外来化学療法を受けるがん患者の“前に向かう力”

Factors that Improve Outcomes for Cancer Patients Receiving Outpatient Chemotherapy

要旨

　本研究の目的は，外来化学療法を受けるがん患者の“前に向かう力”はどのようなものであるかを明らかにし，適応のプロセスを促進させる看護の示唆を得ることである．外来化学療法を受けているがん患者10名を対象に半構成的な面接法を用いてデータ収集し，因子探索型持続比較分析を行った．その結果，“前に向かう力”として【生きることへの信念】【自己の能力の放出】【自己のあり様の創出】【日常的価値の発見】の4つの要素が明らかになった．【生きることへの信念】は他の要素の原動力になっており，患者は生への強い願いを抱きながら，自分自身の能力でできる事柄に懸命に取り組んでいた．またがんや化学療法という現実に向かっていくために，自分自身のあるべき姿を創り出したり，生や日々のありがたさに気づき価値をみいだすとともに，それらの事柄に懸命に取り組もうとしていた．看護師は患者が日常生活のなかにうまく外来化学療法を組み込み，主体的な療養生活を送ることができるように，患者の生きる希望を支えることによって，“前に向かう力”を高め，適応を促進させることができると考える．

Abstract

　The purpose of this research was to gain a better understanding of the factors that improve outcomes for cancer patients who receive outpatient chemotherapy, and provide appropriate suggestions for improving care. We performed semi.structured interviews with ten cancer patients who received outpatient chemotherapy. We then coded the data and conducted a factor. based comparative analysis. The results indicated that the following four factors improved outcomes in cancer patients after outpatient chemotherapy : "belief in living life," "acknowledging the loss of function," "creating one's own circumstances," and "discovering value in everyday life."

　"Belief in living life" appeared to be a driving force for the other three factors. In our study, patients were intensely involved in things they were capable of doing on their own and held a strong belief in living life. In order to move forward with the reality of having cancer and the effects of chemotherapy, patients created their own ideal circumstances and discovered values in everyday life by fostering a greater awareness of life and developing gratitude for everyday things. Patients approached their situation with eagerness. We believe that nurses can strengthen and accelerate a patient's ability to move forward and adapt by supporting a patient's desire to live. This will help patients incorporate outpatient chemotherapy into their lives and continue to live a proactive life while in therapy.