ホスピス・緩和ケアについての相談支援と情報提供に関する研究—末期がん患者と家族の意識

Consultation Service at Hospice Clinic and Information Given at Referrals on Hospice and Palliative Care: The Attitude among Terminally III Patients with Cancer and Family Members

要旨

　本研究の目的は，ホスピス相談外来を初回受診した末期がん患者と家族の実態とホスピス・緩和ケアについての情報提供に関する実態を明らかにすることである．調査対象者に対して調査票を用いた面接法ならびに調査票を配布し，郵送による回収を行った．対象者は有効回答が得られた患者13名（86.7％）と家族53名（91.4％）である．相談対象である患者には苦痛症状が多く出現しており，特に，家族が受診している場合には，患者の病状は進行している傾向にあった．また，外来を受診する患者と家族は痛みの出現の不安に加え，入院やその時期，相談場所の確保，緊急時の対応への不安や心配を高く示していた．さらに，患者と家族へのホスピス・緩和ケアについての情報提供は医療従事者が行っており，情報提供の時期は，患者と家族にとって遅い傾向にあることが示された．末期ケアにおける相談支援の必要性および治療効果の判定以前の早期から，患者の症状に合わせた情報提供の必要性が示唆された．

Abstract

　The purpose of this study was to determine both the attitudes among terminally ill patients with cancer and family members at the hospice clinic and the information on the hospice and palliative care given to the patients and family members. The data was collected by interviews using a questionnaire or distribution of questionnaires to be returned by mail after completion.

　Thirteen(86.7%) patients and 53(91.4%) family members returned completed responses. Patients who needed to consult the hospice clinic had many symptoms of distress, and patients tended to show progressive symptoms when family members visited the clinic without the patients. In addition to anxiety concerning pain, anxiety and worry concerning timing of admission to the hospice or palliative care unit, receiving consultation and measures taken in emergencies were also high.

　Medical staff provided cancer patients and family members with information on the hospice and palliative care, but it was suggested that it was too late for them to obtain such information.

　This study concluded that it is necessary for terminally ill patients with cancer and family members to receive consultation, and medical staff must provide information on the hospice and palliative care at an early stage before evaluation of the results of treatment.