Nursing care focusing on self-recovery in individuals undergoing cancer treatment during the downward phase of the illness trajectory

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  • がん治療を受けながら下降期を生きる人々の自己の回復に着目した援助
  • ガン チリョウ オ ウケ ナガラ カコウキ オ イキル ヒトビト ノ ジコ ノ カイフク ニ チャクモク シタ エンジョ

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[要旨]本研究の目的は，がん治療を受けながら下降期を生きる人々の自己の回復に着目した援助について明らかにすることである。病期分類III期～IV期の消化器がんに対するがん治療を受ける平均年齢69.2歳の５名の研究対象者に対しおこなった14～38日間の援助の経過記録をデータとし，質的統合法（KJ法）を用いて個別分析と全体分析をおこなった。全体分析の結果， がん治療を受けながら下降期を生きる人々の自己の回復に着目した援助は，【環境にゆるがされる現実を生きる対象の苦悩を推し量る】，【苦悩を軽減するために， 対象自らが関与することを推進する】，【苦難に対処しようとする 対象のありのままを見守る】，【ライフストーリーの中に対象の内なる意味を見出す】，【対象のパターンに応じた心地よさを通して，自らを癒す対象の力を引き出す】，【対象のありふれた日常に可能性を見出す】という６つのシンボルマークから成る全体像で示された。がん治療を受けながら下降期を生きる人々の自己の回復に着目した援助は，看護者が対象の苦悩を推し量ることを基盤にセルフケアを推進し，さらに，対象との心地よい豊かな関係性の中で，意味ある体験や社会的役割を踏まえた対象の在り方に関わる可能性を見出すことであると示唆された。

[SUMMARY] The aim of this study was to clarify nursing care focusing on self-recovery in individuals undergoing cancer treatment during the downward phase of the illness trajectory. The study population comprised five patients with an average age of 69.2 years undergoing treatment for stage III or IV digestive tract cancer. Data were collected from the patients’ nursing care records documented by the researcher who was also the primary nurse between 14 and 38 days. The qualitative synthesis method (KJ method) was used for analyzing the components of nursing care focusing on self-recovery within and across cases. These components comprise six characteristics : inferring one’s distress that one is struggling with the surrounding environment, promoting self-care to alleviate distress, affectionately watching over, finding true meaning of life, drawing out one’s power to heal oneself through comfort according to the pattern, and finding out possibility in one’s every day. Nursing care focusing on self-recovery in individuals undergoing cancer treatment during the downward phase of the illness trajectory was directed at promoting self-care, based on the fact that nurses identify patients’ difficulties. Furthermore, it was directed at finding the possibility of how to want to be as individuals that was related to meaningful experience and social roles by establishing a comfortable relationship with individuals.

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