外来化学療法を受けている患者のQOLに影響を及ぼす要因

Factors Affecting QOL in Patients Receiving Outpatient Chemotherapy

要旨

　本研究の目的は，外来化学療法を受けている患者のQOLに影響を及ぼす要因を明らかにし，患者のQOLを維持・向上できるような看護援助について検討することである．外来化学療法を受けている患者を対象にアンケート調査を実施し，95名から有効回答を得た．調査内容は，属性，身体的要因として副作用の程度，社会的要因として外出状況，地域の人々や友人・親戚といった他者との交流状況，仕事や家での用事や役割の遂行状況，サポート状況，心理的要因として外来化学療法に対する経済的負担，時間的負担，外来で治療を受けながら生活することへの不安およびQOLとした．QOLの測定にはFACT—G（日本語版）を使用した．QOLと有意な関係が認められた悪心，下痢，他者との交流，役割遂行，医療従事者の相談，外来治療生活への不安の6項目を独立変数，QOLを従属変数とし，重回帰分析を行った．その結果，外来化学療法を受けている患者のQOLに関連が認められたのは，他者との交流，役割の遂行，そして外来での治療生活に対する不安であった．他者との交流や役割の遂行が行えているものほどQOLが高かった．また，外来での治療生活に対する不安が少ないものほどQOLが高かった．このことから，看護者として，患者の身体面に加え，社会面や心理面にも着目し，援助していくことの重要性が示唆された．

Abstract

　The aims of the present study were to elucidate the factors affecting QOL in patients receiving outpatient chemotherapy and investigate nursing support that maintains and improves patient QOL. We conducted a questionnaire survey on patients receiving outpatient chemotherapy and received 95 valid responses. The survey investigated attribute and physical factors (severity of side effects), social factors(conditions surrounding support, going out, executing role and tasks at work and home, and interacting with others, including local people, friends and relatives), psychological factors(financial burden and time-constraints imposed by outpatient chemotherapy, and concern about lifestyle while receiving outpatient chemotherapy)and QOL. The Japanese version of FACT-G was used to measure QOL. Nausea, diarrhea, interaction with others, role execution, advice from healthcare professionals and concern about lifestyle while receiving outpatient chemotherapy were found to be significantly correlated with QOL. Multiple regression analysis was then conducted with these six items serving as independent variables and QOL as the dependent variable. A relationship with QOL was observed for interaction with others, role execution and concern regarding lifestyle while receiving outpatient chemotherapy. The more patients interacted with others and performed a useful role in society and the lower the concern regarding lifestyle while receiving outpatient chemotherapy, the higher the QOL. These findings suggest that it is important for nurses to pay attention to and provide support for not only physical aspects but also patients' social and psychological aspects.