排泄ケアにみられる身体性 - 国内文献に記述された実践事例のメタ統合を通して

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本研究の目的は,国内文献に記述された実践事例のメタ統合を通して,身体性の観点から排泄ケアにおける看護実践知を明らかにすることである。研究方法は,Paterson ら,Noblit & Hare のメタ統合の手法を参考にした。対象文献に示された事例毎に看護過程を再構成し,排泄ケアの転換点に身体性がかかわっていると思われる事例を選択した。排泄行動における患者の身体性,排泄ケアにおける看護者の身体性という観点で記述を解釈し,看護実践知について考察した。その結果,以下3点の排泄ケアにおける看護実践知が示唆された。「患者の表情やしぐさからにじみ出る患者の尿意や排泄を希求する意思,排泄に伴う快感や不快感に看護者が関心を寄せる」「患者の喜びや排泄の成功体験を看護者が共に味わうことで,患者に合わせた排泄ケアを進める意志や原動力となる」「患者のより自然な排泄を目指し,意図的に関わり続ける」The purpose of this study was to identify practical nursing knowledge of elimination care in terms of corporeality, using a qualitative meta-synthesis of practical case studies in the Japanese literature. The Japanese medical literature database system(Igaku-chouzasshi)was used to search the literature on bowel and urinary elimination care by inputting conjunctive search terms such as “bowel elimination," “urinary elimination, " and “constipation. "The researchers then selected appropriate studies for the present research question. The selected studies were analyzed using the qualitative meta-synthesis method(Paterson et al, Noblit & Here). The analysis was conducted in following steps: 1)carefully reading the individual studies and reconfiguring the described nursing practice; 2)selecting studies in which corporeality influenced the turning point of elimination care; 3)interpreting the described nursing practice in terms of the client's corporeality in elimination behavior and the nurse's corporeality in elimination care; and 4)considering practical nursing knowledge. The results of the analysis suggested the following 3 items of practical nursing knowledge of elimination care: “taking a deep interest in the client's desire to urinate, the client's will to eliminate, and the client's pleasurable or uncomfortable sensations with elimination from his/her expression and behavior",“adapting the attitude and motivation to perform suitable care for the patient by enjoying pleasurable and successful experiences in elimination care with the patient", and “maintaining involvement with the patient purposefully so that he/she can eliminate in more natural style.
2009-06-30

排泄ケアにみられる身体性 - 国内文献に記述された実践事例のメタ統合を通して

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