高齢失語症者とともに生活する妻の知恵の形成プロセス

Developmental Process of Acquisition of the Knowledge among Wives Regarding Living with Elderly Aphasic Husbands

要旨

　目的：医療者の関心が向きにくく，社会の中で孤立しやすい高齢失語症者夫婦の看護に示唆を得るため，高齢失語症者とともに生活する妻の知恵の形成プロセスを記述する．

　方法：高齢失語症者の妻10名に夫への思いや考え方，対応について語ってもらい質的帰納的に分析した．

　結果：妻たちは退院当初【思うように意思疎通がはかれない困惑】を経験し，【困惑や不自由さから逃れる】知恵を働かせる．その中で【失語症である夫を引き受け】，【困惑や不自由さを打開する】知恵を働かせる．しかし，【頑張り続けることの限界】を感じ，苦悩する．このような経験の中で【頑張れる範囲で頑張ると踏ん切る】知恵が生まれ，【周囲からの支えの実感と楽な気持ちでの生活】を送れるようになり，【言葉にこだわらず気持ちを通わせる】知恵を培うことで，【無理しない生活維持と同病者家族への関心の芽生え】を経験していた．

　結論：妻たちは経験を蓄積し，段階が移行する際，知恵を形成していた．このプロセスは，時間とともに夫婦の関係性を深める，言葉から解放されていくという特徴があることが示唆された．

Abstract

　Object: Elderly aphasic patients and their families are often overlooked by the medical community and are easily isolated from society. In this study, acquisition of the developmental process of information among wives of elderly aphasic men is described in order to gain insight in their nursing.

　Methods: Ten wives living with elderly aphasic husbands were interviewed, allowing them to freely express their thoughts on their husband and his treatment. A qualitative and inductive method was applied for analysis.

　Results: A graded process consisting of 9 categories could be ascertained. Initially, wives experience ‘feelings of frustration caused by insufficient communication’ with their spouse. Then they use knowledge to ‘escape the frustration and inconvenience they feel.’ By using such knowledge, wives can ‘recognize that their husband suffer from aphasia.’ Next, they ‘attempt to overcome their frustration.’ In their attempt, wives ‘realize the limitations of continuing to do their best.’ However ‘wives are living and feeling easy realizing that they are supported by many people surrounding them’ through ‘living together as much as possible.’ This condition enables the husband and wife to ‘communicate with each other without verbal communication.’ Finally ‘they live independently and they are gradually interested in other families of aphasic patients.’

　Discussion: Wives in this study accumulated experience and knowledge regarding living with elderly aphasic husbands at each progressive stage of their experience. It is suggested that the process characterizes to deepen their marital relationships and releasing from their verbal communication as time accumulates.