ホスピス入院中の患者の配偶者が行う予期的悲嘆の特徴

Anticipatory Grief Characteristics Expressed by Spouses of Patients in Hospice

要　旨

　研究目的は，ホスピス入院中の患者の配偶者が行う予期的悲嘆の特徴を明らかにすることである．研究方法は，ホスピス入院中の末期癌患者の配偶者10名を対象に，半構成的面接によりデータ収集を行い，クラウンデッド・セオリー・アプローチを用いて，質的帰納的に継続比較分析を行った．その結果，Ⅰ．共に過ごした人生の清算をする，Ⅱ．今しかできないことを精一杯する，Ⅲ．伴侶の死後のことを考える，という3つのカテゴリーが抽出された．3カテゴリーは，プロセスとしてではなく同時に現れていた．しかしケースによってそれぞれ軽重の違いがあり，中心になるカテゴリーは異なっていた．カテゴリーの現れ方から，『伴侶の死に立ち向かう』というコアカテゴリーが得られた．これらのことを達成するために，ホスピス入院中の患者の配偶者に対する看護では，1．配偶者が愛憎共に強い感情が表出できる，2．できる限りのことをしたという達成感を持てる，3．伴侶の死後のことを考えることに罪悪感を持たないようにすることが重要である．さらに，4．課題達成が一気に行われるが，ケースによって中心となる課題は異なるのでそれに添った看護をすることが重要である，ということが示唆された．

Abstract

　The purpose of this study was to prove a characteristic of the anticipatory grief expressed by spouses of patients in the hospice, in terms of couple relationships. Grounded Theory Approach was chosen for this research design and analysis for the purpose of the qualitative and inductive analysis. Partners of ten patients who had been suffering from the terminal cancer in hospice were the subjects for this study. This study was performed using semistructured interviews.

　As the result, interview yielded three categories ; Ⅰ. Reflecting their lives they shared with, Ⅱ. Trying their best in everything they can do only then, Ⅲ. Considering their own lives after their partner's death. Three categories were expressed not as the process but simultaneously in each case, however, emphasis differed in each case. The core category of "facing their partner's death" was extracted from three categories. Thus, it was suggested that four points are important in nursing for partners of patients in the hospice ; 1. Partners can express a strong emotion like love and hatred, 2. They have a feeling of achievement that they had done everything they can, 3. They don't have a sense of guilt of considering their own lives after their partner's death, 4. Their performances of problems are done at a stretch, but main problems differ with each case, therefore, they must be cared in accordance with their case.