手術を受けた肺がん患者の身体経験—手術後早期に焦点を当てて

Early Post-Operative Bodily Experience in Lung Cancer Patients

要旨

　肺がん手術後は，疼痛の残存や肺機能障害により日常生活が制限され，無力感を抱きやすい．本研究は手術を受けた肺がん患者の手術後早期における身体経験を理解し，看護援助への示唆を得ることを目的とする．

　研究デザインは解釈学的現象学の手法を用いた質的記述的研究である．肺がんの診断で肺切除術を受けた手術後8週間以内の17名の患者に面接を行い，データを得た．分析は，Cohenら^1）の方法を参考にして行った．

　手術を受けた肺がん患者の身体経験は，【普段とは違う脆弱な身体に気づく】【行動による感覚から身体の回復をつかむ】【残された肺で挑戦できる身体を取り戻していく】【周りから力を得る身体を認識する】の4つのテーマから理解された．患者は，手術後の細かな変化を普段との違いとして捉え，身体の脆弱性を認識し，生活世界の中で身体の位置づけを考え直す．自分なりに身体の回復を確かめ，残された肺で挑戦できる身体を取り戻そうと努力し，新たな価値や自信を得る．また，周りからの支援を受けとり，信頼や気づかいの感覚を得ていく．脆弱な身体を認識するときや，回復に向けて一歩を踏み出すときに，必要なタイミングで他者からの支援を受けとることで，患者は未来に向かって挑戦できる身体を取り戻していく力を得る．

　The objective of this study was to understand the bodily experiences of patients who have undergone surgery for lung cancer and provide suggestions for nursing support. We conducted qualitative research employing hermeneutic phenomenology methods. Data was obtained from in-depth interviews with 17 patients who had undergone surgery for lung cancer within eight weeks. The data was analyzed with reference to the hermeneutic phenomenological method proposed by Cohen et al^1）.

　Four themes related to bodily experiences of patients who have undergone surgery for lung cancer emerged. They were “Awareness of bodily vulnerability which differed to their usual condition”; “Understanding bodily recovery through action-related sensations”; “Regaining bodily strength with remaining lungs”; “Recognition of bodily strength gain from others”.

　The patients, who realized that they were physically vulnerable when noticing differences from their usual selves, analyzed their bodies differently than usual by checking for signs of physical recovery in their own subjective ways. They seemed to obtain new values and confidence while making an effort to regain their bodily strength, which could cause stress on the remaining lung. And when recognizing their vulnerability, when striving towards physical recovery, and receiving support from others at the appropriate timing, the patients would regain the will to challenge their bodies to enhance their futures.