がん治療を受けながら下降期を生きる人々の自己の回復

Recovery of Self for Individuals Undergoing Cancer Treatment during the Downward Phase of the Illness Trajectory

要旨

　目的：がん治療を受けながら下降期を生きる人々の自己の回復について明らかにすることである．

　方法：ステージIII期あるいはIV期の消化器がんに対するがん治療を受ける5名を対象に看護援助を実施し，その援助経過を記録したデータを質的統合法（KJ法）を用いて個別分析と全体分析を行った．

　結果：自己の回復は【悪化してゆく今ここにある身体の感受】【環境にゆるがされる現実の厳しさの認知】【安らぎを得るための方策の探求】【つながりをもつ他者との応答】【意味ある体験の確認】【今ここにいる自分の在り方の表明】の6つの性質から成り立つことが明らかになった．これは，悪化してゆく身体の感受を基盤に，対人関係に影響を受けるものであった．

　結論：がん治療を受けながら下降期を生きる人々の自己の回復は，他者と共に生きる人としての在り方を表すものであり，その人にとって意味ある時を生きてゆく可能性を内包したものである．本研究の結果は，人々が苦難の状況に置かれていても，その人らしく在ることを支援するケアの視点を示した．

Abstract

　Aim: The purpose of this study was to clarify recovery of self for individuals undergoing cancer treatment during the downward phase of the illness trajectory.

　Methods: The study sample comprised 5 patients undergoing cancer treatment with stage III or IV digestive tract cancer. Data were collected through the records of nursing care offered to the patients by the researcher who was the primary nurse. The qualitative synthesis method (KJ method) was used to analyze the structure of recovery of self within and across cases.

　Results: The structure of recovery of self consists of 6 characteristics: [awareness of physical deterioration], [recognizing that one is struggling with the surrounding environment], [searching for strategies to ease suffering], [responsive to people with whom one feels a connection], [confirming meaningful experiences], and [expressing how one wants to be in the present moment]. It was based on awareness of physical deterioration and was affected by interpersonal relationships.

　Conclusion: Recovery of self for individuals undergoing cancer treatment during the downward phase of the illness trajectory was an expression of how to want to be as individuals living with other people. And it was related to the possibility that they would be able to live meaningfully in the moment. The results of this study confirmed the care viewpoint of supporting how individuals are themselves regardless of the circumstances of their sufferings.