がん体験者の適応を特徴づける認識の構造

The Structure of Cancer Survivors' Perception on Adaptation Process

要約

　本研究は，がんに対する入院治療を終了し，地域で社会生活をおくっているがん体験者が，自己をどのようにとらえ，またその認識をどのように扱っているのかを質的な研究手法を用いて明らかにし，がん体験者の適応を特徴づける認識の構造を帰納的に導き出したものである．

　データ収集にはインタビューと参加観察を用い，研究への同意の得られた成人がん体験者30人にインタビューを実施した．分析の結果，がん体験者の適応過程の進行をあらわす2つのテーマ：①自分自身の責任を果たそうとする意思，②自分がおかれた状況を引き受けようとする意思が導き出された．これらのテーマは，がんの体験に適応していくことに対する，がん体験者の主体性をあらわすカテゴリー：4領域と，その主体性を左右する要因としてのカテゴリー：2領域によって構成されていた．

　本研究結果には，がん体験者は自分と他者とを区別することを通して，自己に対する責任と自分自身の能力を認め，適応を可能にするような自己概念を形成することが示されていた．また，がん体験者が自己の個性を主張できるような関係を形成することの重要性が示唆された．

Abstract

　The purpose of this study was to examine cancer survivors' perception of their cancer experiences on adaptation process. Thirty adult cancer survivors were interviewed and examined through participant observation. They were residents of metropolitan areas in Japan who were discharged from hospitals more than five months ago. An inductive analysis was used to categorize their own words or behavior related to their experience during the adaptation process.

　From an analysis of the data, I withdrew two themes : ① assuming one's responsibility and ② accepting one's condition. Four domains that represent cancer survivors' intent to adapt to cancer experiences were found : ① kinds of responsibility that should be assumed, ② ways to assume responsibility, ③ characteristics of condition that should be accepted, ④ ways to accept conditions. Two cognitive domains through which they adapt to the cancer experience were found : ① awareness of limitations of their own capabilities ; and ② perception of a line between self and others. The cognitive domain was constructed by three categories expressed by ; "there are problems that only I can solve" ; "there are other problems that I cannot solve by myself" ; and "there are matters beyond my control". The latter domain was built around and expressed by : "one cannot solve other people' s problems" ; "I should not disturb the lines of others or burden them with my needs", "I want to keep some aspect of my condition private", and "I appreciate and think about my relationships".

　Cancer survivors establish a sound self concept by distinguishing self from others and realizing their own responsibility to self and their own mental capacity. So nurses should pay attention to how they keep their relationship and help them to represent their self hood.