Research of the Actual State of the Advocacy of Nurses Involved in Cancer Nursing and Establishment of the Counseling System

本研究旨在对参与癌症护理的护士的倡导（帮助患者）的实际情况进行研究，并找出建立临床困境护士咨询体系的问题。在本会计年度，我们对具有（5年以上）癌症护理经验的临床护士进行了半建设性访谈，这些护士被医院病房主任认为具有较好的护理实践，并通过提取护士参与癌症护理的意识、经验和倡导问题的内容进行了定性归纳分析。结果显示，进行癌症护理实践的护士承受着很大的压力，并存在情绪问题。护士在照顾病人死亡的过程中感到悲伤，尤其是传统的医患尊卑关系所产生的问题较多，患者、家属、医生对治疗意见的分歧使护士陷入困境的情况较多。此外，它已经澄清，护士有情绪问题，他们不能履行一个倡导者的角色，为病人。正因为如此，护士们经历了“倦怠”或采取“防御行动”，如抱怨或不深入思考。此外，他们还倾向于把“工作太忙”、“自己不够努力”、“解决问题的能力不高”作为逻辑问题解决不了的原因来责备自己。此外，虽然有一些护士意识到改善工作场所的制度和护理实践的必要性，以解决他们自己的问题，但目前的情况是他们还没有开始采取行动。由此可见，通过对参与癌症患者护理的护士发挥倡导作用，构建护士个人“自我护理”、上级“一线护理”、外部咨询师“院外专家护理”的体系，支持护士心理健康护理的必要性，以开展更高质量的实用护理。少

This study aims to carry out research of the actual situation of the advocacy (help to patients) of nurses involved in cancer nursing, and to find out issues towards the establishment of a counseling system for nurses who are distressed at clinical situations. In this fiscal year, we carried out semi-constructive interviews with clinical nurses having (more than 5 year) experience in cancer nursing that are deemed to have superior nursing practices by the head of the hospital ward, and also a qualitative inductive analysis by extracting contents of awareness, experience and issues of the advocacy of nurses involved in cancer nursing. The result revealed that nurses who carry out practices for cancer nursing suffered from a lot of stress and had emotional problems. Nurses experienced sorrow in looking after the death of patients, and in addition, there were especially many problems arising from the traditional superior/inferior relationship between doctors and nurses, and there were man … More y cases where nurses were in dilemma due to disagreement in opinions concerning treatment among patients, their families and doctors. Furthermore, it has been clarified that nurses had emotional problems that they cannot perform the role of an advocate for patients. Because of that, nurses experienced "burn out" or took "defensive actions" such as complaining or not thinking deeply. In addition, they have a tendency to blame themselves by raising "being too busy with working", "shortage of their own efforts" and "the low level of their problem solution ability" as reasons why logical problems are not solved". Furthermore, although there are some nurses who are aware of the necessity of improving the systems in their workplaces and nursing practices in order to solve their own problems, the present situation is that they have not yet started to take action. From the above, it can be seen that the necessity to support the mental health care of nurses was indicated by performing the role as an advocate to nurses involved in cancer patients and constructing systems of "self-care" by individual nurses themselves, "care by line" by superior officers and "care by experts outside the hospital" through counseling by an external consultant in order to carry out higher quality practical nursing. Less