長期入院を経験しデイケアを利用する男性統合失調症者の地域における生活の再構築—喪失と孤独の中でのつながりの醸成

Rebuilding of Life in Local Communities by Males Living with Schizophrenia who Had Experienced Long-term Hospitalization, and Currently Using Daycare Services: Developing Connections in Loss and Loneliness

要旨

　目的：長期入院を経験し精神科デイケアを利用する男性統合失調症者が，地域においてどのように生活を再構築しているのか，当事者の視点からその特徴を明らかにし支援への示唆を得る．

　方法：男性統合失調症者9人を対象とし，参加観察やインタビューから得られたデータから退院後の生活の再構築についての語りを抽出し，分析した．

　結果：対象者は，【長期入院によるつながりの喪失】を経験し，退院後は馴染みのない【新たなコミュニティのメンバーシップを得ることの難しさ】から寂しさを感じていた．そのようななか，専門職や親族などからの【サポートの活用による病状や生活の維持】を図りながら，【地域におけるデイケアメンバーとのつながりと役割の獲得】により，生活を再構築していた．

　結論：長期入院を経験した男性統合失調症者が地域の中で孤立せず社会参加できるよう，当事者コミュニティと地域コミュニティとの関係づくりを強化することや，入院早期からの就労支援と地域における活動の機会の必要性が示唆された．

　Objectives: Methods of rebuilding the life of males living with schizophrenia who had experienced long-term hospitalization and were currently using psychiatric daycare services in local communities were investigated from the viewpoint of the people to obtain suggestions for supporting them.

　Methods: Qualitative and descriptive research designs were applied by referring to ethnographic methods. Participants were nine males living with schizophrenia who had experienced long-term hospitalization of over three years and were currently using psychiatric daycare services. Rebuilding of their life after discharge were identified from analyzing data obtained through participant observation and interviews.

　Results: Participants experienced “loss of connections because of their long-term hospitalization” and felt lonely because of “the difficulty in obtaining membership of in their new community” that was unfamiliar to them. They tried to “maintain life and circumstances created by their illness through using the support” of professionals and relatives and rebuild their life by “acquiring connections with daycare members and a role in the community.”

　Conclusions: It is necessary to enhance the relationship between the peer community and the local community, providing employment support from early time and local activity opportunities to achieve social participation in which males living with schizophrenia that had experienced long-term hospitalization can live without being isolated.