再発・転移がんサバイバーの療養生活における調和のプロセス

Process of Harmony in the Lives of Recurrent and Metastatic Cancer Survivors during Recuperation

要旨

　目的：再発・転移がんサバイバーの療養生活における調和のプロセスを明らかにする．

　方法：研究参加者16名を対象に半構造化面接を行いM-GTAを用いて分析した．

　結果：調和のプロセスは，『ニュートラルな自分で生きる』を中核に据え，【変わりゆく状況に自己存在が揺らぐ】から【死を傍におき自分軸をもつ】【がんは自分の一部である】【自己の拡がりに気づく】自己認識の拡大プロセスで，【今あるものに意識を向ける】【安定した自分を確保する】方略との相互作用により支えられ促進されるものであった．『ニュートラルな自分で生きる』は，がんの再発や転移を繰り返すなかで生じる絶え間ない揺れに対峙する自己の在りようで，本プロセスの循環により強化されるものであった．

　結論：『ニュートラルな自分で生きる』を中核に据え，自己認識とコントロール感覚の回復・拡大の促しが，最良な健康を保つ療養生活の支えになることが示唆された．

　Purpose: The purpose of this study was to elucidate the process of harmony in the lives of recurrent and metastatic cancer survivors during recuperation.

　Methods: Semi-structured interviews were conducted on 16 participants, and the data were analyzed using the Modified Grounded Theory Approach (M-GTA).

　Results: The process of harmony in the lives of recurrent and metastatic cancer survivors during recuperation centered on "Living with a neutral self", in which there was an expansive process of self-awareness from [Wavering self-existence in changing circumstances] to [Putting death aside and remaining true to oneself], [Cancer is a part of me], and [Perceiving expansion of the self]. This was supported and facilitated by the interactions of strategies for [Directing one's attention to what one has at the moment] and [Maintaining a stable self]. "Living with a neutral self" is a state in which the individual maintains an unwavering self amid the constant changes that occur during the process of repeated rounds of recurrence and metastasis of cancer, and was strengthened by cycling through this process.

　Conclusion: These results suggest that promotion of the recovery and the expansion of self awareness and sense of control that centers on "Living with a neutral self" serve as support for survivors' recuperation in maintaining the best possible health.