小児がん経験者の心的外傷後成長（posttraumatic growth）の概念分析

Conceptual Analysis of Posttraumatic Growth in Childhood Cancer Survivor

要旨

　目的：小児がん経験者の心的外傷後成長（posttraumatic growth：以下PTG）の概念の定義と特徴を明らかにする．

　方法：Rodgersの概念分析手法を用いて48件の文献を分析した．

　結果：属性は【日常を取り戻す】【病気体験と自分の存在意義の反芻】【他者との関係性の進展】【自信の回復から前向きな対処への変化】【人間としての強さを認識】【病気体験の肯定的意味づけによる自己意識の変容と人生の目的の再設定】の6カテゴリ，先行要件は5カテゴリ，帰結は4カテゴリが特定された．

　結論：小児がん経験者のPTGは「日常を取り戻していく中で心身の傷つきをもたらした病気体験を反芻しながら，人間関係の進展や前向きな対処方法への変化，人間としての強さを自覚し，次に病気体験の肯定的意味づけによって人生の目的を再設定していくプロセスであり，人生を乗り越えていく力を身につけることである．」と定義した．

　Objective: This study aimed to clarify the definition and characteristics of posttraumatic growth (PTG) in childhood cancer survivor.

　Method: We analyzed 48 articles using Rodgers' conceptual analysis.

　Results: Six categories of attributes were identified; [recovery of daily life], [rumination about illness experience and meaning in life], [development of social relationships], [change from regaining self-confidence to positive coping], [realization of strengths as an individual], and [change in self-awareness and review of future plans because of the positive meaning of the illness experience]. Five antecedent and four consequence categories were identified.

　Conclusion: PTG in childhood cancer survivor was defined as "a process in which, the child can ruminate on the illness experience that causes physical and mental pain while regaining one's daily life, progress in relationships, changes in coping, and awareness of strengths as an individual. This leads to a change in self-awareness and a reassessment of future purpose through finding positive meaning in the illness experience, ultimately helping the child to gain strength to face future challenges."