炎症性腸疾患患者の大腸内視鏡検査に伴う苦痛の体験

Pain with Colonoscopy Experienced by Patients with Inflammatory Bowel Disease

要旨

　目的：炎症性腸疾患患者が大腸内視鏡検査に伴いどのような苦痛を体験しているかを明らかにする．

　方法：発症後に大腸内視鏡検査を1回以上受けた経験がある寛解期の患者10名に半構造化面接を行い，質的記述的に分析した．

　結果：患者は大腸内視鏡検査に伴い，【前処置による心身の負担】【検査中の痛み】【検査への恐怖】【異性の医療者に対する抵抗感】【検査後の疲労と病状悪化】【検査結果への不安】【時間と費用の負担】という苦痛を体験していた．【検査中の痛み】には『炎症時の内視鏡操作に伴う痛み』『内視鏡挿入時や体位変換時の合併症による痛み』『腸管屈曲部に内視鏡が当たる痛み』『送気による腹部の張りと痛み』があった．

　結論：大腸内視鏡検査に伴い炎症性腸疾患患者は，腸管の炎症や合併症によって疾患特有の苦痛を体験していた．

　Purpose: The study aimed to explore pain with colonoscopy experienced by patients with inflammatory bowel disease.

　Methods: We conducted semi-structured interviews with 10 patients with inflammatory bowel disease who were in remission and analyzed the data qualitatively and descriptively.

　Results: Participants experienced pain with colonoscopy such as "physical and mental burden with the bowel preparation," "pain during colonoscopy," "fear of colonoscopy," "a feeling of resistance to healthcare professionals of the opposite sex," "fatigue and disease aggravation after colonoscopy," "anxiety about investigation results," and "burden of time and cost." "Pain during colonoscopy" included 'pain accompanying the colonoscopy procedure when the inflammation was active,' ' pain due to complications of inflammatory bowel disease when inserting the colonoscope or changing body position,' 'pain when the tip of the colonoscope was in the colic flexure,' and 'abdominal tension and pain from insufflated air.'

　Conclusion: Patients with inflammatory bowel disease experienced disease-specific pain with colonoscopy owing to intestinal inflammation and complications of the disease.