就労可能年齢にある進行大腸がん患者の診断時から初回治療開始前における就労に関する体験

Experiences of Advanced Colorectal Cancer Patients of Working Age in Relation to Employment Between Diagnosis and Initial Treatment

要　旨

　目的：就労可能年齢にある進行大腸がん患者の診断時から初回治療開始前における就労に関する体験を明らかにし，がん患者の就労に関する看護支援への示唆を得る．

　方法：がんの診断時に就労している20〜60歳までの進行大腸がん患者10名を研究対象者とし，診断時に就労について感じたこと，行動したことなどを，インタビューガイドを用いて半構造化面接を行い質的記述的に分析した．

　結果：就労可能年齢にある進行大腸がん患者の診断時から初回治療開始前の就労に関する体験は，【がんと診断されたことによって困惑する】【現実を認識しながら大腸がんに向き合っていく】【予定されている目の前の治療に向かっていく】【仕事と収入への影響について思い巡らせる】【状況をよく考え，仕事上必要な人に報告と相談の機会をもつ】【がんと診断されても就労の継続を志す】【診断から治療を迎えるまでを通して家族からサポートがあると実感する】などの9 つのカテゴリーに集約された．

　考察：就労可能年齢にある進行大腸がん患者は，がんの診断時から自身の仕事について思い巡らせて見通しを立て，仕事上必要な人に報告し，診断されても就労の継続を志していた．就労継続の意思を支えるうえで，看護師からも就労に影響を及ぼす可能性のある治療内容の情報提供や患者の認識の確認を診断時から積極的に行う必要があると示唆された．

　Purpose: This study was aimed at clarifying the experiences of working-age patients with advanced colorectal cancer related to their employment from when they were first diagnosed to before the start of their initial treatment and gathering feedback for nursing support regarding the employment of these patients.

　Methods: Ten patients with advanced colorectal cancer aged 20-60 years who were employed when they first received their cancer diagnosis were included in the study. These patients' thoughts and actions regarding their employment at the time of diagnosis were analyzed qualitatively and descriptively through semi-structured interviews using an interview guide.

　Results: The employment experiences of working-age patients with advanced colorectal cancer from the time of diagnosis to the start of their initial treatment were summarized into the following nine categories: “Bewildered by the cancer diagnosis,”“Facing colorectal cancer while recognizing reality,”“Focusing on the planned therapy,”“Considering the impact of treatment on work and income,” “Considering the situation carefully and having opportunities to keep in close contact with those critical to their work,”“Intending to continue working even after the cancer diagnosis,” and “Realizing the availability of family support throughout the process from diagnosis to treatment.”

　Discussion: Working-age patients with advanced colorectal cancer considered their work from the time of their cancer diagnosis, made plans for their future, stayed connected with those critical to their work activities, and expressed a desire to continue working even after their cancer diagnosis. To support these patients' intentions to continue working, it was suggested that nurses should actively provide information on treatment details that may affect employment and confirm patients' perceptions from the time of diagnosis.