Tamai Mikiko, Kojima Shogo, Baba Yasuko, Kurahashi Kiyoyasu
Department of Anesthesiology, International University of Health and Welfare Mita Hospital, Tokyo, Japan.
Department of Clinical Medical Sciences, International University of Health and Welfare Graduate School of Medicine, Chiba, Japan.
PLoS One. 2024 Dec 31;19(12):e0313158. doi: 10.1371/journal.pone.0313158. eCollection 2024.
In Japan, the escalating demand for anesthesia services has resulted in a shortage of anesthesiologists, presenting a societal challenge. Urgent measures involve the imperative task shifting to nurses. The perspectives of anesthesiologists on perianesthesia nurses (PANs) and the PAN system significantly influence the collaboration between anesthesiologists and PANs.
Twenty-four anesthesiologists initially approached in writing among a pool of 304, ultimately agreed to participate in interviews. Verbatim transcripts from these interviews were analyzed using the framework method. In this procedure, data analysis was facilitated by MAXQDA software (version 22.7.0) to construct a case-code matrix, enhancing the reliability of our findings.
Five themes and fifteen categories related to PAN and its system emerged. Participants provided insights into the diverse social conditions accompanying the implementation of the PAN system. They highly regarded PANs as colleagues, expecting a spectrum of capabilities. Nevertheless, the analysis revealed considerable variation in role expectations across institutions and individuals, with some perspectives being mutually critical. Conflicting opinions emerged on two crucial aspects: assigning anesthesia management conducted by PANs and substituting PANs for anesthesiologists. Multiple suggestions were put forth for enhancing and evolving the PAN system.
This qualitative study is the first to reveal that Japanese anesthesiologists hold diverse perspectives on PANs and the system. The approach was well-suited for exploring diverse perspectives, showing significant differences among institutions and individuals. Our data provided crucial insights, including findings suggesting potential barriers to task shifting of anesthesia duties to PANs.
在日本，对麻醉服务需求的不断增加导致麻醉医生短缺，这成为一项社会挑战。紧急措施包括将任务迫切转移给护士。麻醉医生对围麻醉期护士（PANs）及PAN系统的看法极大地影响着麻醉医生与PANs之间的协作。
在304名麻醉医生中，最初以书面形式联系了24名，最终他们同意参与访谈。使用框架法对这些访谈的逐字记录进行分析。在此过程中，借助MAXQDA软件（版本22.7.0）进行数据分析以构建案例编码矩阵，提高研究结果的可靠性。
出现了与PAN及其系统相关的五个主题和十五个类别。参与者深入探讨了伴随PAN系统实施的各种社会状况。他们高度认可PANs为同事，并期望其具备一系列能力。然而，分析显示不同机构和个人在角色期望上存在很大差异，有些观点相互批评。在两个关键方面出现了相互矛盾的意见：分配由PANs进行的麻醉管理以及用PANs替代麻醉医生。针对加强和改进PAN系统提出了多项建议。
这项定性研究首次揭示日本麻醉医生对PANs及其系统持有不同观点。该方法非常适合探索不同观点，显示出机构和个人之间存在显著差异。我们的数据提供了重要见解，包括表明将麻醉职责任务转移给PANs可能存在障碍的研究结果。
