山梨医科大学紀要　第17巻，068-074(2000)

訪問看護婦のインフォームド・コンセントに対する認識と援助方法の特徴

伊達久美子，齊藤朋子

　本研究の目的は，訪問看護ステーションに勤務する訪問看護婦のインフォームド・コンセントに対する認識と援助方法の特徴を明らかにすることである。28名の訪問看護婦を対象に，半構成的面接調査を実施し，質的に分析した。その結果，ステーションの設置形態による違いが認められた。独立型ステーションを特徴づけるカテゴリーとして『患者や家族と信頼関係を構築する』が，医療施設併設型は『医師，臨床看護婦，チームメンバーとの関係を良好に保つ』が抽出された。『情報を提示し，収集する』，『療養者・家族の理解を助け，高める』，『同意と納得を確認する』は両者に共通して認められ，訪問看護婦が説明力の不足や不安を感じていることがわかった。訪問看護婦は，療養者・家族に対する“説明”が訪問看護の専門性につながることを認識し，“説明”を療養者・家族の自己決定を支援する訪問看護の援助技術の一つとして位置づけ，効果的な方法を確立し，実行していくことの必要性が示唆された。

キーワード：訪問看護婦，インフォームド・コンセント，説明



Recognition and Method toward Informed Consent of Home Visiting Nurses

Kumiko DATE and Tomoko SAITOU

The purpose of this study is to examine characteristics of recognition and assisting method toward informed consent of home visiting nurses who work at home visiting nurse stations. Semi-structured interviews were applied over 28 home visiting nurses, and the result was analyzed by KJ method. The result indicated that differences due to facility style of stations were recognized.
As a characteristic of recognition and assisting method toward informed consent of the home visiting nurses at independent nurse stations, "Home visiting nurses establish trusting relationship with patients and family members," and as a characteristic of the nurses at hospital or clinic combined style, "Home visiting nurses maintain good relationships with doctors,clinical nurses, and other team members" was observed. Though "Information should be opened and collected," "To assist and improve the understanding of patients and family members," and "Agreement and consent should be confirmed "were observed commonly, it was also recognized that home visiting nurses feel less capable to explain and have anxieties.
It was suggested that home visiting nurses should recognize "explanation" for patients and family members as a specialty of home visiting care, assuming that "explanation" is one of assisting techniques to support self-decision of patients and family members. It is also necessary to establish and practice effective methods for this concern.



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