術後回復過程にある肺がん患者のHopeの体験

Hope-Related Experiences of Lung Cancer Patients During Postoperative Recovery

要　旨

　術後回復過程にある肺がん患者のHopeの体験が明らかになることは，初期治療段階における患者の心的エネルギーを維持・高める支援へとつながり，生命の質や長さにも影響する重要な援助の視点となることが期待できる．そこで本研究では，肺がん患者への対象理解を深め，身体的心理的回復に向けた支援の手がかりを得るために，術後回復過程にある肺がん患者のHopeの体験を記述することを目的とする．肺がん手術療法後の回復過程にある肺がん患者を対象とし，半構造化面接による質的記述的研究を行った．その結果，23名の研究参加者のHopeの体験として，【肺がんでも手術ができた】【手術をしてももとの生活ができる】【残された肺とともに生きる】【がんに負けず前向きに生きたい】【今ある症状はそのうち治る】【大切な存在に頑張りを示したい】【手放しで喜べない現実を生きる】の7つのカテゴリーが導き出された．肺がん患者にとって手術ができるということは，がんの治癒や自分の生への可能性が断たれることなく続いていくことと捉えられ，根治的治療としてのイメージが強い手術治療ができたという認識が，患者自身の生命の存続の可能性につながっていた．そして回復の実感と回復に向けた自助努力により患者のHopeに繋がっていることが示唆された．

　Understanding the hope-related experiences of lung cancer patients during postoperative recovery is expected to help support patients with maintaining enhancing their mental energy at the initial stage of treatment and to clarify valuable perspectives of support that influence quality of life.

　The present study aimed to promote a better understanding of lung cancer patients and to identify requirements for physical and psychological recovery by examining their hope-related experiences during postoperative recovery.

　A qualitative and descriptive study including a semi-structured interview was conducted three to six months after surgery involving lung cancer patients during postoperative recovery. The hope-related experiences of 23 patients during postoperative recovery were classified into the following seven categories: even if the patients had lung cancer, they were able to undergo surgery, the patients live with their remaining lung, the patients hope to overcome cancer and live positively, the patients can return to their old lifestyle even if operated on, current symptoms will be cured, the patients hope their loved ones recognize that they are trying their best, and the patients live in a reality where their joy is restrained. For cancer patients, being able to undergo surgery means a cure for cancer and the possibility of continuing to live. As “surgical” treatment is associated with definitive therapy for most patients, the fact that they were able to undergo it helped them recognize the possibility of continuing to live and recover, as well as motivated them to put forth the effort for self-help, which increased their sense of hope.