外来で化学療法を受けるがん患者が知覚している苦痛

Pain Perceived by Outpatients Receiving Chemotherapy for Cancer

要旨

　本研究は，外来で化学療法を受けるがん患者が，治療を受けながら生活をしていくうえで知覚している苦痛を明らかにするために，外来で化学療法を受けているがん患者に対し，面接を通して治療を受けながら生活をするうえで苦痛を感じている内容を抽出することを試みた．外来で化学療法を受けているがん患者の5割以上が苦痛と知覚する症状は，身体的症状では「倦怠感」，「脱毛」，非身体的症状では「治療に来なければならないという思い」，「ほかの患者と待たなければならない」，「仕事や家事への影響」で，上位10項目中6項目が非身体的症状であった．がん患者が知覚する困難や気がかりな内容は，『長期化する治療への苦痛』，『治療を受ける体力への不安』など治療に関する苦痛や不安が6カテゴリー，『家族が病気のことを心配する』，『家族が協力してくれない』など家族への不安や不満が6カテゴリー，そして『仕事への不安』，『経済面への不安』，『常に病気のことが頭から離れない』，『死に対する不安』，『医療者の対応』，『相談できる人がいない』，『社会の偏見』の計19カテゴリーであった．家族への不安や不満など家族関係は化学療法の副作用の知覚に影響するため，患者が化学療法による副作用や不安を最小限にし，QOLが維持できるためにも，家族に患者へのサポートの大切さやサポート方法を援助していく必要があることが明らかになった．

Abstract

　In the present study, cancer patients receiving outpatient chemotherapy were interviewed in order to clarify the types of pain and suffering that they experience in daily living. More than half of the cancer patients receiving outpatient chemotherapy experienced physical symptoms (such as "constantly tired" and "hair loss")and non-physical symptoms("thinking about having to come for treatment", "having to wait for treatment with other patients", and "affects my work/home duties"). Six of the ten most common symptoms were non-physical symptoms. Cancer patients reported experiencing a total of 19 categories of worries and difficulties. These include six categories for treatment-related pain and anxiety including "pain associated with prolonged therapy" and "anxiety about the body's tolerance of therapy"; six categories for family- related anxiety and discontent, such as "family is worried about the disease" and "family is uncooperative"; and other categories including "anxiety about work", "anxiety about finance", "always thinking about the disease", "anxiety about mortality", "responses by healthcare professionals", "lack of people to talk with" and "social prejudice". As family relations such as familyrelated anxiety and discontent affect the patient's perception of chemotherapy side-effects, it is necessary to help family members understand the importance of family support and assist them in providing support so that the patient's anxiety and chemotherapy side-effects can be minimized in order to maintain their QOL.