Trends in the study of the terminal care in critical care in Japan

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  • わが国のクリティカルケア領域における終末期看護研究の動向
  • ワガクニ ノ クリティカルケア リョウイキ ニ オケル シュウマツキ カンゴ ケンキュウ ノ ドウコウ

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The purpose of this study was to examine the literature on terminal care patients, their families, and nurses in the field of critical care during the last 15 years in Japan, to elucidate the trends in research and to discuss future tasks. A search of the literature was conducted using Japana Centra Revuo Medicina, and the 18 articles identified were analyzed. The following categories could be extracted from the articles: “clear statement of the terminal care practiced,” “management of families of terminal patients,” “nurses’（medical staff）recognition of terminal care,” “ethical dilemma,” and “patients’ families who gave up treatment and the medical staff’s recognition of their state.” These categories could be broadly divided by content into those related to terminal care and those related to difficulties in terminal care in the field of critical care. Regarding the contents related to terminal care, while death of the patient was expected, nurses encouraged the patients’ families to recognize the present situation, brought them peace, and allowed the patients to face death with peace and dignity. Regarding the contents related to difficulties in terminal care, it was clarified that the difficulties included those related to the premise of life-saving in hospitals, the fragile relationship between the medical staff and the patients’ families, short anticipatory grief of families, and nurses’ dilemma. In the future, evaluation of the nursing care practiced, interventions for patients’ families with high tension or anxiety levels and their evaluation, and testing of hypotheses proposed in case reports are required. Furthermore, it is necessary to conduct research on systematic support that would relieve the nurses’ dilemma, and to understand the characteristics and recognition of the relationship between patients and their families.

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