眞嶋 朋子

INTRODUCTION: Advances in treatment have transformed cancer from a fatal to a chronic illness. This requires healthcare professionals, particularly nurses, to have advanced knowledge and collaborative skills. However, challenges persist in implementing patient-centered care in the context of evolving treatment complexity. OBJECTIVES: This study aimed to clarify nurses' support practices in providing cancer pharmacotherapy at a university hospital in Japan and compare these practices based on nurses' years of experience. METHODS: A questionnaire survey was conducted from February to April 2023 among 430 nurses involved in provision of cancer pharmacotherapy at a Japanese university hospital. Nurses were asked about the types of support they provided during care for patients undergoing cancer pharmacotherapy. Nurses' cancer pharmacotherapy support practices were extracted using factor analysis, and differences in support scores by years of experience were examined. RESULTS: Responses were received from 184 nurses (42.8% response rate). Three support factors were identified: "Providing patient-centered cancer pharmacotherapy," "Management of continued cancer pharmacotherapy treatment," and "Assessment of and response to physical symptoms." Scores for "Providing patient-centered cancer pharmacotherapy" were significantly lower than those for the other two factors (p < .001). The group with ≥10 years of nursing experience had statistically significantly lower practice scores than those with 4-9 years of experience. CONCLUSIONS: Enhancing nursing education and interprofessional collaboration are crucial to overcome barriers to patient-centered cancer care. Continuous learning opportunities are essential to adapt to evolving cancer treatment protocols and ensure delivery of patient-centered care, particularly for experienced nurses.

COVID-19流行に伴い臨地実習日数が制限されたが、実習目標を変更せずに達成できることを目指し、臨地実習前に関連部署の見学実習とシミュレーション演習を組み込んだため、学生による実習評価を実施した。シミュレーション演習の内容は、事例の看護展開と事例の内容を想定したシナリオを用いてシミュレーターに対して全身状態の観察とアセスメントを行い報告することとした。シミュレーション演習後と臨地実習後に、学生へ授業過程評価スケールを用いた実習の質評価、自己評価、自由記載回答を求めた。授業過程評価スケールによる評価では、シミュレーション演習と臨地実習ともに中等度以上の質と評価されたが、【学生-患者関係】の項目は、シミュレーション演習の平均点が低かった。自己評価は従来と同様の達成度であった。シミュレーション演習を組み込んだ統合実習は、実習目標を変更せずに達成することができ、臨地実習日数の減少を補完できる可能性がある。シミュレーション演習および臨地実習を通して得られる看護実践能力をよく認識し、実現可能な実習に向けた授業設計が必要である。(著者抄録)