診断後1年間にわたる頭頸部がんを経験する人々のクオリティ・オブ・ライフ

Quality of Life in Survivors of Head and Neck Cancer Over the First Year Following the Diagnosis

要旨

　本研究は，診断後1年間にわたる頭頸部がんを経験する人々のQOLのありようを明らかにすることを目的とした．

　初めて頭頸部がんに罹患した8名を研究参加者として，がん専門病院初診時から1年間にわたり，受け持ち看護師として看護を実践した．研究参加者と受け持ち看護師としての研究者との言語的・非言語的相互行為の記述資料を素材として，質的帰納的に，研究参加者一人ひとりのQOL，及び個別性を越えて浮かび上がったQOLのありようを記述した．

　診断後1年間にわたる頭頸部がんを経験する人々のQOLは，その時そこでの，一人ひとりの【がんを完治できる確信】を核として，【がんの完治の優先性】，【生きる営みに寄せる実践的関心】，及び【自己のありようへの了解】に特徴づけられることが明らかになった．

　看護職者は，看護実践を通して，時機を得てかつ継続的に，頭頸部がんを経験する一人ひとりの先述の4つのありように関するより深い対話ができる立場におり，一人ひとりとの対話に基づいてQOLのありようを理解し，その理解を看護実践に反映できると考えられた．

Abstract

　The purpose of this study was to investigate aspects relating to the quality of life (QOL) in survivors of head and neck cancer over the first year following the diagnosis.

　The data were obtained through clinical nursing practice between the 8 participants, who had been newly diagnosed primary head and neck cancer, and the researcher, as a primary nurse, during the 1 year following their first visit to a cancer medical center. The detailed descriptions of verbal and nonverbal interactions were analyzed in terms of each participant's QOL and cores across the all participants' QOL by qualitative inductive analysis.

　The 4 cores across the 8 participants' QOL were revealed; (1) confidence for a complete cure of one's cancer, (2) priority of a complete cure of one's cancer, (3) practical concern for one's life, and (4) acceptance of one's present self.

　The QOL in survivors of head and neck cancer over the first year following the diagnosis was characterized by individuals through 4 aspects. Nurses are in a good position to open the depth-dialogue with individuals regarding these 4 aspects timely and continuously through interactions in the context of clinical nursing practice, so as to understand individualized QOL.