網膜離患者の体験の構造とその特徴

Structure and Characteristics of the Experiences of Retinal Detachment Patients

要旨

　【目的】突然に重要な感覚を失う可能性に直面することを強いられた網膜剥離患者の体験の意味を理解し，構造と特徴を明らかにする．

　【方法】9名の網膜剥離患者に非構成的な面接を行い，得られたデータを現象学的アプローチを用いて質的記述的に分析する．

　【結果】網膜剥離患者の体験する構造は，以下のとおりであった．網膜剥離患者は，視覚の変化を気にしながらもすぐに治るだろうと考えていたが，変化は進んでいくばかりだった．そこで患者は周りの人の後押しもあって病院へ行き，医師から病名と手術しなければ失明するので緊急入院・緊急手術が必要と告げられて驚き動揺していた．直後に手術をすれば失明はしないとわかり安堵し，即座にその日の手術を受諾していた．しかし，手術を待つまでの間に万一の場合の失明不安に思いが至り，再び気持ちが揺れ動いていた．手術後，視力を保持していると実感して安心することができていた．経過は順調かどうかを自分の視覚を用いて自己確認をしていた．退院後，発病以前の生活に戻ることができ，社会的役割の喪失はないが，払拭しきれない再発の不安を抱えていた．その対処行動として定期的に検診を受診していた．

　【結論】網膜剥離患者の体験の特徴は，突然に与えられた失明の不安と失明回避による安心を繰り返すという揺れる経過をたどるものであった．

Abstract

　Retinal detachment patients face the possibility of suddenly losing an important sensory function. The purpose of this study was to understand the significance of these patients' experiences, and to clarify the structure and salient characteristics of their experiences. Nine retinal detachment patients participated in unstructured interviews, and the data was analyzed by a qualitative method based on a phenomenological approach. The following are the results obtained by Giorgi's analysis.

　The retinal detachment patients assumed the abnormalities in their sight would heal quickly but the abnormalities only became worse. As a result, the patients were convinced by friends and family to go to the hospital. The patients were surprised and dismayed when they were told that they must enter the hospital and undergo emergency surgery to avoid becoming blind. After the patients understood that they would not become blind if they received surgery, they were relieved and readily agreed to the surgery. However, as the patients were waiting for their surgery, they began to worry about the possibility of becoming blind and became uneasy again. After surgery, when the patients realized that their sight would be preserved, they were relieved. The patients constantly checked their own vision to confirm that it continued to progress well after the surgery. After discharge from the hospital, the patients were able to return to their former lifestyles and maintain their roles in society, but they continued to worry about relapsing. Consequently, the patients displayed coping behavior and attended all regular ophthalmological examinations.

　In summary, this study found that retinal detachment patients experience alternating anxiety and relief as they undergo diagnosis, treatment and recovery.