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Please use this identifier to cite or link to this item: http://hdl.handle.net/10285/6258

NII Resource type: Journal Article
Title: 小児医療における親の意思決定:概念分析
Other Titles: Parental Decision Making in Children's Healthcare: A Concept Analysis
Authors: 小泉, 麗
Keywords: 意思決定

An investigating method or the measure : 概念分析
concept analysis
Shimei: 聖路加看護学会誌
Volume: 14
Issue: 2
Start page: 10
End page: 17
Issue Date: 31-Aug-2010
Publisher: 聖路加看護学会
Abstract: 【研究目的】 「小児医療における親の意思決定」の概念の定義,属性,先行要件,帰結を明らかにし,その 結果から小児医療における親の意思決定の支援について検討する。 【研究方法】概念分析の方法は,Rodgers(2000)の概念分析アプローチを参考とした。収集した49文献 から,「小児医療における親の意思決定」の定義,属性,先行要因,帰結について検討した。 【結果】分析の結果,「小児医療における親の意思決定」の属性として,1)親が情報や意見を解釈し医療 者との合意のもと最終選択に至ること,2)医療者とのかかわりを基盤に形成される選択,3)親の判断の 下において子どもの意見を反映した選択,の3カテゴリーを抽出した。先行要件として,1)子どもの最善 の利益の視点から正解のない選択肢の存在,2)親が子どもの代理の意思決定者という前提,3)ヘルスケ アチームの一員としての親の役割,の3カテゴリーを抽出した。帰結として,1)選択への満足と後悔,2) 体験の意味づけ,3)責任の引き受け,4)医療者と家族・患者との関係性,の4カテゴリーを抽出した。 「小児医療における親の意思決定」は,「親が情報や意見を解釈し医療者との合意のもと最終選択に至ること。 その選択は親と医療者のかかわりを基盤に形成され,親の判断の下において子どもの意見を反映する」と定 義した。 【考察】本研究で明らかになった属性は,親が子どもの代理として専門的知識を要する選択を求められる という小児医療の特性を反映していた。小児医療において,看護師は,親が最終選択に至る過程を支援する ことが求められる。
Abstract-Alternative: 【Purpose】To clarify characteristics of parental decision making in children's healthcare using Rodgers'(2000) approach and to consider the support for parental decision making in children's health care. 【Methods】Forty-nine publications written in English and Japanese were reviewed and analyzed to identify attributes, antecedents, consequences of parental decision-making in children's healthcare. 【Results】AttriButes: 1)Making a final choice relying on an agreement with a health care provider through a process of interpreting information and opinion; 2)Making a choice Based on involvement with health care provider and 3)Making a choice reflecting the child's opinion based on parental judgment. Antecedents: 1)No correct answer from the view of child's best interest; 2)Premise that parents are the surrogate decision-makers for their child and 3)Parental role as a health care team member. Consequences: 1)Parental satisfaction or regret for their choice; 2) Giving meaning to parental experience; 3)Accepting responsibility for their decision and 4)Relationship between parents, child and health care provider. The following definition is proposed: Parental decision making in children's healthcare involves making a final choice relying on agreement with the health care provider through a process of interpreting information and opinion. The choice is based on involvement with health care provider and reflects child's opinion under parental judgment. 【Discussion】The attributes indicates that parents need to make a surrogate decision for their child using expert knowledge. It is important for nurses to support parents while they make choices through the decision-making process.
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URI: http://hdl.handle.net/10285/6258
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