看護師によるがんサバイバーの運動支援の現状と関連要因

Current Status of Exercise Support for Cancer Survivors by Nurses and Related Factors

要　旨

　本研究は，看護師によるがんサバイバーへの運動支援の現状とその関連要因を明らかにすることを目的とする．一般病院5施設の看護師を対象に無記名による自記式質問紙調査を実施し，463名から有効回答を得た（有効回答率71.2％）．質問項目は看護師の特性，看護師の運動効果の知識，看護師が捉える運動支援の阻害要因，看護師の運動支援のニーズである．運動支援との関連要因は2項ロジスティック回帰分析を行った．がんサバイバーへ運動支援を実施している者は193名（41.7％）であった．運動効果の知識が高い項目は，「QOL向上」329名（71.1％），「睡眠改善」310名（66.9％）であり，「倦怠感緩和」125名（27.0％）や「再発リスク軽減」129名（27.8％）は低かった．運動支援の関連要因は，看護師の特性である「性別」「がん患者のケアの割合」「運動習慣」，看護師の知識項目である「倦怠感緩和」「不安の軽減」，運動支援の阻害要因である「適応患者が分からない」「安全性が分からない」「継続期間が分からない」「患者の知識不足」「家族のニーズ」の10要因が抽出された．以上の結果より，看護師によるがんサバイバーへの運動支援は低く，運動支援には看護師の知識不足だけでなく，患者の知識不足や家族のニーズも関連していた．がんサバイバーへの運動支援を促進するためには，看護師と患者・家族への運動の予防効果の啓発が重要である．

　The purpose of this study was to clarify the current status of exercise support for cancer survivors by nurses and related factors. We conducted an anonymous questionnaire-based survey of nurses involved in oncology nursing at five general hospitals and obtained responses from 463 nurses (valid response rate, 98.5%). We included questions were regarding attributes and implementation status of providing exercise support, knowledge of prophylactic benefits of exercise and obstacles to and needs for providing exercise support. Factors related to exercise explored using logistic regression analysis. Exercise support for cancer survivors was provided by 193 nurses (41.7%). Among items regarding prophylactic benefits of exercise, most of the nurses were familiar improvements in quality of life (329 nurses, 71.1%) and sleep (310 nurses, 66.9%), while less were familiar with fatigue relief (125 nurses, 27.0%) and reduced recurrence risk (129 nurses, 27.8%). Ten factors related to exercise support were identified, including sex, percentage of cancer care, exercise habits, including anxiety reduction, safety of exercise, duration of exercise, patients' lack of knowledge, and family needs. These results showed that the implementation rate of exercise support for cancer survivors by nurses was low. The factors were nurses' lack of knowledge regarding prophylactic benefits of exercise, support methodology, patients' lack of knowledge and family needs. To promote exercise support for cancer survivors, it is important to disseminate knowledge regarding prophylactic benefits of exercise to nurses as well as to patients and their families.