心臓手術を体験する高齢者の発達的変容の研究

A Study on the Transformation in Elderlies Experienced the Cardiac Surgery

要旨

　本研究の目的は，心臓手術を受ける高齢者の発達的変容を見いだすことである．

　M. Newmanの提唱する理論をふまえ，高齢者の発達的変容を意識の拡張という視点から捉えることを前提とした．

　Grounded Theory Approachを用いた質的機能的研究を行った．68歳から83歳までの心臓手術を受ける高齢者男性8名女性2名の合計10名を対象とした．対象者の平均年齢は72.5歳だった．術前から術後約2ヶ月目まで関わり，公式面接及び随時の面接，参加観察を行った．得られたデータは継続的に比較分析した．

　心臓手術を受ける高齢者の発達的変容は，≪自分らしさ≫を中核カテゴリーとして発展していくプロセスであることが見いだされた．このプロセスには，関連して進行する3つのカテゴリーと，3つの段階が見いだされた．さらにこのプロセスを通して，対象者は〈生きる力〉を産み出していることが明らかとなった．

　一見高齢者に否定的な影響を及ぼすように思える心臓病と心臓手術の体験は，高齢者が≪自分らしさ≫を発展させ，主体的・肯定的な変容を遂げていく一つの契機となりうることが示唆された．また，高齢者の個別性や多様性を追求していくことの必要性，高齢者が≪自分らしさ≫を発展させていくことを促していけるような援助の必要性が示唆された．

Abstract

　The purpose of this study was to discover the transformation in elderlies who experienced the cardiac surgery. Based on M. Newman's theory, transformation was explored as expanding consciousness. The subjects were 10 elderlies, 8 male and 2 female. Their age were from 68 to 83 and the mean age was 72.5. Using the Grounded Theory Approach, data were gathered from interviews and participant observations and were analyzed by the constant comparative method.

　The transformation in elderlies was clarified as a process of developing “sense of own himself or own herself” which was how elderlies see themselves and their way of interaction with environment. This process advanced interacting with 3 dimensions, which are 'awareness of physical condition', 'deceleration of life rhythm' and 'awareness of others' harmonious change'. Also this process included 3 stages and created 'life energy'.

　These findings suggest that even though the physical decline seems to give the only negative effect on elderlies, it has possibility to influence on them in a positive way as an opportunity for the developmental transformation. Also it was suggested that considering their individuality and diversity and assisting their developmental process are needed.