長期入院統合失調症患者が地域で社会の一員としての自己価値を見いだすプロセス

Process of Recovering Their Sense of Self-Worth as Members of Society in the Community for Long-Term Hospitalized Patients With Schizophrenia

要旨

　目的：長期入院統合失調症患者が地域で社会の一員としての自己価値を見いだすプロセスを明らかにした．

　方法：精神科病院に1年以上入院し，6ヶ月以上地域生活を継続した統合失調症患者10名を対象とした．データは修正版グラウンデッド・セオリー・アプローチを用いて分析した．

　結果：長期入院による【社会から疎外された自己価値】を抱く患者は，安寧を満たすシステム/人的要因の【安寧な地域生活の保障】/【身近な人との支え合い】を受けて，【社会とのつながりの拡張】を体験し《意思を持って社会で生きる》という核心を形成し，【地域生活の営み】と【生きがいの発露】を経て【社会構成員としての自己価値】に至った．

　結論：安寧を満たすシステム/人的要因を受け社会とのつながりを拡張することが，社会の一員としての自己価値を取り戻し主体性を回復する契機であった．自らの意思を持ち社会で生きることにより，社会構成員としての自己価値に至った．

　Objective: We aimed to clarify the process of long-term hospitalized patients with schizophrenia having recovered their sense of self-worth as members of society in the community.

　Methods: The subjects were 10 patients with schizophrenia, who had been hospitalized in Japanese psychiatric hospitals for 1 year or longer, and then continuously living in communities for 6 months or longer. Data were analyzed using a Modified Grounded Theory Approach.

　Results: The patients felt their ＜sense of self-worth alienated from society＞ due to long-term hospitalization, received ＜assurance of a peaceful community life＞ and ＜mutual support by people close to them＞ as systems human factors that satisfied their peace of mind, and experienced the ＜extended social ties＞ and formed a core for ＜＜participating in society with their own will＞＞. Thus, they came to have ＜their sense of self-worth as members of society＞ by ＜living in the community＞ and ＜feeling fulfillment in their lives＞.

　Conclusions: Extending social ties while receiving the systems human factors that help them achieve peace of mind was the opportunity for them to regain their sense of self-worth as members of society and to recover their independence. By living in society with their own will, they came to recover their sense of self-worth as members of society.