高齢がん患者の心理的適応に影響する要因―身体症状に対する認知，身体的状況，セルフ・エフィカシーに着目して

Factors Influencing the Psychological Adjustment to Cancer among Elderly Patients：Perception of Physical Symptoms, Physical Condition, and Self-efficacy

要旨

　目的：高齢がん患者のがんへの心理的適応に影響する要因を知ることを目的として，身体症状に対する認知，身体的状況，セルフ・エフィカシーに着目し関連を検討した．

　方法：65歳以上の52名の高齢がん患者を対象とし，自記式の質問紙法を実施した．質問紙は，「末期がん患者用セルフ・エフィカシー尺度」「日本語版Mental Adjustment to Cancer Scale」「VAS」「KPS」を用いた．Kendallのτと重回帰分析を用いて分析した．

　結果：「前向きな態度」と身体的状況，セルフ・エフィカシーとの間で有意な正の相関があり，「絶望感」と身体的状況，身体症状に対する認知，セルフ・エフィカシーとの間で有意な負の相関がみられた．さらに，影響要因を検討した結果，「絶望感」に対して身体的状況と身体症状に対する認知が各々有意に影響していた．

　結論：身体的状況と症状に対する認知を包括した看護ケアを提供することで絶望感が軽減できる可能性が示唆された．

Abstract

　Purpose: To examine the factors influencing the psychological adjustment to cancer among elderly patients, with specific focus on their perception of physical symptoms, physical condition, and self-efficacy.

　Methods: The subjects were 52 elderly cancer patients (age, ＞65 years). The data were collected using questionnaires based on the following scales: the self-efficacy scale for advanced cancer, the Japanese edition of the Mental Adjustment to Cancer Scale, the Visual Analog Scale (VAS), and the Karnofsky Performance Scale (KPS). Kendall's τ correlation analysis and multiple regression analysis were performed to statistically assess the above-mentioned factors.

　Results: A significant positive relationship was noted between the patients' “Fighting Spirit” and their physical condition and self-efficacy. However, a significant negative relationship was noted between the “Helpless/Hopelessness” and the patient's physical condition, perception of physical symptoms, and self-efficacy. In addition, “Helpless/Hopelessness” seemed to be influenced by the patient's physical condition and perception of physical symptoms (R2=0.55, R=0.74).

　Conclusion: Our results suggested that to improve the feeling of hopelessness among elderly patients, nursing care should be designed on the basis of their physical condition and perception of their physical symptoms.