多重問題を抱える頭頸部がん患者の退院後の生活体験

The Daily Life Experiences of Head and Neck Cancer Patients Suffering from Multiple Problems Following Discharge

要旨

　目的：多重問題を抱える頭頸部がん患者の退院後1年以上経過した生活体験を明らかにする．

　方法：治療（手術療法，化学放射線療法）を終え退院後1年以上経過した外来通院中の頭頸部がん患者のうち，研究参加への同意が得られた11名に対してインタビューガイド（生活の中での不自由な点と，その乗り越え方など）に基づく半構造化面接を行った．データ分析は質的帰納的に行った．

　結果：多重問題を抱える頭頸部がん患者の退院後の生活体験として，【食べやすく調整して動ける体を保つ】【苦痛を耐えしのぎ，体を守る】【意思や経験を今在る自分が伝える】【苦しくても支えがあるからできることをする】【生きている今を普通に過ごす】の5個のカテゴリーが抽出された．

　結論：頭頸部がん患者は，自分の思うように生きることを願っているが，意思を表出できにくい状況にある．看護師は患者が手さぐりで自分に合う方法を見つけ出す状況を真摯に受け止め，患者が意思を十分に表出できて，納得した行動をとれるように，支援する姿勢を持ち続けてケアすることの重要性が改めて認識された．

　Purpose: The purpose of this study is to clarify the daily life experiences of head and neck cancer patients suffering from multiple problems following hospital discharge.

　Methods: We conducted semi-structured interviews with 11 head and neck cancer patients who were being seen on an outpatient basis at least 1 year after discharge from hospital following completion of treatment (surgical therapy, chemoradiotherapy) and who gave their consent to participate in this study. The semi-structured interviews were based on an interview guide (inconveniences in their daily lives, how they overcame these inconveniences, etc.). Data were qualitatively and inductively analyzed.

　Results: Five categories were extracted as daily life experiences of head and neck cancer patients suffering from multiple problems following discharge. These were “altering the diet to make food easier to eat and maintaining physical mobility,” “enduring pain and protecting one's body,” “communicating one's current intentions and experiences,” “doing what one can because one has support for the pain,” and “living one's life normally.”

　Conclusions: Head and neck cancer patients wish to live in their own way but find it difficult to express their intentions. The results of this study reaffirmed the importance of nurses providing support that allows patients sufficient opportunity to express their own intentions and to take actions that are acceptable to them.