慢性閉塞性肺疾患患者の呼吸困難と対処過程の質的検討

A qualitative analysis of dyspnea and coping processes among patients with chronic obstructive pulmonary disease

要旨：本研究の目的は，慢性閉塞性肺疾患患者の呼吸困難の発生状況と活動の実施，あるいは制限に至る過程を明らかにすることである．方法は，慢性閉塞性肺疾患患者10名を対象に半構造化面接を実施し，グラウンデッド・セオリー・アプローチを用いて解析した．慢性閉塞性肺疾患患者の呼吸困難は，労作時や複雑な思考を伴う活動等，さまざまな状況で生じていた．その対処過程では【活動の試みと対処】を中心的なカテゴリーとする9つのカテゴリーが生成され，4つのプロセスパターンが抽出された．慢性閉塞性肺疾患患者の活動の実施や継続を支援する上では，各患者の対処過程と活動の実施や継続に繋がる条件を意識して援助することが重要である．

　[Objectives] The purpose of this study was to clarify the occurrence of dyspnea in patients with chronic obstructive pulmonary disease and the process leading to the implementation or limitation of activities. [Methods] Semi-structured interviews were conducted with 10 patients with chronic obstructive pulmonary disease and analyzed using a Grounded Theory Approach. [Results] Dyspnea in patients with chronic obstructive pulmonary disease occurred in a variety of situations, including exertion and activities involving complex thinking. Nine categories were generated in the coping process, with “activity attempts and coping” as the central category, and four process patterns were extracted. [Conclusion] In supporting the implementation and continuation of activities in patients with chronic obstructive pulmonary disease, it is important to be aware of each patient's coping process and the conditions that lead to the implementation and continuation of activities.