重症慢性閉塞性肺疾患患者の希望を脅かす要素

Threats to Hope in People with Severe Chronic Obstructive Pulmonary Disease

要旨

　本研究は，重症慢性閉塞性肺疾患(chronic obstructive pulmonary disease，以下COPD)患者の希望を脅かす要素を抽出，記述することを目的とした．10名の研究参加者に対し，半構造化面接を実施し，得られたデータを質的帰納的に分析した．その結果，重症COPD患者の希望を脅かす要素として，《七転八倒の息苦しさの持続》，《衰え・悪化を知る兆しや証拠》，《活動を妨げる感覚》，《個人としての価値や人格を無視した周囲の対応》の4つのカテゴリーが抽出された．COPD患者が絶望に苛まれることのないよう，このような体験にともなう重症COPD患者の苦痛や苦悩に関心を向け，寄り添う看護師の態度は重要である．看護師は希望を脅かす要素の可能な限りの除去や最小化，あるいは適切な対処へと導くこと，また，それが困難な場合に生じた苦痛や苦悩の緩和をはかることにより，重症COPD患者が絶望を回避，希望を維持できるよう助ける必要がある．

Abstract

　This study identified threats to hope in severe chronic obstructive pulmonary disease (COPD) people. Data were collected from semi-structured interviews with a convenience sample of 10 patients with COPD. The responses from the interviews were analyzed using an inductive qualitative method.

　As a result, four categories were identified from interview responses to elaborate on threats to hope. The four categories were: (1)‘Continuance of suffocative suffering,’(2)‘The evidence of decline and the worse,’(3)‘Disturbance to performance of activities,’(4)‘Unconcern attitude with value as a being and identity.’

　Nurses should show a concern with suffering and distress caused by such experiences, and be with severe COPD people. Nurses can use the categorical themes identified in this study to help COPD people to maintain hope and avoid hopelessness through minimizing or eliminating hoping inhibitors, palliating unavoidable suffering and distress.