短期入院による化学療法を継続する大腸がん患者のセルフケアに関する研究

application/pdf本研究の目的は，短期入院による化学療法を継続する大腸がん患者のセルフケアを行う上での問題とセルフケアを明らかにし，セルフケアの促進に必要な援助を検討することである。対象者は，大腸がんで研究同意の得られた5名で，データ収集は，半構成的質問紙を用いて面接を行い，質的帰納的に分析を行った。患者のセルフケアを行う上での問題は，【がん罹患や病状に対する悲観】【治療処置そのものに関する懸念】【抗がん剤の副作用よる苦痛な身体症状】【副作用症状に対する否定的な思い】【化学療法を継続することに関する懸念】【不安定な現状と将来への不安】【社会的役割が遂行できない難しさ】の7つのカテゴリーとセルフケアは『自己調整型行動』『環境調整型行動』『感情調整型制御』の3つのカテゴリーが抽出された。以上の結果より，患者のセルフケアを促進する看護援助として，1）持続する副作用による苦痛な身体症状に対する援助，2）がん罹患や病状の進行への不安に対する援助，3）不確かで限られた治療を継続することを支える援助の3つの援助の必要性が示唆された。The purpose of this study was to determine problems regarding self-care in patients with colorectal cancer who continue chemotherapy through short-term hospitalization, and to consider the necessary support to facilitate such self-care.Subjects were those with colorectal cancer who provided consent for the study.Data were collected by interview using semi-structured questionnaires,and qualitative and inductive analyses were performed.Seven categories were selected for problems regarding patient’s self-care:“painful physical symptoms caused by side effects of anticancer agents”,“concerns about the treatment itself”,“negative feeling over symptoms of side effects”,“pessimism regarding the cancer and symptoms”,“concerns about continuing chemotherapy”,“anxiety over the fragile existing condition and future”,and “the difficulty of playing a social role”. Three categories were selected for self-care:“self-adjusting behavior”, “environment-adjusting behavior” and “emotion-adjusting control”. Therefore, the need to provide three kinds of support was suggested as support to facilitate patientself-care: “support for painful physical symptoms caused by continued side effects”“support for anxiety regarding the cancer and progression of symptoms”,and“support for the continuation of uncertain and limited treatment”.報告|Report

Development and testing of nursing intervention model to promote prevention of dehydration in elderly cardiac surgery patients

The purpose of this study was to develop and test a nursing intervention model for promoting the prevention of dehydration in elderly patients who have undergone cardiac surgeries. The study was conducted using a case study method with due ethical considerations by obtaining approval from the institutional review boards at the centers participating in the study. A nursing intervention model was developed based on the literature and researchers' nursing intervention for elderly patients who underwent cardiac surgery. The goal of intervention was that these patients can understand the necessity of preventing dehydration, take actions to prevent it, and be aware of any abnormalities such as dehydration and heart failure. The timing of intervention was prior to hospital discharge and at the first visit to an outpatient department. The intervention focused on the abilities of these patients to: 1) understand the necessity of preventing dehydration, 2) drink more than 1,000 ml of water per day, and 3) identify any abnormalities related to the symptoms of dehydration and cardiac failure. The nursing intervention model was tested by applying it to one male patient in his 70s who underwent coronary artery bypass grafting; this patient achieved the goal of intervention, suggesting the usefulness of the nursing intervention model.本研究の目的は，心臓手術を受けた高齢患者の脱水症予防を促すための看護介入モデルを作成し，検証する ことである。研究方法は，事例研究とし，倫理的配慮は，研究協力施設の倫理委員会の承認を得て実施した。看護介入モデルは，文献および研究者の心臓手術を受けた高齢患者の看護実践に基づいて作成した。介入の目標は，心臓手術を受けた高齢患者が脱水症予防の必要性を理解し，脱水症予防や脱水症，心不全の異常の発見行動ができるとした。介入の時期は退院前を第1 回目，初回外来受診時を第2 回目とし，介入の焦点は①脱水症予防の必要性を理解することができる② 1000ml/日以上飲水することができる③脱水症，心不全症状の異常の発見ができるとした。看護介入モデルの検証は，作成した看護介入モデルに沿って，冠状動脈バイパス術を受けた70 歳代の男性1 名に適応し，介入の目標を達成することができたことから，看護介入モデルの有用性が示唆された。症例報告Case Report