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Practical Nursing Model for Holistic Care for Enable Intractable Cancer Patients

实用护理模式为难治性癌症患者提供整体护理

基本信息

批准号：
21592784
负责人：
YOSHIDA Mitsuko
金额：
$ 2.83万
依托单位：
Japanese Red Cross College of Nursing
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2009
资助国家：
日本
起止时间：
2009 至 2011
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-21592784/
关键词：
難治性がんがん看護患者・家族支援

项目摘要

The objective of this study is to develop a practical nursing model for holistic care that would enable intractable cancer patients, who can hardly expect treatment with a view to complete recovery, to choose a treatment on their own initiative and to live through.More specifically, the study aims at creating nursing support theory taking into consideration characteristics of support associated with the course and nature of disease by structuralizing intractable cancer patients' experience and nursing required in response, based on 1) clarification of patients' experience and needs, and 2) analysis results of cases experienced by nurses. Interviews were carried out with participating six patients and five nurses. A verbatim record was made from the interview data, of which characteristics of patient 'experience and nurses' support experience were analyzed and interpreted based on phenomenological approaches in philosophical anthropology advocated by P. Benner. The narratives of the six … More intractable cancer patients were described as those characterizing the experience of intractable or rare cancer :"to look for a way to live through when my death comes in sight,""to be prepared for reoccurrence and live through seeking for treatments,""to build my life on past experience of disease, without being caught up by the seriousness,""no other way but to find the meaning of my own life,""to acquire knowledge is the tactic to livethrough," and "to live with perseverance despite uncertainty." The five nurses' narratives included" to support the patient to live through regardless of the prognosis,""to support the patient's decision to accept or stop treatment for prolonging life,""to promote seamless transition to palliative care,""to identify the background that may complicate the patient's anguish," and "to support the patient with regard to their anxiety about high incidence of reoccurrence and death."As a result, it was suggested that, when providing support for intractable cancer patients, the support should be given so that the patients can find meaning in their remaining life and maintain or recover their mental link to life. To achieve this, it was also suggested that the efforts in creating support theory should be centered around the social implication of'intractable' that closes up the patients' orientation to the future and has been incorporated in their mind as well as temporality perceived differently by medical practitioners and patients. Less

本研究的目的是建立一种实用的整体护理模式，使难治性癌症患者能够主动选择治疗方案，度过难治性的难治性癌症患者的完全康复；更具体地说，本研究旨在通过结构化难治性癌症患者的经历和应对所需的护理，在1)澄清患者的经验和需求的基础上，结合护士经历的病例分析结果，创建护理支持理论。参与访谈的有6名患者和5名护士。对访谈数据进行逐字记录，并基于P.Benner倡导的哲学人类学现象学方法，对患者体验和护士支持体验的特征进行了分析和解释。The Six…的叙事更难治的癌症患者被描述为那些经历了难治性或罕见癌症的人：“当我的死亡迫在眉睫时，寻找一种生存的方法”，“为复发做好准备，通过寻求治疗来生活”，“建立在过去的疾病经验之上，而不是被严重性所困扰”，“别无选择，只能找到自己生命的意义”，“获取知识是生存的策略”，以及“在不确定的情况下坚持不懈地生活”。这五位护士的叙述包括“支持患者度过难关，不管预后如何”，“支持患者决定接受或停止治疗以延长生命”，“促进向姑息治疗的无缝过渡”，“识别可能使患者痛苦复杂化的背景”，以及“支持患者对复发和死亡的高发生率感到焦虑”。因此，有人建议，在为顽固的癌症患者提供支持时，应给予支持，使患者能够在剩余的生命中找到意义，并保持或恢复他们与生命的精神联系。为了实现这一点，也有人建议，创建支持理论的努力应该集中在“顽固”的社会含义上，这种社会含义关闭了患者对未来的导向，并已纳入他们的头脑中，以及医生和患者对暂时性的不同感知。较少