母子間生体腎移植におけるドナーの経験

Experience perception by living donors who are mothers of patients in renal transplants

　母子間生体腎移植ドナーの経験を明らかにするため，母親20名を参加者に半構造化面接を実施し，逐語録を質的・帰納的に分析した．移植決定の時期に見出されたコア概念は《わが子を助けたい一心で決めた移植》であり，4つのカテゴリー【元気にしてあげたい】，【普通の生活にしてあげたい】，【透析から解放してあげたい】，【食事の苦労から解放してあげたい】で構成されていた．母親の望みを一方的・全面的に託しており，移植決定に至る相応の判断がみられない点が特徴であった．提供者決定の時期に見出されたコア概念は《はじめから母親がと決めた提供》であり，5つのカテゴリー【夫には仕事があって無理】，【きょうだいは将来のある身で無理】，【こんな身体にしたのは私のせい】，【丈夫に産めなかった母親の責任】，【母親の提供は暗黙の了解】で構成されていた．提供は自由意思とはいえ母親の自責・負い目から自分の提供を決意しており，喪失の危機過程がみられない点が特徴であった．手術の体験の時期に見出されたコア概念は《わが子だけに注目した手術体験》であり，4つのカテゴリー【子どものことを思えば怖くはない】，【渡す腎臓がうまく合ってほしい】，【あの子の元気な姿が一番】，【しんどいは言えない言葉】で構成されていた．母親も手術を受けながら不安・恐怖や病人役割がみられない点が特徴であった．

　In order to clarify the donor experience in live kidney donation between mothers and children, semi-structured interviews with 20 mothers were carried out. The transcripts were analyzed qualitatively and inductively. At the decision to transplant, we saw 【the decision to transplant was wholeheartedly made from the wish to save my child】, and this was comprised of 〔I want him/her to be well〕, 〔I want to let him/her lead a normal life〕, 〔I want to free him/her from dialysis〕, and 〔I want make him/her able to eat or drink anything〕, with the mother's hopes entrusted unilaterally and totally. It is notable that we cannot see a reasonable or proper decision-making process. For the decision on the donor, we saw 【it was always going to be the mother】, comprised of 〔my husband has to work〕, 〔the siblings have their lives ahead of them〕, 〔it is my fault he/she ended up like this〕, 〔I was responsible for not giving birth to a healthy child〕, and 〔the mother being the donor was the unspoken assumption〕, with the mother's feelings of self-recrimination and bearing responsibility, though it was her free decision. It is notable that we do not see any loss risk process. At the time of the operation, we saw 【a transplant experience only focusing on my child】, comprised of 〔I am not afraid when I think of my child〕, 〔I hope the kidney I pass on matches well〕, 〔seeing him/her happy is all that matters〕, and 〔“hardship”is a word I cannot use〕, and notable for not being able to see any role of the mother as a patient, or her worries and fears, as well.