放射線治療を受けているがん患者の不確かさと対処

Uncertainty and Coping of Cancer Patients Undergoing Radiotherapy

要旨

　本研究は，放射線治療を受けているがん患者の不確かさと対処を明らかにし，患者が不確かさの体験を通して主体的に治療完遂に向かうための看護援助について示唆を得ることを目的とした．初めて根治目的の放射線治療を受けているがん患者8名を対象に半構成的質問紙を用いて面接を行い，得られたデータを質的帰納的に分析した．その結果，放射線治療を受けているがん患者の不確かさとして，【放射線そのものの存在が漠然としている】，【放射線治療が適切なのか判断できない】，【今後の治療経過を予測できない】，【治療が複雑すぎて十分に理解できない】，【曖昧な身体状況を捉えることができない】，【自分の状況をコントロールできない】，対処として，【自分なりに物事を解釈する】，【自分でできる情報収集を行う】，【意図的に物事を考えないようにする】，【気がかりを自分の中に留めておく】，【今やるべき放射線治療を継続する】，【未来に確信がもてるよう気持ちを整理する】のそれぞれ6つの大カテゴリーが抽出された．患者は，不確かな状況で放射線治療を継続することに意味を見出しており，不確かさに対して対処を繰り返し行うことで，不確かさに対して新たな見方を獲得していくと考えられる．

Abstract

　This study aimed to reveal the uncertainty and coping of cancer patients undergoing radiotherapy in order to gain insight about nursing support that helps patients independently face treatment and cope with uncertainty until its completion. Study participants were eight cancer patients undergoing curative radiotherapy for the first time. Interviews were conducted using a semi-structured questionnaire, and the data obtained was qualitatively and inductively analyzed. Six main categories were identified for uncertainty experienced by cancer patients undergoing radiotherapy: "the existence of the radiation itself is amorphous," "I can't judge if radiotherapy is appropriate," "the future course of treatment is unpredictable," "treatment is too complicated to fully comprehend," "it is hard to grasp my illdefined physical state," and "I can't control my situation." For the patients' forms of coping, six main categories were elicited as follows: "I interpret things in my own way," "I collect information on my own," "I intentionally avoid thinking about it," "I shut up concerns inside myself," "I continue the radiotherapy that needs to be done," and "I sort out my feelings so I can be certain about the future." This suggests that, in an uncertain situation, patients find meaning in continuing radiotherapy and repeatedly work to cope with uncertainty, thereby obtaining a new perspective on uncertainty.