舌がんとともに生きる体験

Experiences of Living with Tongue Cancer

要旨

　研究目的は，患者が舌がんと診断されて手術を受け，その後現在に至るまでのことをどのような体験として意味づけているのかを明らかにし，患者理解を深め，今後の看護の示唆を得ることである．研究デザインは，現象学を基盤とする質的記述的研究であり，データ収集は7名の参加者に非構造化面接法を用いて行った．分析は現象学的方法にもとづいて行った．

　分析の結果，10個の意味単位から【診断まではがん患者にしてもらえることに苦労し，手術後はもう患者なのに自分でがんから守ると決意しなければならない】【舌がん患者であることを，ことさらに気づかされる場面が日常にある】【“舌足らず”の発語が，人との関係を窮屈にさせている】【医師が治そうとしてくれた身体と命の期待に，今は自分も応えようとしている】の4つのテーマが導き出された．それは，舌の痛みを自覚した時から始まる舌がん患者になるための思いや行動，舌を喪失したことによる戸惑い，そしてそれでもなお，社会に適応していこうとする現在も含んだ舌がん患者としての生活のいとなみであった．

　看護師は患者の置かれている状況を理解し，がんサバイバーとして認め生きることへの支援，新たな食事方法を獲得するための支援，人との関係をはじめとする社会生活への支援を行っていくことの重要性が示唆された．

　The purpose of this study is to clarify how patients with tongue cancer attach meaning to their experiences up through the present after diagnosis and surgery through to the present, and to deepen medical professionals' understanding of patients, as well as to derive suggestions for future nursing practice.

　The study's design was a qualitative and descriptive study based on phenomenology: unstructured interviews were conducted with seven participants to collect data, which were analyzed based on a phenomenological method.

　As a result of the analysis, four themes were derived from ten meaning units: the difficulty of receiving recognition as a cancer patient before diagnosis, and the need for postoperative determination to protect themselves from the cancer despite already being a patient; regularly experiencing occasions that particularly remind the patient that they have tongue cancer; feeling awkward around other people due to impaired articulation caused by partial or complete removal of the tongue; and starting to try to meet the expectations of the doctor who has worked to cure the disease and to save their life.

　These themes represent the patients' feelings and behaviors as they develop and are diagnosed with tongue cancer, beginning with pain in the tongue, their embarrassment at losing their tongue, and their daily lives as tongue cancer patients, trying to adapt socially despite difficulties.

　The results suggested the importance of nurses understanding the patients' situations, and the need to assist them in living with acceptance of their status as cancer survivors, becoming accustomed to their new eating methods, and living in society in a way that involves relationships with others.