緩和ケア病棟における患者と家族の死の準備行動と行為空間の事例的研究

本研究以安宁疗护病房住院病人及其家属的行为观察为中心，以听觉、文学作品为基础，探讨住院病人及其家属的行为结构与医疗环境的关系，以明确安宁疗护设施的设计准则。分析结果认为：1.对终末期病人应加强专科护理;提供一个在姑息治疗单位中易于接受的护理计划也是必要的。2.住院病人的病情是有变化的，我们可以将其分为3个阶段。第一阶段是医务人员与患者之间的信息披露时间。第二个阶段是在精神衰退的情况下度过余生。最后一个阶段是当他们到达终点时。我们了解到，像病房这样的医疗环境的结构必须分三个阶段来考虑。3.病房内的交流空间没有被住院病人充分利用。有必要根据2或3人的通信规模执行计划，以便使患者能够自由地利用空间。

The purpose of this research is the relation between the deed suructure and its medical treatment enviroment of inpatients and their family to show obviously the design guideline of palliative care facilities.The analysis given here is based on hearing, literary writings, and centering around the observation of the deed of the inpatients and their family in a palliative care unit. The result of our anaysis are abstracted as lollows :1.It is necessary that the inpatient at the terminal stage should be offered an intensive and specialized care. It is also necessary to offer the plan in which the care is easily taken in a palliative care unit.2.The condition of inpatients is subject to change and we can divide it into 3 stages. The first stage is the time of the information disclosure between the medical staff and the inpaitents. The second stage is when living the rest of life with a declining spirit. The last stage is when they meet the end. We understand that the structure of the medical treatment environment like patient's room must be considered differently by 3 stage.3.The commucication space in the ward are not sufficiently utilized by inpatients. It is necessary to carry out a plan on the basis of communication scales of 2 or 3 persons in order to make the patients feel free to utilize the space.