在宅ホスピスケアにおける訪問看護師のストレスと対処

Abstract

The purpose of this study was to clarify from their narratives how visiting nurses cope with stress, as part of basic information exploring the ways that visiting nurses who practice home hospice care deal with stress. The subjects were 10 visiting nurses with at least 3 years' experience as visiting nurses and with experience in home hospice care. Data was collected by individual interviews using semi-structured questionnaires. Inductive qualitative analysis was applied to the content obtained from the interviews. The results showed that stress felt by visiting nurses doing home hospice care were "distress at being unable to support the decision-making at the final moments", "pressure from the attending family", "poor cooperation with medical professionals" and "lack of confidence in their own judgment and ability", while they dealt with it by "finding a change of pace", "having an opportunity to reflect on nursing", "close cooperation" and "sense of accomplishment after caregiving". These results suggest that to reduce stress in visiting nurses and improve their coping ability and quality of care, it is necessary to establish a training system whereby high expertise as a visiting nurse can be acquired, to develop and enhance a workplace environment withopportunities to receive advice from professionals, and to enhance the system of cooperation between healthcare workers.