看護師が認識する長期療養高齢者の苦痛

This study aimed to explore the discomfort experienced by elderly people receiving longterm medical care based on nurses’ perceptions. Sixteen nurses working at hospitals with long-term care beds in Prefecture A participated in a semi-structured interview. Their responses were qualitatively and inductively analyzed. The discomfort of elderly people receiving long-term medical care, as perceived by nurses, was categorized into five categories: physical discomfort associated with disease progression or disuse, discomfort associated with loss of autonomy, physical discomfort associated with care, discomfort resulting from being treated without proper consideration of dignity, and discomfort resulting from loss of relationships or uncertainty. The study found that elderly people receiving longterm medical care endure not only discomfort caused by disease progression and age-related functional impairment but also distress caused by the discomfort itself, as well as discomfort that can be avoided or alleviated through appropriate care by healthcare professionals. The implications of this study for nursing practice highlight the importance of recognizing signs of discomfort and providing appropriate treatment to alleviate it. This approach can help prevent increased distress and mitigate inappropriate care, thereby protecting the dignity of elderly people.

本研究の目的は、長期療養高齢者の苦痛を、看護師の認識から明らかにすることである。 A県内の医療療養病床に勤務する看護師16名を対象に、半構造化面接を実施し、質的帰納的に分 析した。看護師が認識する長期療養高齢者の苦痛として、【病気の進行や廃用に伴う身体的苦痛】 【自律の喪失に伴う苦痛】【ケアに伴う身体的苦痛】【尊厳に配慮ない扱いを受けることに伴う苦 痛】【関係性の喪失や不確かな状況により生じる苦痛】の５カテゴリーが明らかになった。長期 療養高齢者は、病気の進行や加齢に伴う機能低下により生じる苦痛のみならず、苦痛から生じる 苦悩、医療者の適切なケアによって回避・緩和できる苦痛をもつと考えられた。看護実践への示 唆として、苦痛のサインを捉え、緩和可能な苦痛に適切に対処することにより苦悩への増大を防 ぐこと、不適切なケアを防ぐこと、すなわち高齢者の尊厳を守る実践が重要であると考えられる。