Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
Pediatric Cardiology and Cardiac Surgery 33(2): 100-109 (2017)


心臓移植医療におけるチャイルド・ライフ・スペシャリストの果たす役割The Roles of Child Life Specialist in the Field of Pediatric Heart Transplantation

1認定チャイルド・ライフ・スペシャリストCertified Child Life Specialist

2国立研究開発法人国立循環器病研究センター移植医療部Department of Transplant Medicine, National Cerebral and Cardiovascular Center ◇ Osaka, Japan

3国立研究開発法人国立循環器病研究センター小児循環器科Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center ◇ Osaka, Japan

発行日:2017年3月1日Published: March 1, 2017

補助人工心臓(VAD)の開発と承認などにより,移植待機中の患者の状態が多様化している今日の小児心臓移植医療の現場において,移植待機期間中,そして移植後も子どもとその家族への心理社会的支援の提供は重要である.医療環境下にある子どもや家族に,心理社会的支援を提供する専門職であるChild Life Specialist(CLS)は,小児心臓移植医療の現場において,①治癒的遊びと環境の提供,②医療体験への心の準備のサポート,③検査・処置中の心理的サポート,④退院・復学支援,⑤きょうだい・家族へのサポート,⑥グリーフ・サポートなどを通して,子どもたちが主体的に医療に臨めるように医療チームの一員として活動している.CLSを含む移植医療に関わる多職種が,チームで連携し協働することにより,子ども一人ひとりのニーズに合った支援の提供と,その家族全体の包括的な支援が心臓移植待機中,そして移植後も継続して可能になると考える.

Since the Berlin Heart EXCOR were approved for pediatric patients in Japan, the condition of the patients while waiting for having heart transplant has become increasingly varied. Additionally, post-transplant patients still frequently require medical follow-up and obey various restrictions in their daily life to prevent rejection. Therefore, medical professionals in the field of pediatric heart transplantation should be aware of the physical, emotional, and psychosocial impact of the experience of heart transplantation the experience of heart transplantation on both the patients and their families. As one of the members of the hospital multidisciplinary team, the Child Life Specialist (CLS) provides various psychosocial support to meet the children’s needs. Some examples of psychosocial support provided by the CLS include: 1) establishing developmentally appropriate and therapeutic play opportunities; 2) providing psychological preparation; 3) delivering distraction and pain management during procedures and examinations; 4) helping the children prepare for discharge and school re-integration; 5) offering sibling support and family care; and 6) contributing grief and loss support. Through these interventions, the CLS provides opportunities for children and their families to learn about heart transplantation and associated treatment, as well as express their feelings in therapeutic ways. This helps the children and their families to reduce their stress and anxiety regarding their medical experiences and enhance their ability to cope with difficulties in a hospital setting. Communication and collaboration with other professionals and families are essential for the CLS to provide such psychosocial support for pediatric patients. The CLS believes that this comprehensive psychosocial support has positive influence on the quality of life of these children.

Key words: Child Life Specialist; pediatric heart transplantation; post-transplantation; psychosocial care; collaboration

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This page was last modified on 2017-04-12T19:19:13.305+09:00