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要約
本研究においては，がん患者の身体的心理・社会的状態を的確に把握し，検討することを目的に入院患者342名（がん患者251名，非がん患者91名）ならびに看護婦を対象に，質問紙調査法によって，患者の体験している心身状態および看護婦の患者認知についてアセスメントし，以下の結果を得た．
1．がん患者の心身状態は，非がん患者に比べ，心身状態測定項目の親和行動，依存行動．達成行動，摂取行動，回復行動，交流分析のAdultおよびQOLが，有意に高い得点平均値であり，がん患者の心身状態の特徴を示していた．
つまり，がん患者の特徴は，自らの生活の質の低さにもかかわらず，自分と周囲をコントロールして自己を律した状態に保ち，身近な人々との関係づくりを積極的に行い，他者を頼り，他者の援助を有効に活用し，回復への意欲を燃やしているというものであった．
2．痛みは，がん患者の心身状態項目を変化させるものである．
3．看護婦と患者の痛み評価にはくいちがいがある．
4．がん患者の病名認識は患者の心身状態に影響を及ぼす．この影響は，特に痛みの有無に関係して確認され，病名を正しく知っている患者では，痛みによる心身への影響は少ない．
5．入院生活上の不満，要求および，医療者との関係に生ずる問題は，患者の心身状態測定項目に反映する影響要因である．
6．がん患者の心身状態把握のための今後の課題は，入院生活の充実を患者自身が評価する項目の検討，痛みの適正な評価，病名・病状の告知，および心身状態測定項目の有効な活用である．
The purpose of this study is to clarify psychosomatic characteristics and issues concerning the assessment of psychosomatic state of cancer patients.
The subjects were 342 patients(251 cancer and 91 non cancer patients)and their nurses in 3 cancer and general hospitals in Japan. Questionnaire 1 include 39 items derived from Johnson Behavioral system Model and 66 items from 3 Psychological Tests, in order to measure the present psychosomatic state of patients. Questionnaire 2 used Visual Analogue Scale to measure patients' psychosomatic state from the view point of Quality of Life. Answers of these two Questionnarires were written by patients. Questionnaire 3 included patients' informations concerning their psychosomatic state and etc., and was written by nurses.
The following results were obtained.(1)There were siginificant differences between cancer patients and non cancer patients in terms of characteristics of the psychosomatic state.(2)There was a significant difference between degrees of perceived pain by patients and evaluation of patients' pain by nurses. The result indicated the difference in the nurses' evaluation of patients' pain.(3)There were different characteristics between cancer patients who knew their diagnosis and who were uncertain about their diagnosis. Patients' awareness of diagnosis affected the perception of pain. Knowledge about the diagnosis influenced psychosomatic state of cancer patients.(4)There was a difference between cancer patients who had complaints and disires about their hospitalization and who did not have them. Patients' satisfaction with hospitalization influenced patients' psychosomatic state.
(Accepted December 20, 1992)
Copyright © 1992, Japanese Society of Cancer Nursing All rights reserved.
