外来で治療を続ける再発乳がん患者が安定した自分へ統合していく体験

The Quest for Self-Integration in Patients with Recurrent Breast Cancer During Outpatient Treatment

要旨

　本研究は，外来で治療を続ける再発乳がん患者が安定した自分へ統合していく体験を記述，解釈し，その体験の意味を明らかにすることを目的とした．研究方法は研究協力者の主観的な体験の意味を明らかにするために，現象学的アプローチ法を基に質的記述的方法を用いた．データ収集は外来で治療を続ける再発乳がん患者4名に非構成的面接を行った．

　体験を記述，解釈し，意味づけた結果，安定した自分へ統合していく体験は，【現実を受け入れて，現在を生きていく】，【他者とのつながりを通して，自分らしく生きていく】にまとめられた．これらの意味は「時間性として，厳しい状況を自分の現実として受け入れ，自分のありようや新たな可能性を見いだし，それらを目指して現在に価値を置いて生きていくこと」や「信頼のおける他者との開かれた関係性の中で自分らしく在り続け，自由に生きていく」ことであり，さらに厳しい状況の中でも自分の可能性を伸び拡げ，よりよい将来をもたらす可能性があると考えられた．この体験は自ら，安定した自分へ統合していくものと示唆され，それには重要他者の存在や他者との語り合いが重要であった．

Abstract

　The purpose of this study is to describe and interpret the experiences of selfintegration in outpatients with recurrent breast cancer, and identify the meaning of their experiences. Non - structural interviews were conducted with four patients. The data were analyzed using qualitative and descriptive methods based on phenomenology to explore the implications of their subjective experiences. Two major themes emerged from the analysis : to accept the reality and live in the present ; and to live by one's own values through the relationship with others. According to the Heidegger hermeneutical approach, it is rooted in temporality : the original unity of the future, the past and the present. It implies accepting painful reality, seeking for being oneself and new possibilities and living fully in the present moment. It also indicates being oneself in the open relationship with reliable others, and living at one's own will. Even in harsh reality, achieving one's potential would bring a better future. The results suggest that the patients direct themselves toward self-integration through these experiences. Thus, the existence of the significant others and talking to them are vital.