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看護婦のインフォームド・コンセントの認識と役割行動に関する研究


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Title: 看護婦のインフォームド・コンセントの認識と役割行動に関する研究
Other Titles: Recognition of informed consent by nurses and their role behavior
Authors: 石原, 和子 / 門司, 和彦 / 小林, 初子 / 橋村, 洋子 / 松武, 滋子
Authors (alternative): Ishihara, Kazuko / Moji, Kazuhiko / Kobayashi, Hatsuko / Hashimura, Yoko / Matsutake, Shigeko
Issue Date: 31-Mar-2001
Citation: 長崎大学医療技術短期大学部紀要 = Bulletin of the School of Allied Medical Sciences, Nagasaki University. 2001, 14(1), p.97-104
Abstract: 1995年に医療法の改正が行われ,「医療従事者は,医療を提供するに当たり,適切な説明を行い,医療を受ける者の理解を得るように努めなければならない」というインフォームド・コンセント(以下ICと略す)の義務化が打ち出された.この度,ICにおける看護婦の役割の重要性に鑑み,N大学医学部附属病院の看護婦(士)を対象にICの認識と看護婦の役割行動に関する非構成的アンケート調査を実施した.対象者420名のうち有効回答416名(看護士11,看護婦405)で回収率99.0%であった. 回答者の最終学歴,年齢,臨床経験年数の3つは相互に強く関連し,かつすべてICとも関連していた.そこで本研究では最終学歴に着目して分析をした.また,勤務場所の内科系・外科系別の分析をも行った.今回のアンケート調査では,看護婦のICに対する認識と役割行動について以下の3点に集約することができた. 1)ICの認識については,「医療従事者側からの情報開示,患者側の理解,納得,同意,選択」を回答した割合が8割以上を占めていた.ICの目的は「患者の自己決定権を重視するため」と回答していた.短大卒以上と各種看護学校卒では,「患者の自己決定権を重視するため」,「法的根拠の目的(医療訴訟の対抗上)」,「治療内容の充実のため」の3つについてそれぞれに有意差が見られた. 2)ICは日本文化,精神風土に馴染みにくい理由として,「患者の医師依存傾向」,「医師のパターナリズム(父権主義,温情主義)」の回答の割合が高く,短大卒以上と各種看護学校卒では,「医師の認識不足」,「医師のパターナリズム」のそれぞれに有意差が見られた.また内科系と外科系では,「患者の医師依存傾向」に有意差が見られた. 3)ICにおける看護婦の役割行動は,「IC後の患者への精神的ケア」,「IC時に同席する」,「IC後の患者の理解度を確認する」の割合が高く,内科系と外科系では,「IC時に同席する」,「医師からの説明後,補足説明をする」,「説明内容を記載する」について有意差が見られた. / In 1995, the Medical Law was revised, and the following description was added, making informed consent (IC) obligatory : " When providing medical care, people who are engaged in medicine should offer an appropriate explanation and make efforts to obtain the full understanding of people who receive medical care " . Considering the importance of the role that nurses play when obtaining IC, we carried out a non-structured questionnaire survey regarding IC and the role behavior of nurses at a hospital affiliated with our university. Effective replies were obtained from 416 (11 males and 405 females : 99.0%) of 420 subjects. A marked relationship was seen among their education level, age, and duration (years) of clinical practice. Among them, since the education level was closely related to the other two factors, close attention was paid to this factor in the analysis. An analysis according to the type of work (medical or surgical) was also performed. The results of this questionnaire survey could be summarized as follows in terms of the recognition of IC and role behavior. 1) Regarding IC, more than 80% of the nurses supported " The release of information by the medical staff and obtaining the full understanding, agreement, and consent of the patient " . Regarding the purpose of IC, 81.3% of the nurses " Attached importance to the right of patients to make their own decisions " . Significant differences were observed between the graduates of only junior colleges and graduates of various nursing schools regarding the reply rate of " Attached importance to the right of patients to make their own decisions " , " To obtain legal permission (to avoid medical suits) " , and " To improve the quality of treatment " . 2 ) Concerning the reason why it is difficult for IC to take root in Japanese culture, the reply rate was high for " The Patients tended to completely rely on the judgement of physicians " and " Most doctors take a paternalistic stance " . Differences were observed between the graduates of junior colleges and those of various nursing schools regarding the reply rates of " Insufficient recognition by physicians " and " Most doctors take a paternalistic stance " and between medical and surgical nurses regarding the replay rate of " The Patients tended to completely rely on the judgement of physicians. 3 ) Regarding the role of nurses in IC, the reply rate was high for " Provide emotional support after obtaining IC " , " Being present at the time IC is obtained " , " Confirm the degree of understanding of the patients after obtaining IC " . Differences were observed between medical and surgical nurses m the reply rate of " Being present at the time IC was obtained " , " Providing supplementary explanations after the physicians' explanation " , and " Making a written gist of the physicians' explanation " , but no significant difference was observed between the graduates of junior colleges and those of various nursing schools.
Keywords: インフォームド・コンセント(IC) / 看護婦の認識 / 看護婦の役割行動 / Informed consent / recognition of nurses / role behavior of nurses
URI: http://hdl.handle.net/10069/18348
ISSN: 09160841
Type: Departmental Bulletin Paper
Text Version: publisher
Appears in Collections:Volume 14, No. 1

Citable URI : http://hdl.handle.net/10069/18348

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