心臓手術を受ける高齢患者の意思決定に影響した要因

Factors influencing elderly patients' decision making to undergo cardiac surgery

　研究目的は、心臓手術を受ける高齢患者の意思決定に影響した要因を明らかにし、意思決定を支える援助を検討することである。対象者は8名で、半構成的質問紙を用いて面接を行い、質的帰納的に分析を行った。心臓手術を受ける高齢患者の意思決定に影響した要因は、【心臓手術を予期していたこと】【心臓手術の適応について説明を受けること】【心臓手術を任せることが出来ること】【心臓手術に関して期待すること】【存続する役割を遂行すること】【生きることへの希望があること】【家族から支援を受けること】【心臓手術体験者から情報を得たこと】の8つであった。心臓手術を受ける高齢患者の意思決定を支える援助は、予期的な思いを支える援助、心臓手術について受け止めを促す援助、心臓手術を受けることの意味を見いだす援助、社会的支援の活用を促す援助の必要性が示唆された。

　The purposes of the present study were to identify factors influencing the decision by elderly patients to undergo cardiac surgery, and to discuss the support required to facilitate such decision-making. The subjects were eight elderly patients. Semi-structured interviews were conducted, and the results were analyzed qualitatively and inductively. The following eight factors influencing their decision-making to receive cardiac surgery were extracted: prediction of cardiac surgery; receiving an explanation of the cardiac surgery indicated; reliability of cardiac surgery; expectations regarding cardiac surgery; playing roles that they still have; hope of continuing to live; being supported by family members; and obtaining information from people who have undergone cardiac surgery. To encourage elderly patients to make the decision to undergo cardiac surgery, it is necessary to provide support to: understand their anticipatory feelings; encourage them to accept the fact that they should undergo cardiac surgery; help them understand the meaning of receiving cardiac surgery; and encourage them to utilize social support.