長期生存を続けるがんサバイバーが生きる意味を見いだすプロセス

The Process of Long-term Cancer Survivors Seeking Meaning to Live

要旨

　本研究の目的は，長期生存を続けるがんサバイバーは，どのように生きる意味を見いだしているのか，そのプロセスを明らかにすることである．生きる意味を見いだすことは，スピリチュアルなニーズの一部として位置づけた．研究方法はグラウンデッド・セオリー・アプローチ法を用いた．対象者は，病名を知っているがん患者7名であった．データの収集は，半構成的面接と参加観察を行った．

　分析の結果，生きる意味を見いだすプロセスは，がんの罹患によって《生きられる時間に対する認識》が変化し，それに沿って《自分の存在価値の模索》が繰り返し行われるプロセスであった．《自分の存在価値の模索》のプロセスには〈存在価値の模索動因の段階〉〈存在価値を試す段階〉〈存在価値を確かめる段階〉という3つの段階があった．さまざまな現実に直面する中で《自分の存在価値の模索》は繰り返し行われていた．

　がんサバイバーは，がんという病いによって，生きられる時間が不確かになり，自分自身の存在価値も揺さぶられた．その中で，自己の内面に向き合いながら，新たな自分の存在価値を模索し，自分の存在価値を人とのつながりを通して確かめられた時，生きる意味を見いだしていた．

　がんの生存率が向上し今後ますます生存期間の長期化が予想される．長期間にわたりがんを抱えながら生活するがんサバイバーを継続的に支援していくことの重要性が示唆された．

Abstract

　This research is intended to clarify the process of events that long-term cancer survivors face and how they find meaning to live. Data was collected through semistructured interviews and participant observation. Data was analyzed by the revised grounded theory approach. The subjects were seven patients who were informed of their diagnosis.

　The results showed that the process of the patients finding meaning for their lives changed "awareness of the time remaining" and accordingly this process brought forth to "seeking value in one's existence" continually. There were three steps involved in "seeking value in one's existence." The steps were "seeking motivation to find value in one's existence", "testing the value of one's existence" and "confirming the value of one's existence."

　The cancer survivors felt that the value of their existence was shaken due to their disease and the uncertain time left for them. They sought meaning for their lives by establishing relationships with people who have found new value for their existence as well as facing their inner selves.

　It can be predicted that the chronic period of cancer survivors will be prolonged more than ever due to the increase in the survival rate. Therefore it is important to provide nursing services and a social system that supports and enables chronic cancer survivors living in the community to cope with difficulties or problems on their own.