The development of nursing care model for alleviation of children's pain with cancer.

本系列研究的目的是为减轻儿童癌症疼痛提供有效的护理模式。在前面的研究中，我们开发了由三个部分组成的综合评估工具。第一部分包括照顾癌症疼痛儿童的基本知识。第二部分由三种形式的文件组成，通过记录加强护理过程。第三部分是手册，描述这些知识基础和形式，以便开展良好的姑息护理。这一阶段研究的设计是一项行动研究，涉及临床工作人员和患者进行护理和评估。来自四家医院的护士(N=14)被邀请担任合作研究员和护理提供者。在研究过程中，举行了两次讲习班和几次单位协商。首席调查员和大学同事走访了每个参与单位，并查看了手头的案例，以反映他们对工具的使用和知识在实践中的应用。从这些讨论中提炼出研究结果。结果，护士意识到了他们在实践中的变化，以新的视角使用基本的疼痛知识，并将患者的疼痛记录作为与患者和/或家人互动的工具。然而，与此同时，护士们认识到，如果没有反思课程，就很难将知识付诸实践。剩下的问题，按小组确定，是单位所有人员，如医生和其他工作人员，对患者护理方向有共同的理解，并确定了有人能够加强对个别患者护理过程的反思的重要性。

Purpose of this series of investigation is to develop effective nursing care model for alleviation of children's pain with cancer. In the previous study, we have developed comprehensive assessment tool constructed with three parts. First part includes basic knowledge for caring children with cancer pain. Second part consists of three forms of documentation to enhance nursing care process by keeping record. Third part is manual to describe these knowledge base and forms in order to carry out good palliative care. The design of this phase of study was an action research to involve clinical staff and patients to conduct the care and evaluate them. The nurses (N = 14) from four hospitals were invited to be co-researcher and care providers. During the course of study, two workshops and several unit consultations were carried out. Primary investigator and college colleague visited the each participating unit and went over the cases at hand to reflect their use of tools and application of knowledge to practice. From these discussion study result were abstracted. As the results, the nurses was aware of their change in practice with new perspective using basic pain knowledge and using a patient's pain records as tool to interact with patient and/or family. However, at the same time, the nurses recognized difficulty in putting the knowledge in to practice if there were no reflective session. The remaining problem, which identified by group, was having common understanding about direction in patient care among all personnel in the unit, such as physician and other staffs.Importance of having someone who can enhance reflective thinking about individual patient care process was identified.