重度の合併症のない2型糖尿病患者が家族に思いを抱くという体験

Thoughts of type II diabetes patients with no severe complications about their families

　重度の合併症のない時期の2型糖尿病患者が家族に思いを抱くという現象の存在の確認と，その患者の体験を記述・説明することを目的に，現象学的アプローチを用いて因子探索研究を行った．その結果，以下のことが明らかになった．

　重度の合併症のない時期の2型糖尿病患者が家族に思いを抱くという体験は，患者は家族に思いを抱いているが，常にそのことを意識してはいなかった．家族に思いを抱くことを意識する機会により，意識的に振り返り現在をみつめ，糖尿病になる前とは違う家族への思いに気づくことで，糖尿病になる前の家族への思いにも気づき，その時の家族が自分にかけてくれた思いに心が溢れ，現在の自分のことをも大事に思っている家族を思い描いた．

　そのような家族を思い描いた患者は，自分の思いと想像する家族の思いを重ねながら，実際にはどうすることもできずにいるが，家族と歩調を合わせたい，自分と家族にとってよりよい距離をとりたい，家族に目標を示し自分と家族に変化を起こしたい，自分がせめて家族にできることをしたい，心許ない姿が家族に映らないようにしたいと，家族とよりよく生きたいと願っていた．

　以上の結果より，重度の合併症のない時期に2型糖尿病患者が家族に思いを抱く体験を意識することを，看護者が意識的につくることで，患者自身が家族を積極的にサポート源として取り込んでいくきっかけとなり得ることが示唆された．

　We carried out factor analysis using a phenomenological approach for the purpose of clarifying the thoughts of type II diabetes patients with no severe complications about their families, describing and explaining such patients' experiences. As a result, the following was revealed.

　Type II diabetes patients with no severe complications thought about their families while not always being aware of the fact. Having an opportunity to stop and become aware of their feelings about their families, they came to realize how much their families cared about them before they became diabetic. The feeling brought on by this realization moved them and caused them hope that their disease would not change their families' feelings.

　The patients who hoped to have such families considered their own feelings about the families and imagined the feelings of their families. Although they may not be able do anything about the feelings, they hoped to act in concert with their families, maintain good distance, show their desire to make positive changes for themselves and their families, do what they could do for their families, and avoid showing insecurity. They hoped to live good lives with their families.

　These results suggest that it is essential for nurses to actively create opportunities for type II diabetes patients to consider their feelings and the feelings of their families while they are as yet free of complications as a chance for patients to accept their families as a source of support.