外来化学療法を受ける高齢がん患者に対する熟練訪問看護師の看護実践

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This study is intended to clarify the nursing practices of skilled visiting nurses for elderly cancer patients undergoing outpatient chemotherapy. A semi-structured interview was conducted with six full-time visiting nurses with five years’ experience of service at a visiting nurse station. The interview was analyzed qualitatively and descriptively. Nursing practices for elderly cancer patients receiving outpatient chemotherapy were extracted and divided into nine categories including: “taking measures against adverse events so that users can continue their daily lives at home,” “supporting users and their families while giving consideration to their family relationships,” “trying to understand vacillating feelings about endless treatment,” “respect and interact with the user’s way of life from the story,” “being involved while anticipating future situations so that they can spend their time without regrets.” It was suggested that skilled visiting nurses understand the characteristics of elderly cancer patients undergoing outpatient chemotherapy and use their extensive knowledge and experience to support them in continuing their treatment and living at home.

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本研究の目的は、外来化学療法を受ける高齢がん患者に対する熟練訪問看護師の看護実践を明らかにすることである。訪問看護ステーション勤務年数５年以上の常勤看護師６名に対し半構造化面接を実施し、質的記述的分析を行った。外来化学療法を受ける高齢がん患者に対する熟練訪問看護師の看護実践として、【利用者なりの日常生活が継続できるように有害事象対策を行う】【家族関係に配慮しながら利用者と家族を支える】【終わりのない治療に対する揺れる思いを分かろうとする】【語りから利用者の生き方を尊重して関わる】【後悔なく過ごせるように今後起こり得る局面を予測しながら関わる】など９つのカテゴリーが抽出された。熟練訪問看護師は、外来化学療法を受ける高齢がん患者の特徴を捉え、豊富な知識と経験を活用しながら、治療と在宅生活の継続を支えていることが示唆された。