Comparison in the views of life and death between nurses and docters of a University Hospital

医師と看護師の死生観とその影響要因の相違をふまえ，質の高い緩和ケアチームについて検討することを目的とした．A 大学病院に勤務する医師と看護師に死生観について質問紙調査を行った．平井らが開発した死生観尺度（▯＝０．８８，７因子２７項目）を用いた．有効回答は医師１２０名（医師群）と看護師３４７名（看護師群）であった。統計処理については危険率５％未満を有意差とした．分析にはSPSS１１．０J for Windows（SPSS社製）を用いた．倫理的配慮は倫理審査会の承認を得た後，対象者へは参加の自由とプライバシーの保護を保証した．①「死への恐怖・不安」と「人生の目的意識」の因子には群間で有意差は認められなかった．②「死後の世界観」，「解放としての死」，「死からの回避」，「死への関心」や「寿命観」の５因子において両群間で有意に看護師群の方が高かった．③年齢などの各要因と死生観尺度との関係は両群者ともに年齢と「寿命観」で有意差が認められた．④死を迎える時に，希望する場所と死生観尺度得点に有意差が認められた．医師と看護師の死生観は「死後の世界観」などの因子得点で有意差が認められ，緩和ケアチームを効果的に展開していくためには双方の死生観の理解と，ケアへの活用の必要性が示唆された．A high quality palliative care team has been examined considering the differences between doctors and nurses in their views of life and death and its influential factors. A survey has been conducted on doctors and nurses employed at A University Hospital in their views of life and death. “Rinroshiki Syakudo”, a scale developed by Hirai et al（▯＝０．８８，７ factors，２７ items）, has been used as a scale of their views. The results of １２０ doctors and ３４７ nurses were analyzed by t-test, and significant difference was defined as a risk below ５％. SPSS １１．０J for Windows（by SPSS）was used for the analysis. After an approval of an audit for an ethical consideration, participants were ensured their freedom to participate and privacy protection. １） No significant differences have been found in factors “death anxiety” and “life purpose” in scales of views of life and death ２） However ５ factors， “after life belief”， “death relief”，“death avoidance”， “death concern” and “supernatural belief” were significantly high in nurses. ３） There was also a significant difference between the age and their “supernatural belief” in both doctors and nurses. ４） There were also significant differences in “where they want to die” and the total score of the scale, when facing own death. There being differences in factors such as “afterlife belief” between doctors’ views and those of nurses, the result suggested the need to understand both of the views and reflect them to palliative care

Suffering Among the Families of Cancer Patients : Conceptual Analysis

We clarified the construct of the suffering among the families of cancer patients based on domestic and overseas studies that had been announced up to now as original article. Referencing Walker’s concept analysis, we extracted the concept of suffering by looking at the general uses of the word “suffering”, suffering as viewed in psychology and studies on the suffering of families of cancer patients. We found that such, suffering consisted of two constructs unpleasant psychological pain and uncertainty about the future. Also it was considered that the precedent matters of the suffering of the families were “To understand the pain of the patients” and “To be put in a difficult situation where there was no prospect”. As a result of the suffering, “Depression that made one staying indoors in oneself leading a decline in a sense of emotion and joy” and “Anger that easily raised negative feelings leading inability to maintain harmonious relations with others” was revealed. “Loss of a sense of control”, “Loss”, “Sense of guilt”, “Incompetence” “Insensibility” and “Conflict” were also found as sub-concept of “Unpleasant psychological pain”. Subconcept of “Uncertainty about the future”, “Therapeutic effect, disease progressing and prognosis” “Family like style including that of patients themselves”, “Life after a patient’s death” and “Potential genetic predisposition to ward cancer among family members” were suggested. The clinical scenes tends to deal only empirically with family suffering as these effect family quality of life during medical treatment, so an appropriate assessment is needed to reduce suffering. This is turn makes necessary to clarify the process of suffering among the families during medical treatment and to construct of a nursing model