特発性肺線維症患者が呼吸困難感と共に生きる体験

Experience of Japanese Patients with Idiopathic Pulmonary Fibrosis who Cope with Dyspnea

要旨

目的：特発性肺線維症（IPF）患者が，呼吸困難感と共に生きる体験を記述することである．

方法：歩行時にボルグスケール1以上の呼吸困難感が出現しており，自由意思により同意が得られた対象者14名に半構成的面接を実施し，質的帰納的に分析した．

結果：7カテゴリが抽出された．特発性肺線維症患者が呼吸困難感と共に生きる体験は，【身体の変化への戸惑い】，【膨らんでいく無力感】，【呼吸困難感と生きるための生活変容】，【労作時に生じる呼吸困難感と酸素で楽になる身体との葛藤】，【他者と協調できずに断つ交流】，【家族や友人に見守られる生活】，【体験がもたらす意味への思索】であった．

結論：特発性肺線維症患者は，呼吸困難感や在宅酸素療法のスティグマのために生活活動範囲を縮小させ，生じる葛藤に対処しながら，呼吸困難感との生活に適応するため人生観を変容し，病いがもたらす意味を思索していた．

　This study aimed to clarify experiences of Japanese patients with idiopathic pulmonary fibrosis (IPF) who were coping with dyspnea. We conducted semi-structured interviews with a total of 14 subjects who had developed dyspnea (Borg Scale I or higher) on walking. The data obtained were subjected to qualitative and inductive analyses, which led to the extraction of 36 subcategories. These subcategories were divided into 7 categories, each of which represented the following 7 experiences of IPF patients coping with dyspnea: 1) distress due to physical changes, 2) a growing sense of helplessness, 3) making adjustments to one's lifestyle in order to cope with their sensation of dyspnea, 4) feeling conflicted between dyspnea that occurs during work hours and its alleviation by taking oxygen, 5) being estranged from other people due to an inability to cooperate with them, 6) one's life in which they require assistance from their family and friends, and 7) searching for the significance of experiencing dyspnea. IPF patients restricted their own daily activities due to the stigma of suffering from dyspnea and needing to receive at-home oxygen therapy. In addition, to cope with such a sensation, while feeling conflicted, they changed their perspective on life, and searched for the significance of experiencing illness.