進行肺がん患者の退院支援における意思決定の影響要因

Factors influencing decision-making conducted by advanced pulmonary cancer patients in relation to support for their discharge from hospital

　研究目的は進行肺がん患者の退院支援における意思決定に影響する要因を明らかにし、意思決定を支える支援を検討することである。対象者は10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。進行肺がん患者の退院支援における意思決定の影響要因は、【生き方に対する考え方】【今までと変わらない生活がしたいという希望】【治療をして長生きしたいという希望】【日常生活を送る困難さ】【家族の十分なサポート】【治療効果】【情報の適切さ】【医療者から治療について方向づけられたこと】の8つであった。以上の結果から、意思決定を支える支援は、その人らしさを支える支援、日常生活を充足させるための支援、家族からのサポートを整える支援、適切な情報を得るための支援、治療を継続する意欲を支える支援が考えられた。

　The present study involved patients with advanced pulmonary cancer, and aimed to identify factors influencing their decision-making in relation to discharge from hospital, and discuss appropriate support required for their decision-making. Interviews with ten subjects were conducted using a semi-structured questionnaire, and the results were analyzed qualitatively and inductively. In relation to support for discharge from hospital, the following eight factors influencing their decision-making were identified: 【thoughts on lifestyles】, 【the wish to continue their lifestyles】, 【the wish to receive treatment to live a long time】, 【difficulty leading a daily life】, 【adequate support provided by family members】, 【the effects of treatment】, 【appropriateness of information】, 【orientation conducted by health care professionals in relation to treatment】. From these results, it was suggested that nursing care to support patients' decision-making included to: help patients live as themselves, improve their daily lives, coordinate support provided by family members, obtain appropriate information, and enhance their motivation to continue to receive treatment.