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目的：在宅で生活する青年期にある医療的ケア者の日常生活における意思決定の経験を明らかにし，対象者が日常生活の自立に向けて意思決定をしていくための看護支援の示唆を得ることである。方法：質的記述的研究デザインとし，概ね18～25歳の医療的ケア者に半構造化面接を行った。対象者に自立の転機の場面を取り上げてもらい，誰とどのように意思決定してきていたのかを聴取した。分析は，事例毎に逐語録を作成後，意思決定のコードを作成し，連関する意思決定のコードを時系列に集約し，要約を作成した。意思決定の経験の焦点となる習得・熟達した力の観点で分類し，意味内容を表すテーマを生成した。結果：男性４名から125の意思決定のコードを得て22の要約を作成し，【進路選択において葛藤や挫折を繰り返しながら，自身の方向性を明確にしていく】【親からの心理的自立に向けて，支援者との関わりを模索しながら意思を実現する方法を拡大していく】等，５の意思決定の経験のテーマを生成した。考察：青年期にある医療的ケア者の意思決定の経験は，葛藤や挫折を繰り返しながら心理的自立に向けて支援者と調整する力等を習得し，成長とともに拡大させ，自らが意思決定の「主体」へと移行していく特徴があった。円滑な「主体」の移行に向けた準備性を高める看護支援とともに，対象者の日常に伴走して関係性を深め，対象者の価値観に基づく意思決定支援が重要である。

Objective: This study explored decision-making experiences in the daily lives of adolescents requiring medical care at home and gathered recommendations for nursing support to promoting their independence in daily living. Method: This qualitative descriptive study involved semi-structured interviews with adolescents aged 18-25 years who required medical care and lived at home. Participants were interviewed regarding the turning points in their independence and their decision-making process, including how and with whom they made decisions. Analysis, verbatim transcripts were generated for each participant, and data related to decision-making were compiled in a time-series format to develop a summary. These summaries were then categorized in terms of acquired and mastered competencies, which were the central focus of the decision-making experience. Themes representing the semantic content of the data were generated. Results: Five themes of decision-making experiences were generated, including “clarifying the direction of one’s career path while repeated conflicts and setbacks stand in one’s way of being” and “expanding avenues to achieve personal goals while seeking support and building relationships to achieve psychological independence from parents.” Conclusion: The decision-making experience of these adolescents was characterized by repeated conflicts and setbacks. However, through these challenges, they acquired the ability to collaborate with their supporters to attain psychological independence. As adolescents matured, they took on the role of the main decision-maker. Nursing support should focus on preparing adolescents for the transition to a “main decision-maker” by accompanying them in their daily lives, deepening relationships, and providing decision-making support aligned with their values.