臨牀透析 Vol.34 No.3(3-3)


特集名 キュアとケアをつなぐナーシングスキル
題名 実践報告(3)透析療法を受ける患者に対するキュアとケア―治療と生活とを結びつける,キュアとケアを融合した看護実践
発刊年月 2018年 03月
著者 中村 雅美 大阪府立大学地域保健学域看護学類・慢性疾患看護専門看護師/透析看護認定看護師
【 要旨 】 看護師が日常的に行う「診療の補助」としてのキュアは,人間を生活体として全人的に捉えて理解し,健康問題への反応を観察し,患者の生活を支えるという看護学を基盤としている.慢性疾患患者へのケアにおいては,患者の病いの体験(illness)を理解し,それらに寄り添って生活を支える視点が重要である.血液透析患者のセルフマネジメントを支える事例では,患者のillnessに寄り添って全人的に患者を捉える視点が一貫して存在し,医学的知識をもとに身体を理解しつつ,治療と生活とを結びつけるというキュアとケアを融合した実践が見出せた.キュアとケアを融合した看護実践により,キュアとは異なる視点から,患者の健康問題にアプローチできる.
Theme Nursing skill -- integrating cure and care
Title Integration of cure and care in nursing practice -- linking a life with treatment
Author Masami Nakamura School of Nursing, Osaka Prefecture University / Certified Nurse Specialist in Chronic Care Nursing, Certified Nurse in Dialysis Nursing
[ Summary ] Routine nursing provides "assistance with medical care," based on nursing science, i.e., holistic assessment and understanding of a person as a living entity, while observing reactions to health-related problems and supporting the lives of patients. While caring for patients with chronic diseases, it is essential that nurses understand a patient's experience of illness and act from the perspective of supporting the patient's lifestyle by familiarizing themselves with this experience. For example, to support self-management in a patient undergoing hemodialysis, nurses familiarize themselves with the patient's illness, with the consistent perspective of holistic assessment. Furthermore, nurses identify practices that combine care with cure by linking treatment to the patient's lifestyle, while simultaneously gaining an understanding of the patient's physical state based on medical knowledge. Hence, nursing practice should integrate care and cure to allow nurses to approach a patient's health-related problems with a perspective different from that for a cure.
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