痛み治療を継続するために外来通院するがん患者が直面する困難と取り組み

Difficulties and Grappling of Cancer Outpatients with Continue Pain Treatment

和文抄録

　本研究の目的は、外来で痛み治療を受けているがん患者の困難と取り組みの状況を明らかにすることである。がんの痛みにより通院で痛み治療を受けている12名を対象に、面接調査法を用いてデータ収集し、質的帰納的に分析した。その結果、がん患者が直面する困難は、【痛み治療を一部担う困難】【がん治療を並行して受ける困難】【痛みの存在による活動の困難】【痛みの存在により家族関係が変化する困難】の4つが、取り組みは、『専門医を信頼し治療を任せる』『鎮痛薬使用の判断と副作用の調整を行う』『痛みの出現や増強を予防する』『必要なサポートを判断する』『気持ちを働かせる』『がん治療と痛み治療を上手く並行させる』『自分の状況を肯定的に受け止める』の7つが抽出された。困難への取り組みは、患者自身の体験や専門家から提供される知識をもとに行われていたが、痛み治療を効果的にし、がん治療を良好な状況で受け、自分らしい日常生活を送るために必要な取り組みであった。これらの取り組みを可能にしていたのは、信頼できる専門家と家族の存在であり、看護の役割としては、知識や援助ケアの提供に加え、同じ目標に向かうパートナーとして患者に寄り添える存在となることが重要だと考える。

　The aim of this study was to clarify difficulties and grappling of cancer outpatients toward pain management. We performed a qualitative and inductive analysis of data collected through interviews 12 outpatients experiencing cancer pain and undergoing pain treatment.

　As a result, the outpatients experiencing cancer pain were faced with difficulties, such as “shouldering part of their pain treatment”, “going cancer treatment and pain treatment at the same time”, “physical and mental exhaustion caused by cancer pain”. Grappling with difficulties of cancer outpatients were put together 7 final categories, such as “trust a medical specialist and entrust with their pain treatment”, “judge of use analgesics and adjustment of a side effect”, “prevent appearance and increase of pain”, “judgment necessary support for their”, “use own feelings”, “going better condition their cancer treatment and pain treatment at the same time”, “affirmative accept own situation”. They were grappling with difficulties base on their experience and knowledge provided by medical specialist. And their grappling with difficulties is necessary for undergoing pain treatment effectively and undergoing cancer treatment in better condition. There were important to achieving self-actualization for cancer outpatients. Cancer outpatients having cancer pain make possible by reliable medical specialists and their family.

　The results suggested that nurses were demand not only provide knowledge and care about cancer pain and treatment but also be partner going a goal with cancer outpatients. And nurses must improve communication skills and attitude consider cancer outpatient's pain.