乳がん診断後に妊孕性温存しないと意思決定した女性の体験

Experiences of Women Deciding Not to Preserve Their Fertility After a Breast Cancer Diagnosis

要旨

　目的：乳がん診断後に妊孕性温存しないと意思決定した女性の体験を明らかにする．

　方法：妊孕性温存しなかった女性19名に対し半構造化面接を行い，質的内容分析を行った．

　結果：質的データからは2つのテーマが抽出された．【突然のがんと妊孕性の問題に人生設計の再考を迫られる】では，予想外の診断にがんと向き合う準備が整わないなか，周囲の支えで妊孕性温存するかしないか自分の意思に向き合っていた．妊孕性温存しない意思決定の背景には明確な理由もあったが，断念せざるを得ない状況による諦めや，妊孕性温存以外の方法の模索もあった．【自分が選んだ結果を生きる】では，がん治療が一段落ついた頃から気持ちの変化が見られ，その後は前向きな気持ちが芽生える状況，様々な気がかりを残した状況の相反する体験が明らかになった．

　結論：妊孕性温存しない意思決定は，挙児希望や子どもの有無にかかわらず苦痛を伴う体験であった．

　Purpose: This study aimed to clarify the experiences of women who decided not to preserve their fertility after a breast cancer diagnosis.

　Methods: Semi-structured interviews were conducted with 19 women who decided not to engage in fertility preservation. Qualitative content analysis was used to analyze the data collected from the interviews.

　Results: Two main themes were extracted from the qualitative data. In the theme "Forced to reconsider life planning due to sudden cancer and fertility issues," the participants were surprised by their unexpected cancer diagnosis, but they confronted the decision of whether to preserve their fertility with the support of their family and healthcare staff. There were clear reasons behind their decision not to preserve their fertility, but there was also resignation because of the circumstances that forced them to give up and a search for methods other than fertility preservation. In the theme "Live with the consequences of my choice," the participants showed a change in feelings when cancer treatment was over. The subsequent situation revealed conflicting experiences; a situation in which they developed positive feelings and a situation in which they were left with a variety of concerns.

　Conclusion: The participants' decisions not to preserve their fertility was a painful experience regardless of whether they wanted to have a child.