がんサバイバーと家族員のパートナーシップ—夫婦に焦点をあてて

Partnership between Cancer Survivors and Family Members: Focus on the couple

要旨

　本研究の目的は，がんサバイバーと家族員におけるパートナーシップとはどのようなものかを明らかにし，新たながんサバイバーと家族員の理解や両者を対象とした一体的な看護介入の示唆を得ることである．

　そこで，初回がん治療を終了したがんサバイバーと家族員のペア2名1組を研究参加者とし，半構成的面接法を用いてジョイント・インタビューを実施し，質的記述研究を行った．倫理的配慮として，所属施設の倫理審査委員会の承認を得て実施した．結果として，がんサバイバーと家族員のペア9組18名が研究に参加し，がんサバイバーと家族員のパートナーシップとして，2つの局面と7つのカテゴリーが導き出された．相互理解を深め対等な関係を再形成する局面では，【個人にしか分からない辛さを分かり合う】【気遣いすぎない】の2つのカテゴリー，がんと生きていくために協働する局面では，【迷っている時は背中を押す】【“大丈夫”という安心感で支え合う】【お互いに歩み寄りながら決める】【力を合わせて治療を乗り越える】【がんと付き合う力を醸成する】の5つのカテゴリーが明らかとなった．

　がんサバイバーと家族員は，個人にしか分からない辛さがあることをお互いが実感し，相手に対して自分がどう行為するかを試行錯誤しながら，気遣いすぎないという関係を基盤とし，がんと付き合う力を醸成するという新たな家族像の示唆を得ることができた．また，がんサバイバーと家族員のパートナーシップを促進するためには，2者間への介入を基盤にした看護援助が重要である．

　This study aimed to clarify what a “partnership” is between cancer survivors and their family members. This is qualitative descriptive study conducted on 18 participants consisting of 9 pairs, each a first-time cancer treatment survivor and a family member. Data were collected between August 2016 and July 2017 via semi-structured joint interviews between the cancer patient and the family member using an interview guide.

　We identified two aspects of the cancer survivor and family member partnership emerged. 1) Re-formation of mutual trust with a deepened understanding of the patient's involvement with cancer. 2) Working cooperatively to enable living with cancer. Seven core constituent elements of the partnership were identified: (1) A shared understanding of the suffering and trials which only the patient or family members can understand, (2) Not being overly concerned, (3) Providing an emotional boost during hard times, (4) Providing support through reassuring words like “It's going to be okay”, (5) Making decisions by meeting each other halfway, (6) Surviving treatment by emotionally uniting, (7) Fostering abilities to live and engage with cancer.

　The return to an equal relationship of trust via not being overly concerned forms the basis of a partnership between a cancer survivor and family member. To return to this trust, a mutual understanding of the cancer patient's “suffering and trials which only the individual can understand” is essential. We were able to obtain suggestions a new family image that cancer survivors and family members foster the ability to live and engage with cancer based on the relationship of not being overly concerned. We thought that dyadic intervention-based nursing assistance is needed to promote partnerships between cancer survivors and family members.