Terminal Care Nursing in Pediatric Oncology and the Development of Nursing Protocols

本研究主要以扎根理论分析为基础，以57位护理人员为访谈对象，描述有经验的儿科护理人员在癌症晚期患儿家庭中扮演何种角色。在临终阶段，护士不仅要照顾一个家庭的焦虑和不确定性，但同时试图引导家庭接受他们失去孩子的事实，并鼓励他们谨慎地做出决定。当一个孩子非常接近死亡，护士试图创造一个“好死”的情况。他们这样做是为了确保所有适当的人都在现场，家庭成员能够与孩子有身体接触，并且环境是平静的。护士评估他们的表现在终端护理情况的基础上，他们能够准备的条件，为“好死”。他们根据这一评价修改了他们的“善终”概念。这样，他们就可以被看作是一个舞台导演的角色，根据他们的“好死”概念来塑造局面。

Based mainly on grounded theory analysis of interviews with 57 nurses, this study describes what kind of roles experienced pediatric nurses take with families who have children in the terminal stages of cancer. During the terminal stage, the nurses not only work to take care of a family's anxieties and uncertainties, but at the same time try to lead the family toward accepting the fact that they are losing a child and encourage them to make their decisions carefully. When a child is very close to dying, the nurses try to create a "good death" situation. They do this by making sure that all the appropriate people are at the scene, that the family members are able to have physical contact with the child, and that the setting is calm. The nurses evaluate their performance in terminal care situations on the basis of how well they were able to prepare the conditions for a "good death". They modify their concept of a "good death" based on this evaluation. In this way, they could be seen a taking the role of a stage director, molding the situation according to their concept of a "good death".