一般病院精神科病棟における精神看護学実習での学生の学びの特徴と課題

The purpose of this study is to clarify the learning characteristics of nursing students during practical psychiatric nursing training at the general hospital of psychiatry. The other purpose is to consider the issues in the development of practical psychiatric nursing training. The subjects involved were 34 students who agreed to use their complete learning reports upon completing their practical training. The students were in their third year in the school of nursing, faculty of medicine at A university in 2006. After analyzing the contents of the students learning reports we isolated six categories and twenty-three sub-categories. The six categories were the following: "The approach to the mind and body of the patient who has a physical and mental disease", "The confusion which results in trying to understand the isolation and restriction of meaning with a treatment", "The process and development of building a relationship of trust", "The deepening of experience in obJective understanding", "Self understanding which is essential for the development of concern", "Understanding the environment which surrounds a patient and the problem." The students learned the technical aspects of patient's mental disease and the treatment-techniques. The students also learned the approach to the mind and body of the patient who has a physical and mental disease.

本研究の目的は,精神看護学実習を展開する上での課題を検討するために,一般病院精神科病棟における精神看護学実習での学生の学びの特徴を明らかにすることである。対象は,2006年度A大学附属病院精神科病棟で精神看護学実習に取り組んだ,A大学の3年次の看護学生のうち同意が得られた34名の実習終了時のレポートの内容である。レポートから学びの内容を分析した結果,6のカテゴリー【身体疾患と精神疾患をあわせもつ患者の心身へのアプローチ】【隔離・拘束の治療的意味を理解するまでの戸惑い】【信頼関係を築き発展させるプロセス】【体験を通した対象理解の深まり】【かかわりの進展に欠かせない自己理解】【患者を取り巻く環境の理解とその課題】と23のサブカテゴリーが抽出された。学生の学びの特徴は,精神疾患患者のもつ特徴的な症状の理解,精神科で用いられる各種治療技術・看護技術の理解と合併症をもつ患者の心身へのアプローチであった。