がん患者に対する漸進的筋弛緩法の継続介入の効果に関する研究

Effects of Repeated Interventions with Progressive Muscle Relaxation in Cancer Patients

要旨

　本研究の目的は，がん患者の漸進的筋弛緩法（以下，PMR）介入による効果を免疫力を含めた生理学的評価より明らかにすること，またPMRによる体験内容を明らかにすることである．15名のがん患者を対象に2週間PMRを介入し，実施前後に唾液中分泌型免疫グロブリンA（以下，S-IgA），収縮期血圧値，脈拍数の測定を行い，実施後にインタビューを行った．その結果，S-IgAは実施後有意に上昇しており，収縮期血圧値と脈拍数も実施後ほとんど有意に低下していた．PMRについての主観的な体験は内容分析の結果，10カテゴリーが抽出され，そのうち【肯定的な気持ちになれる体験】が1週間，2週間共に最も多くの割合を占め，2週間後にはさらに増加していた．しかし【習得のプロセスで感じる困難さの体験】も挙げられたことにより対象の状態に合わせて指導していく必要性も示唆された．また，がんについての体験も6カテゴリー挙げられ，対象者はPMRを通して，研究者にがんの発症からの経過や今後に対して不安，また自分ががんになってしまった悔しさなど，がんについての思いも語っていた．2週間のPMRの体験は，S-IgAを上昇させたり，がん患者の心身をコントロールしていくために有効な技法であること，またPMRの指導の関わりを通して，がん患者の思いを表出できることが示唆された．しかし，がん患者は症状が悪化しやすいため，状態の落ち着いている時期からPMRの指導を行い習得できるよう支援していくことが重要である．

Abstract

　The purpose of this study was to physiologically clarify the learning effect of progressive muscle relaxation(PMR)intervention using immunological evaluation in cancer patients, and also to clarify patients' experience of PMR.

　PMR was applied to 15 cancer patients for 2 weeks. They were interviewed, and measurements were made at the time of PMR application of salivary levels of secretory immunoglobulin A(S-IgA), systolic blood pressure and pulse rate. The results showed that S-IgA increased significantly after PMR application, along with significant decreases in the systolic blood pressure and pulse rate. Content analyses of subjective experiences with PMR yielded 10 categories, wherein 'the experience of having a positive mood' was seen in a greater proportion after two weeks than after one week. However, 'the experience of difficulty felt in the learning process' was also elicited, suggesting a need for guidance to be given according to the patient's state. Experiences related to cancer were also present in 6 categories. By means of PMR patients told the researchers about the course from the diagnosis of cancer, anxiety for their future, regret of being affected by cancer, and other concerns.

　Application of PMR for 2 weeks was useful in increasing S-IgA levels and for assisting cancer patients both mentally and physically. Guidance regarding PMR should include explanations of how patients will feel. It is important to support cancer patients by introduce PMR early on when their symptoms are stable, as their condition can easily worsen.