末梢血幹細胞移植を受けたAさんのライフヒストリー―新生自己の創出

Life History of a Patient Undergoing Peripheral Blood Stem Cell Transplantation: Creation of a New Self

要旨

　本研究の目的は，悪性リンパ腫と診断され自己末梢血幹細胞移植を受けたAさんの生活史を記述し，その中から経験の意味を解釈することであった．

　本研究は，Merleau-Pontyの身体論を理論的前提とし，データ収集および分析にはライフヒストリー法を用いた．

　研究方法は，①Aさんが病を克服する過程について聞き取りを行い，②語られた内容に基づいて逐語録を作成し，③逐語録に基づいてライフヒストリーを構成した．研究者は，面接の際にカウンセラーとしての態度をとり，病の経験を理解することを目指した．

　結果，Aさんにとっての病の経験に関する中心的なテーマは，《新生自己の創出》と解釈できた．この中心的なテーマは，3つの時期およびサブテーマによって構成されていた．

　看護実践への示唆としては，患者に対する精神的ケア，家族の緊張感や負担感を軽減させるための精神的ケア，そして患者の苦悩に寄り添う看護ケアを開発することが重要だと考える．さらに，患者が病の肯定的な意味を見出したり，前向きに生きるために長期にわたる援助が必要だと考える．

Abstract

　The purpose of the present study was to describe and interpret the meaning of the life history of a female patient with malignant lymphoma who received peripheral blood stem cell transplantation.

　The philosophical perspective of the present study was Merleau-Ponty's phenomenology of embodiment. Data collection and analysis were performed according to the life history method.

　The following research method was used：(1)The patient participated in semi-structured interviews about her process of survival. (2)The narrative of the patient's experience was recorded verbatim. (3)The life history of the patient was described according to the life history method.

　During the interviews, the investigators aimed to understand one individual's experience with an illness from a counseling perspective.

　As a result of the interpretation of interview data, the central theme of the patient's experience with her illness was understood as the“creation of a new self”. This central theme was structured based on 3life stages and 3sub-themes.

　The recommendations for nursing practice that were derived from the patient's experience were recognizing the importance of providing psychological care for patients, providing psychological care that alleviates the stress felt by the patient's family,and developing nursing care that addresses the patient's suffering. In addition, the patient's experience emphasized the importance of providing long-term assistance for patients in order to identify the positive meaning of their illness and to allow them to live positively.