外来化学療法を受ける初発乳がん患者の就労上の困難と対処

How to Support Primary Breast Cancer Patients Undergoing Outpatient Chemotherapy Who Have Difficulty Working

要旨

　本研究の目的は，外来化学療法を受けている初発乳がん患者の就労上の困難と対処を明らかにすることである．就労しながら外来化学療法を受けている初発乳がん患者8名に半構成的面接を行い，質的帰納的に分析した．

　就労上の困難として【化学療法による副作用症状は仕事に支障を来たす】【治療中は全力で仕事に打ち込めない】【化学療法による副作用は女性としての外見に影響する】など8カテゴリー，その対処として【仕事が万全にできるように自己管理する】【女性としての外見が変わらないように工夫する】【仕事をよりどころとして前向きに生きる】【重要他者を心の支えにする】など7カテゴリーが抽出された．仕事は前向きに生きるよりどころとなっていたが，副作用症状は仕事や家事に支障を来たしていた．中でも脱毛により女性として外見が変化していくことは心理面だけでなく社会的にも影響を及ぼしていた．また，がんや副作用を抱え仕事を継続している同病者はモデル的存在となっており，交流を通してレジリエンスを獲得していた．化学療法を受けながら就労する上でアピアランスケアやピアサポートの必要性が示唆された．

　This purpose of this study was to clarify the difficulties primary breast cancer patients undergoing outpatient chemotherapy who have difficulty working. We had a semi-structured interview with 8 employed primary breast cancer patients who are undergoing outpatient chemotherapy, and then analyzed the obtained data in a qualitative and inductive manner.

　The following 8 categories were deduced; “The side effect symptoms from the chemotherapy hinder my work”, “I can't fully focus on my work during the treatment”, and “The side effect symptoms from the chemotherapy affect women's appearance” were the difficulties regarding employment, and “I control myself so as to fully focus on my work”, “I try to maintain my womanly appearance.”, “I live proactively, feeling my work is a base of support”, “I regard people important to me as emotional support” were the approaches to the difficulties. Work is the patients' support system while the side effect symptoms significantly hinder their work and household chores. Especially, the appearance change caused by epilation affects the patients psychologically as well as socially. Additionally, the patients who are continuing working suffering from the same cancer and/or side effects are regarded as models, and resilience is acquired through interactions. It was suggested that appearance care and peer support are necessary for those working while undergoing chemotherapy.