がん患者の補完代替療法に関する看護師の経験とその困難─大学病院看護師を対象として

Nurses' Experience and Difficulties with Complementary and Alternative Medicine for Cancer Patients : A Survey of University Hospital Nurses

要旨

　本研究の目的は，がん患者の補完代替療法（CAM）に関する看護師の経験の実態を経験度と経験の中で感じた困難の内容から明らかにすることである．関東近郊の大学病院4施設でがん看護に携わる看護師375名を対象に，自記式質問紙調査を行った．回収は230名で，そのうち記入漏れのあった16名を除いた214名を分析対象とした．分析は，経験度は記述統計，Kruskal Wallisの検定を用い，困難の内容は質的に分析した．その結果，CAMの経験度は全体的に低かった．また「鍼灸」「ホメオパシー」「サメ軟骨」「アガリクス」「メシマコブ」「プロポリス」「マッサージ」「カイロプラクティック」「ハーブ」「丸山ワクチン」の10項目において，がん看護経験年数が長ければ経験度も高い傾向を示した．困難は，【患者・家族の自己判断】【患者の身体や治療への影響】【看護師として主体的に対応しにくい】【看護業務の弊害】【患者と医師の考えの相違】の5カテゴリ，11サブカテゴリに分類された．

　以上のことから，看護師にはCAMを取り入れる患者・家族をありのままに受け入れる姿勢をもつと同時に，患者・家族がCAMについていつでも相談できる環境をつくっていくこと，そしてCAMに対する知識や情報を得ていく必要性が示唆された．

Abstract

　The present study aimed to clarify the state of nurses. experience with cancer complementary and alternative medicine(CAM)based on their extent of experience and CAM-related difficulties. A selfadministered questionnaire survey was conducted on 375 nurses involved in cancer nursing at four university hospitals in the Kanto Region and surrounding areas. Responses were received from 230 (61%)nurses ; analysis was conducted on the remaining 214 responses after excluding 16 incomplete questionnaires. Analysis was comprised of descriptive statistics and Kruskal-Wallis test for the extent of experience. Qualitative analysis was used for difficulties content. Results revealed an overall low extent of CAM experience ; however, the extent of experience tended to increase with increased length of cancer nursing experience for the following 10 alternative therapies : acupuncture and moxibustion, homeopathy, shark cartilage, Agaricus subrufescens, Phellinus linteus, propolis, massage, chiropractic medicine, herbs, and the Maruyama vaccine. Five categories of difficulties were identified, .self-judgment by patients and families., .effect on patient.s body and treatment., .difficulties in finding approaches to patients care among nurses., .adverse effects on nursing services. and .differences in opinion between patient and doctor.. These were further divided into 11 subcategories.

　The present findings indicate the need for nurses to willingly accept patients undergoing CAM and their families while simultaneously creating an atmosphere in which they can always ask for CAM-related advice. Nurses must also acquire CAM-related knowledge and information.