離島在住乳がん患者の専門的診療機関への継続受診における困難感：質的記述的研究

Perceived Difficulties in Continued Access to Specialized Breast Cancer Medical Institutions Among Women Living on Remote Islands: A Qualitative Descriptive Study

要旨

　目的：離島在住乳がん患者が，島外の専門的乳がん診療機関での治療から，その後のフォローアップに至る継続的な受診において，どのような困難感を有しているのかを明らかにする．

　方法：離島在住乳がん患者14名を対象に半構造化面接調査を実施し，質的記述的分析を行った．

　結果：離島在住乳がん患者は，島外の専門的乳がん診療機関への受診にあたり，島外に出るための移動や手続きに伴う身体・精神・経済的な困難感を有していた．また，治療に際して，家族や医療者からの支援を得にくいことも困難感として抽出された．乳がんは，長期にわたる治療やフォローアップが必要であり，島外に長期的に出向くことに対する困難感が抽出された．

　結論：離島在住乳がん患者は，島外受診において，離島特有の困難感を抱えていた．今後は，離島在住乳がん患者の島外受診に対する継続的な支援体制を整備し，困難感の軽減に努めることが必要である．

　Objective: To clarify the difficulties breast cancer patients living on remote islands perceived when visiting specialized breast cancer medical institutions outside the island for treatment and subsequent follow-up care.

　Method: Semi-structured interviews were conducted with 14 breast cancer patients living on remote islands, and qualitative descriptive analysis was conducted.

　Results: Breast cancer patients living on remote islands held physical, mental, and financial difficulties associated with the procedures and arrangements required to travel outside the island to visit specialized breast cancer medical institutions outside the island. In addition, difficulty in obtaining support from family and medical professionals during treatment was also identified as a difficulty. Breast cancer requires long-term treatment and follow-up, and difficulties were identified in traveling outside the island for long periods of time.

　Conclusion: Breast cancer patients living on remote islands felt difficulties unique to remote islands when accessing specialized cancer medical institutions outside the island. In the future, continuous support system will be established, for breast cancer patients living on remote islands to visit institutions outside the island, and strive to reduce these difficulties.