集中治療室における面会制限に関する研究 : 国外文献から日本のあり方への展望

Abstract

【目的】集中治療室(ICU)における面会制限に関して、国外の文献から研究の動向と実態を明らかにし、日本におけるICUの面会のあり方への示唆を得る。【方法】PubMed、CINAHLのデータベースを用いて、18論文を対象とした。【結果】ICUおよび病院施設を対象とした調査、面会制限の変更前後を比較検討した研究、ICU医療者と患者、家族を対象とした研究に分類された。国外では、面会制限を時問、回数だけでなく、待合室、情報提供などを含め報告していた。面会は、患者と家族の満足感の向上をもたらし、医療効果が得られたとの報告がある一方、看護師の負担や患者への有害要因との指摘もあった。【結論】日本におけるICUの面会制限について、家族の満足度、患者への医療効果、待合室等のアメニティー、情報提供体制などのシステムも含めて捉えることが今後の課題である。

【Purpose】This study aimed to clarify trends in and status of research on visitation limitation in intensive care units (ICUs) by examining literature from abroad, and to obtain suggestions on ICU visitation policy in Japan.【Method】We examined 18 papers by using the PubMed and CINAHL databases. 【Results】Studies examined hospitals and ICUs; compared changes before and after implementing changes in visitation restrictions; and examined their impact on ICU staff, patients, and families. Further, studies conducted outside Japan have examined ICU visiting restrictions on the duration and frequency of visits, and they have assessed the provision of amenities such as waiting rooms and information provision systems. ICU visits were found to improve patients' and their family members' satisfaction levels, and medical effects were reported. However, some studies reported that visits were a burden on nurses and that they led to harmful effects on patients. 【Conclusion】Future challenges concerning visiting restrictions in ICUs in Japan pertain to the creation of systems to address family members' satisfaction, medical effects on patients, and provision of amenities such as waiting rooms and information provision systems.