在宅精神障害者の家族介護者の生活体験から捉えるSense of coherenceに関する記述的研究

Descriptive Research of the Sense of Coherence of Family Caregivers of Persons with Mental Disorders

要旨

　目的：在宅精神障害者の家族介護者が持つSOC（把握可能感，処理可能感，有意味感）を明らかにする．

　方法：在宅精神障害者の家族介護者24名に半構成的面接を実施し，質的記述的分析を行った．

　結果・結論：家族介護者にとって【家族員の精神疾患発病】は，家族介護者の人生において辛い体験として位置づけられていた．家族介護者の処理可能感は，時間経過の中で【試行錯誤】を繰り返し，【他者からの支援】を受けながら患者への関わり方や生活に対する【気持ちの持ち方】は変化し，【患者と向き合う力】を見出した．把握可能感は，まず患者の病気を【精神疾患と把握する】ことから始まり，【状況の予測・理解の難しさ】の中で，【生活の見通し】のなさを感じている家族介護者が複数いた．また，有意味感は，これまでの生活や介護に【意義や価値の獲得】を行う一方で，【生活や介護への不全感】を感じている者がおり，介護を継続していく力として介護への【使命感】が大きいと考えられた．

　Aim：This research aimed to clarify the sense of coherence (comprehensibility, manageability, meaningfulness) of family caregivers of persons with mental disorders living in the community.

　Methods：Twenty-four family caregivers participated in this research. Semi-structured interviews were conducted and the descriptions of interviews were analyzed by content analysis.

　Results & Conclusion：The “family members' onset of mental disorders” was regarded as a painful experience in the caregivers' lives. Caregivers' manageability repeated ‘the trial and error’ in the progress of a time, and “the attitude for having feeling” of relationship and life with patients changed while receiving “support from the others”; these caregivers acquired “the strength to face the patients.” Concerning comprehensibility, at first caregivers comprehend that “the family member was a mental disorder.” And some caregivers felt that “there is no prospect of improvement in their lives” due to “the difficulty of predicting and understanding the circumstances.” For meaningfulness, the caregivers felt they “acquired significance or value” in their life due to caregiving. However, some of the caregivers had “the feeling of insufficiency of their lives or caregiving.” A “sense of mission” to continue the caregiving was an important strength.