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

本系列调查的目的是建立有效的护理模式，以减轻癌症患儿的疼痛。在之前的研究中，我们开发了由三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。第二部分包括三种形式的文件，通过记录来加强护理过程。第三部分是手册对这些知识库和形式进行描述，以便更好地开展姑息治疗。这一阶段的研究设计是一项行动研究，让临床工作人员和患者共同进行护理并对其进行评估。邀请来自四家医院的护士（N = 14）作为共同研究者和护理提供者。在研究过程中，举办了两次讲习班和几次单位协商。首席调查员和大学同事参观了每个参与单位，并检查了手头的案例，以反映他们对工具的使用和知识在实践中的应用。从这些讨论中总结出研究结果。结果，护士意识到他们在实践中的变化，以新的视角使用基本的疼痛知识，并使用患者的疼痛记录作为与患者和/或家属互动的工具。然而，与此同时，护士们也认识到，如果没有反思会议，将知识付诸实践是困难的。剩下的问题，由小组确定，是有共同的理解方向的病人护理的所有人员在单位，如医生和其他工作人员。确定了拥有能够增强对个体患者护理过程的反思思考的人的重要性。

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.