乳がん体験者が運動を生活に取り入れていくための運動行動パターン

The Process of Home-Based Exercise in Daily Life for Breast Cancer Survivors

要旨

　本研究の目的は，乳がん体験者が運動を生活の中に取り入れていくプロセスを明らかにすることである．外来通院中で運動をしていない乳がん体験者24名に対し，6カ月間の運動支援と運動の実施状況や運動を継続する認識について，半構成的面接を平均11.4回実施した．主たる支援は，乳がんの再発や副作用に対する運動の予防効果の情報提供，電話支援1回/週/2カ月，歩数計の配布，運動日記を用いた振り返りである．さらに，調査開始時に運動を継続している乳がん体験者15名には，運動の影響要素や運動継続の認識について半構成的面接を行った．面接内容は，逐語録を作成して質的帰納的に分析した．

　結果，乳がん体験者が運動を生活に取り入れていく意識と行動の変化には，「知識獲得後移行型」「自信獲得後移行型」「非移行型」の3つの運動行動パターンがあった．まず1つ目に，乳がんの再発や副作用に対する運動の予防効果の情報提供だけで運動を生活に取り入れ継続するという信念（以下，運動信念）に移行できる「知識獲得後移行型」，2つ目は徐々に自信を獲得し運動信念に移行できる「自信獲得後移行型」，3つ目は運動の予防効果を知っても再発の不安などで運動に思考が向かず，運動信念へ移行できない「非移行型」である．運動を継続するには乳がん体験者が生活の中で歩く方法を自ら見出し，運動を継続するという信念をもつことが重要であった．運動支援として，乳がん体験者が生活に取り入れる運動行動パターンに応じた個別的な支援をすることが重要である．

　The purpose of this study was to identify process of how breast cancer survivors undertake home-based exercise in daily life in Japan. This study was the prospective exploratory study for a 6 -month home-based walking program with 24 breast cancer survivors who have not exercised before. We instructed the breast cancer survivors to try to find their own way of home-based walking exercise in their daily life with 8 weekly phone calls, and providing a pedometer. Data was collected by semi-structured interviews. Furthermore, we conducted semistructured interviews about exercise with 15 breast cancer survivors who have exercised already. Data was analyzed by a quantitative inductive approach. As a result, three patterns of process were found in a home-based walking exercise. The first pattern was that breast cancer survivors easily found their own walking style in their daily life immediately learning the benefits of walking. The second pattern was that it took time to find their own confident walking style. The third pattern was that they could not find their walking style because of concerns about symptoms or anxiety of cancer recurrence, and other problems. The key was for paterns to find their own walking style with confidence and walking belief in a daily life. It is very important that nurses know the process how breast cancer survivors can find out their own walking style in their daily life.