安定期慢性閉塞性肺疾患患者の日常生活における体調調整の特徴

A Study on the Daily Healthcare Behavior of Patients with Chronic Obstructive Pulmonary Disease

要旨

　目的・方法：本研究では安定期にある15名のCOPD患者に半構造化面接法を用い，日常生活の中でどのように体調調整を行っているのかをSchutzの示した日常生活の認知様式を構成する視点を手掛かりに明らかにしていった．

　結果：日常生活における体調調整の行為として【COPDによって変化した身体が日常化する】【今の身体の状態を感じ取ることでCOPDを持つ身体を体験する】【身体への信頼を失っていく感覚と生に対する思いを持つ】【呼吸を安定させるための方略を持つ】【心身を安定させるための方略を持つ】【動ける身体を維持するための方略を持つ】【療養法を生活の中にうまく取り入れる】【身体の調子と生活時間を調整する】【社会の一員として存在するための方略を見つける】【病気や治療の知識，見通しを持つ】【役割や楽しみを持つ努力をする】の11の構成要素が明らかになった．本研究では，Schutzの考え方を用いたことで生活者として患者側から見た体調調整のあり方を明らかにしていくことができた．

Abstract

　Purpose/Methods：The purpose of this study is to clarify how patients with chronic obstructive pulmonary disease（COPD） understand and manage their bodily condition in daily life, in reference to the cognitive models proposed in Schutz. The method used was a semistructured interview conducted with 15 patients.

　Results：The healthcare behavior of COPD patients identified in the interview was classified into the following 11 categories：［1］accepting their bodily changes caused by COPD, ［2］carefully examining and comprehending their physical condition, ［3］take in feeling to be alive and loss of reliance in the body, ［4］trying to familiarize themselves with the way they stabilize their breathing, ［5］learning how to achieve and keep physical and mental stability, ［6］maintaining physical mobility, ［7］implementing body therapy techniques in such a way as to steadily continue them in daily life, ［8］adjusting their lifestyle in accordance with their physical condition, ［9］finding ways to continue as a member of society, ［10］acquiring sufficient knowledge concerning COPD, such as its treatment and future prospects, and ［11］trying to fulfill their own roles and find enjoyment in daily life. In this study using the idea of Schutz, therefore, the daily healthcare behavior was able to be clarified from the aspects on the patients side.