初発乳がん患者に対する教育的グループ介入の有効性の検討―情報への満足度に関して

The Effect of Educational Group Intervention on Satisfaction with Information among Japanese Women with Primary Breast Cancer

要旨

　がん患者の情報への満足度は概して低く，その支援策を検討していくことは医療者にとって急務である．そこで，本研究では，初発乳がん患者に対して教育的グループ介入を行い，情報への満足度に関する効果について無作為比較対照試験を用いて検討した．

　対象は，年齢65歳以下，術後経過期間4～18ヶ月の初発乳がん患者である．介入内容は毎週1回90分，全6回，教育，コーピング技能訓練，リラクゼーションの3部から構成されるものである．介入のアウトカムである情報への満足度の評価はベースライン時，介入6週後，介入6ヶ月後の3回，Visual Analogue Scaleを用いて行った．

　151例の適格者のうち50名（33％）が研究に参加し，介入群（ｎ＝25）および対照群（ｎ＝25）に無作為に割り付けられた．6週間の介入により，介入群は対照群に比べ，乳がんに関する情報（ｐ＝.04），がんによるストレスに関する情報（ｐ＝.0001），がんへの対処法に関する情報（ｐ＝.0001），および医療全体（ｐ＝.0009）への満足度が6ヶ月間にわたり有意に改善した．

Abstract

　Many studies have pointed out that most cancer patients have unmet informational needs and they are often dissatisfied with information they receive. However, no studies have investigated the effect of informational supports on the satisfaction with information for Japanese cancer patients. The aim of this study was to determine the effect of an educational group intervention in improving satisfaction with information among patients with primary breast cancer in a randomized controlled trial.

　The patient selection criteria were age less than 65 years, and surgery undergone within the previous 4-18 months as of the start of the study. We conducted a 6-week educational group intervention. The intervention consisted of health education, coping skills training, and relaxation. Subjects were assessed for the satisfaction with medical information and psychological information using the Visual Analogue Scale (VAS) at the baseline, at 6 weeks, and at 6 months.

　Fifty (33%) of the 151 patients participated and were randomized, and 46 (30%) completed the study. The experimental group had significantly higher scores than the controls for the satisfaction with the information about breast cancer (p=.04), stress of having cancer (p=.0001), and coping methods to cancer (p=.0001), and the satisfaction with total medical services they receive (p=.0009) over the study period.

　The results of this study suggest that a short-term educational group intervention produces significant long-term improvement in the satisfaction with information of Japanese patients with primary breast cancer.