外来化学療法を受ける男性消化器がんサバイバーの就労継続の様相

Aspects Affecting Employment Continuation in Male Gastrointestinal Cancer Survivors Undergoing Outpatient Chemotherapy

要旨

　本研究は，外来化学療法を受ける男性消化器がんサバイバーの就労継続の様相を明らかにすることを目的とする．外来化学療法を受けながら仕事を継続している消化器がんと診断された男性5名を対象に，半構成的面接を行い，質的帰納的方法で分析した．外来化学療法を受ける男性消化器がんサバイバーの就労継続の様相は，21のサブカテゴリーより8つのカテゴリー，【職場の理解と配慮】【融通のきく仕事の形態】【治療の場・治療内容】【病状安定の自覚】【経済的負担感】【家族の支え】【医療者の支え】【仕事への向き合い方】が導かれた．就労継続していくうえで，経営者や上司，同僚からの理解が就労意欲にも影響を与え，仕事の時間や内容を調整できる職種であること，外来で行える治療であることが日常生活と治療との両立を可能としていた．また，がんサバイバーは，自身にとっての仕事の意味を通して自身の存在を再確認して仕事に取り組んでいた．その中で，治療に伴う有害事象や疾患による症状を自覚しながら，自分なりの対処法をつくり上げ，体調に合わせられる仕事に切り替えるという新たな生活の再構築を行っていた．男性がんサバイバーの就労継続は，日本において男性のアイデンティティとしての仕事への価値観に影響されていることも示唆された．

Abstract

　The present study aimed to clarify the aspects affecting employment continuation in male gastrointestinal cancer survivors undergoing outpatient chemotherapy. Using a qualitative descriptive approach, semi.structured interviews were conducted with 5 men continuing to work while undergoing outpatient chemotherapy for gastrointestinal cancer. Content relating to employment continuation was extracted from the interview transcripts and qualitatively and inductively analyzed, resulting in 8 categories and 21 subcategories derived from 86 codes. Aspects affecting employment continuation comprised 'understanding and consideration from the workplace', 'flexibility of work format', 'treatment location and content', 'approach to work', 'awareness of disease stability', 'sense of financial burden ', 'support from family', and 'support from medical staff'. Understanding from company executives, superiors and colleagues affected desire to work, and the decision to undergo outpatient treatment facilitated the compatibility of everyday life and treatment. The cancer survivors reaffirmed their existence through the meaning provided by work, constructed coping methods unique to themselves and reconstructed a new lifestyle by switching to work that suited their physical condition while being aware of disease symptoms and adverse events associated with treatment. It was suggested that employment continuation in male cancer survivors was influenced by men's identity in Japan being strongly connected with their work ethic.