終末期がん患者を抱える家族の家族機能の特徴とその影響要因

Characteristics and Effective Factors of Family Functioning with Terminally Ill Cancer Patients

要旨

　本研究は，終末期がん患者を抱える家族の家族機能の特徴を終末期がん患者を含まない家族との比較を通して明らかにし，家族機能の影響要因を検討することである．分析対象は，終末期がん患者の家族46家族，比較群とした家族49家族である．家族機能を測定する尺度（FSHM），支援ネットワーク，家族属性についての質問紙調査を実施した．分析はMann.Whitney U検定や重回帰分析を用いた．その結果，1）終末期がん患者を抱える家族は比較群と比べ時間空間の共有，信頼に基づくきずなが高いことが示唆された．2）家族機能には，家族間コミュニケーションが影響を及ぼしていることが明らかとなった．下位尺度別にみると，信頼に基づくきずな，時間空間の共有には手段的ネットワーク，役割達成性には手段的ネットワーク・介護者数，環境への適応性には主介護者の性別が影響要因として示された．主介護者が男性の場合は，女性の場合に比べ環境への適応性が低いことが明らかとなった．以上より，終末期がん患者を抱える家族の家族機能を促進するためには，家族間のコミュニケーションが円滑に行われるような関わりの必要性が示唆された．

Abstract

　The purposes of this study were to clarify the characteristics of the family functioning with terminally ill cancer patients and to examine the factors that affect the family functioning.

　The questionnaire survey was conducted with 46 families with terminally ill cancer patients, and 49 families without patients as a comparison group. The survey was comprised of the Family Systems Health Measurement(FSHM). Each family was also asked to complete a form of their demographic profiles and social support networks they used. Mann-Whitney U-test and multi-regression analysis were used to identify the characteristics of the family functioning.

　The following results were indicated: 1)families with terminally ill cancer patients had higher scores on 'sharing time and space' and 'family ties based on trust' items, 2)family communication affected family functioning. According to the subscales, a factor that affect 'family ties based on trust', 'sharing time and space' and 'role achievement' items was instrumental network, while the number of family members who provided care was also an effect factor for 'role achievement'. Sex of family member affected 'the adaptation of environment'. If male members of the family were responsible for the patient care, they were less 'adaptable to the environment' than female members.

　In order to improve the family functioning, it is necessary to facilitate communication among family members.