臨牀透析 Vol.25 No.11(3-6)


特集名 腎不全患者への支援についての再考 --「指導」「教育」のあり方
題名 [ケース別にみた指導・教育]VI. 看護学生にどう患者教育を教授するか --「ナラティブアプローチ」の活用
発刊年月 2009年 10月
著者 中村 光江 日本赤十字九州国際看護大学
【 要旨 】 看護のナラティブアプローチにおいては,ナラティブ(物語)を通して語り手の病い経験を理解するとともに,語り手と聴き手が「語り,聴きとる」共同作業を通して物語を作り上げていくことが重要であり,対話そのものがセラピーの意味をももつことに注目する.聴き手は語り手の病いの経験については何も知らないという「無知の姿勢」で対話に臨み,「教えてもらう」立場に徹することが求められる.基礎看護教育では,講義内で患者の話を聴く機会をもったり,実習で「病みの軌跡」を聴きとる機会をもったりすることで,ナラティブアプローチを活用している.これらは,学生が対象者への理解を深め,患者教育を含め看護をより対象者に添ったものとする学習に大きな効果を上げている.また,対象者との援助的関係性の形成や,学生自身の個人的課題を見出すことにもつながっている.
Theme Reconsideration of Support to Renal Failure Patients
Title How to teach "patient education" to nursing students : application of narrative approaches
Author Mitsue Nakamura The Japanese Red Cross Kyushu International College of Nursing
[ Summary ] When any narrative approaches are applied to nursing, patients may tell their illness related experiences to their nurses. It is important that cooperative relationships between the storyteller and the listener create narratives. It is also important that the listener develops an understanding of the illness related experiences through the narrative. Nurses should understand that narrative approaches are an effective form of therapies. The listener should join in the conversation in open mind and imply lack of knowledge concerning the illness related experiences of the storyteller. It is called "Not-knowing" approach. The listener is required to act as a sounding board for the patient. The education of nursing students requires narrative approaches which used in listening to the narratives of patients who are invited to classes. Students are also required to understand a patient's "illness trajectory" in clinical practicum. There is a major impact on students in terms of their understanding of patients and providing better care to them. This method also helps students to develop supportive relationships with patients and to develop method to solve their own personal problems.
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