糖尿病性下肢潰瘍患者の体験世界の理解

Understanding of Diabetic Foot Ulcer Patients' Experienced World

　本研究の目的は，入院中の糖尿病性下肢潰瘍患者（以下，潰瘍患者）の体験世界を記述することから，体験の意味を明らかにすることである．入院治療中で足趾切断をした潰瘍患者3名に，対話的かかわりによる面接を実施した．Giorgiの現象学的研究方法で分析後，さらに体験の意味を導き出した．分析の結果，5つの体験の意味が明らかになった．潰瘍患者は，〈病とともに生きる世界構成の難しさ〉をもちつつも，〈生活時間と生活空間保持への希求〉があり，〈主体的になることで世界へ積極的関与が行える〉．家族や医療者との〈関係性の世界のなかで生きる〉ことで，〈自己世界の変容と自己成長〉を可能にしていた．これらから，患者は自分の置かれた状況で苦しさを感じていたが，家族・医療者とのかかわりによって解放される体験をしていた．よって，看護師とのかかわりが，潰瘍患者のケアに重要であることが示唆された．

　The objectives of the present study were to describe and determine the meanings of the experiences of hospitalized patients with diabetic foot ulcer (hereafter, ulcer patients). Dialogue interviews were conducted with three hospitalized ulcer patients who had undergone toe amputation. After performing analysis using the phenomenological methodology of Giorgi, the meanings of experiences were further identified. Based on analysis, the following five factors were identified as the meanings of experiences: while ulcer patients faced the difficulty of living with the illness, they also had“hopes to maintain living time and space”and had“the ability to actively engage in the world by acting independently”. Also, by“living in a world of relationships”with family and medical staff, ulcer patients were able to achieve“modification of the subjective world and personal growth”. Therefore, these patients felt agony regarding their own situations, but found that release from this agony could be obtained through interactions with family and medical staff. Interactions with nurses should thus be considered important in care for ulcer patients.