケアを行う看護師による家族に対する情報共有に関連したケア

本研究は術後早期のケア場面における手術を受けた患者の家族に対する看護師の情報共有とそれに関連したケアの内容を明らかにし，手術を受けた患者の家族に対する情報共有を基盤とした看護ケアのあり方を検討することである．研究対象者は術後早期の患者のケアを行う看護師８名であり，半構造化面接とケア場面の参加観察を行った．収集したデータは質的帰納的に分析を行った．その結果，手術を受けた患者の家族に対する看護師の情報共有に関連したケアとして，【術後早期に家族が情報を得られるように面会を調整する】【家族の患者に関する情報の理解や受け止めを捉える】【不安な家族に配慮した情報提供を心がける】【術後早期の患者の状態に関する情報提供を行う】【患者や家族を理解するために多角的に情報収集を行う】【術後早期の患者と家族を情報共有でつなぐ】【情報不足でネガティブになりがちな家族を気にかける】が明らかになった．看護師は家族に対して術後の様々な場面で情報提供を行っており，看護師が捉えた家族の心理状態を考慮して実施されていた．また，看護師は術後のケアを通して，術後の家族のネガティブな発言や行動を気にかけており，術前の入院期間の短縮化による家族との関わりの希薄さや緊張する場面でのケア実施が影響していると考えられた．看護実践において，看護師自らが情報収集および情報共有の必要性を認識し，限られた時間の中で患者や家族の状態の把握に努めるとともに，家族へ提供し，共有する情報の質保証の必要性が示唆された．

This study aimed to understand the early postoperative care activities of nurses, such as sharing information with the families of patients who have undergone surgery, and about nursing care based on information sharing with these families. The study participants were eight nurses in charge of care for early postoperative patients. Data were collected through semi-structured interviews and observations of care activities. Data were analyzed qualitatively and inductively. We identified the following categories related to the care activities of nurses in sharing information with the families of postoperative patients : ‘arranging family visits at the early postoperative stage so that the families can obtain necessary information’, ‘perceiving understanding by and thoughts of the families about the postoperative patients’, ‘trying to provide relevant information considering the feelings of the anxious families’, ‘providing information related to the patient conditions at the early postoperative stage’, ‘collecting information from various points of view to understand the families’, ‘connecting the patients and their families by sharing information’, and ‘caring about the families who are likely to feel negatively due to any lack of information’. The nurses provided information for the families in various postoperative situations by considering their psychological state. Furthermore, nurses cared about negative behavior and remarks of the families throughout postoperative care, suggesting that this is influenced by a weak relationship with the family due to the shortened preoperative hospitalization period and by the fact that nurses feel tension in providing care. These findings suggest the necessity that nurses ensure the quality of information provided for and shared with families while making efforts to understand the situation of patients and their families in the limited amount of time with awareness of the necessity of having to collecting and sharing information by themselves.