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

本研究旨在探讨有效的护理模式，以减轻癌症病儿的疼痛。在先前的研究中，我们开发了一个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。第二部分是通过三种形式的文件记录来加强护理过程的记录。第三部分是手册，描述了这些知识库和形式，以便开展良好的姑息治疗。本研究阶段的设计是一项行动研究，让临床工作人员和患者参与护理并对其进行评估。来自四家医院的护士（N = 14）被邀请为合作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磋商。主要研究者和大学同事访问了每个参与单位，并回顾了手头的案例，以反映他们对工具的使用和知识在实践中的应用。最后总结了研究结果。结果，护士意识到他们在实践中的变化与新的视角，使用基本的疼痛知识，并使用病人的疼痛记录作为工具，与病人和/或家人互动。然而，在同一时间，护士认识到，在把知识付诸实践，如果没有反思会议的困难。剩下的问题，这确定了小组，是在单位的所有人员，如医生和其他工作人员之间的病人护理方向的共识。重要的是有一个人谁可以加强反思个人病人护理过程中的思考。

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.