消化器系手術を受けたがん患者が術後早期に回復を実感する要因

Factors Contributing to the Early Perception of Recovery after Digestive System Surgery in Cancer Patients

概要

　本研究は、消化器系手術を受けた患者が術後早期に回復を実感する時期とその要因を明らかにすることを目的に面接調査を行った。対象者の条件は、近畿圏内のＡ病院に入院している患者で、術後にカテーテル類が全て抜去され、術後合併症がないがん患者とした。対象者は10名（男性7名、女性3名）、平均年齢は75.3歳であった。回復を実感する要因は多い順に、①痛みの消失、②動ける、③食事、④医師の話であり、特に男性患者は医師の話から回復を感じる傾向にあった。回復を実感する時期は平均4.8日、ドレーンの有無は必ずしも影響していなかった。回復を実感した時の気持ちは多い順に、①すっきり、②吹っ切れる、③明るい、④晴れやか・喜ばしいであった。術後患者が回復を実感する要因は、痛みや体に挿入されている管から解放されて動けることが最も重要であり、回復を実感する時期は要因と関係が深かった。また男性患者は、医師に対する信頼感が強く、医師の説明内容で回復の実感が左右される傾向にあった。退院促進への看護援助は、患者が回復を実感し、明るい気分になっている時期に行うことが効果的であり、患者個人の実感を重視した患者理解が重要と考える。

　An interview-based study was conducted to clarify the period when patients perceive recovery in the early stages after gastrointestinal surgery, as well as factors associated with it. Ten (7 males and 3 females) patients with a mean age of 75.3 were involved based on the following inclusion criteria: inpatients of a hospital in the Kinki area; cancer patients with all catheters removed after surgery; and those without postoperative complications. The patients perceived the recovery of their conditions the most frequently when: 1) pain disappeared, followed by: 2) when mobility was restored, 3) diet improved, and 4) so stated by the doctor, in this order. The tendency to perceive recovery based on the doctor's statements was particularly marked among males. The mean number of days needed to perceive recovery after surgery was 4.8. The presence/absence of a drain did not necessarily influence this period. The most frequent feeling when perceiving recovery was: 1) relieved, followed by: 2) refreshed, 3) light-hearted, and 4) cheerful/delightful, in this order. The restoration of mobility by reducing pain or removing catheters inserted into the body was the most important factor for the patients to perceive recovery, and the period of such perception was closely associated with this. Placing much confidence in doctors, male patients tended to perceive recovery, depending on the contents of their explanations. Based on the results, it may be effective to provide patients with nursing support as part of discharge promotion when they perceive the recovery of their conditions, and feel light-hearted. At this point, promoting the understanding of individual patients, while attaching importance to their perception, may be important.