がん患者を在宅で看取った家族の覚悟を支えた要因

Factors of Supporting Decisions Made by Families That Provided End-of-Life Care at Home for Cancer Patients

要旨

　家族が在宅で患者を看取れるように支援することは，がん患者の在宅ケアには不可欠である．そこで，がん患者を在宅で看取った家族の覚悟を支えた要因を明らかにすることを目的として，がん患者を在宅で看取った家族15名からなぜ在宅で看取ることができたのかという問いを立てて半構成的インタビューを試み，その内容をGrounded Theory Approachの手法を用いて分析を行った．その結果，115のコード，32の概念，8のサブカテゴリー，3のカテゴリーが抽出された．がん患者を在宅で看取った家族の覚悟を支えたカテゴリーは，家族の人生観・死生観である《在宅での看取りを受け入れる思い》，家族を取り巻く人間関係である《周囲の人々の協力》，家族が患者・家族の置かれた現状を認識する《在宅ケアを継続する勇気》であった．家族の在宅での看取りの覚悟を支えるには，これらの要因に介入していくことが必要であることが示唆された．

　Support is indispensable for families providing home care for cancer patients. This study investigated factors supporting decisions made by families that provided end-of-life care for cancer patients at home. Semi-structured interviews were conducted with members of such families (N=15) about why they could provide such care. The responses were analyzed using the Grounded Theory Approach. The results indicated 115 codes, 32 ideas, eight subcategories, and three categories. The categories were: (1) the feelings of accepting end-of-life care at home, i.e. the family's view of life and death, (2) support from people around the family, i.e. human relationships with surrounding people, and (3) the courage to continue home care, i.e. the family members' recognition of the condition in which the family and the patients are placed. It is suggested that interventions for these factors are necessary to support the decisions made by families providing end-of-life care for patients at home.