@article{oai:hsuh.repo.nii.ac.jp:00007059,
 author = {尾形, 裕子 and Ogata, Yuko},
 issue = {1},
 journal = {北海道医療大学看護福祉学部学会誌, Journal of School of Nursing and Social Services, Health Sciences University of Hokkaido},
 month = {Mar},
 note = {P(論文), 本研究の目的は,臨床判断を構成する要素の1つ"状況の把握"に焦点をあて,経験3年以上の看護師が,患者に対するケアについて決定を下す過程の特徴を明らかにすることである.研究デザインは半構成的面接法を用いた質的記述的研究であり,実務経験3年以上の看護師12名からデータを収集した.臨床判断の全34場面を分析し,【その場に入って対象者の力や変化に注目する】,【その場で注目することの指標となる観点を捉える】,【注目することに対策を講じる】,【場面で講じた対策を再び吟味して対象者の意図と合わせる】,【その場にあわせた手段を用いる】の5カテゴリーと,〔経験による直行型〕,〔意味追及による反復型〕,〔行為先行型〕といった3つのパターンを抽出した.臨床判断の概念化の手がかりを得るため,"状況の把握"と他の臨床判断を構戒する要素との関連や,"状況の把握"のパターンに関連する経験について論じた., This study focuses on how nurses grasp the patient's situation, which are among the factors on which clinical judgment is based. This study aims to clarify the processes that nurses with a minimum of three years of work experience undergo before determining appropriate care for patients. For this purpose, a qualitative and descriptive study was conducted by means of semi-structured interviews. Data were collected from 12 nurses, and their clinical judgment processes were analyzed with regard to a total of 34 clinical situations. These processes were found to consist of five steps : 1) paying attention to the patient's condition and changes, 2) figuring out which indicators the nurse needs to pay closer attention to before making appropriate judgments, 3) taking measures according to the judgments made on the basis of what the nurse has learned from the indicators, 4) reviewing the consequences of the measures in light of the benefits to the patient, and 5) taking additional measures that the nurse determines necessary under the circumstances. The clinical judgment processes are classified into three types : 1) clinical judgment based on the nurse's past experiences of similar situations, 2) clinical judgment based on repeated reflection on the measures taken, and 3) clinical judgment immediately based on observation of the patient. To help conceptualize the clinical judgment processes, this study elaborates on the relationship between assessments of patients' clinical situations and other factors necessary for clinical judgment, as well as on nurses' experiences related to various types of assessments of patients' clinical situations.},
 pages = {11--20},
 title = {状況の把握に焦点をあてた臨床判断のパターン : 経験3年以上の看護師における臨床判断の特徴},
 volume = {8},
 year = {2012}
}