がんの再発・転移で化学療法を受けるがん患者と家族の気がかり

本研究の目的は，がんの再発・転移の告知を受け外来で化学療法を受けるがん患者とその家族がどのような気がかりを抱えているのかについて，患者と家族，双方の視点から明らかにすることである．外来で化学療法を受けているがん患者１０名とその家族１２名に半構成的面接を行い，質的帰納的に分析した．結果，がん患者の気がかりは【副作用によるさまざまな影響】【がん治療が難しくなっていく】【家族にかける負担の大きさ】【がんの再発・転移を抱える恐れ】【心身のつらさが家族に伝わらない】の5 カテゴリー，家族の気がかりは，【副作用に煩わされている患者のつらさの察知】【がん治療の先行きが見えない】【患者の闘病を支える責任の重さ】【患者の再発・転移による苦悩】【患者へのかかわり方がわからない】の５カテゴリーが抽出された．看護師は，がんの再発・転移を抱え療養しているがん患者と家族が多くの気がかりを抱え，それに対応しながら療養生活を送っていることを理解する．患者と家族の気持ちの根底には，がんという不確かな存在がありお互いの気持ちにずれが生じやすいことを踏まえ，患者や家族の価値観を尊重しながら，タイムリーに支援できるよう，診断早期から患者と家族の状況を把握していくことが大切である．

The objective of this study was to clarify the concerns of family members who were living at home with the patients who have been diagnosed with recurring or metastatic cancer, and are receiving outpatient chemotherapy. The study also examined ways of supporting patients who were diagnosed with cancer, and their families. Semi-structured interviews were performed with ten patients with cancer, and twelve family members who were receiving chemotherapy at the outpatient. These interviews were transcribed and analyzed using a qualitative descriptive study design. Findings of the study revealed that the concerns of patients with cancer can be categorized into five factors, namely : ［ Various side effects of treatments］, ［The burden of cancer treatment］ ［The magnitude of the burden on the family］ ［The mind and body are not transmitted to family］ ［Fear of having cancer recurrence or metastasis］. The family’s concerns can be classified into five categories, namely : ［ Patient suffering from side effects］ ［Invisible prognosis of cancer treatment］ ［Burden of responsibility to support the patient’s fight against the disease］ ［Suffering from cancer recurrence and metastasis］ ［Inability to relate to the patient］. However, nurses understand that cancer patients and their families who may have relapsed/metastasized cancer will have greater demands for care, and many family members will have more worries while living life.
Underlying the patient’s and family’s concerns are the uncertainty of illness caused by cancer and is likely to cause a divide. Between diagnosis and treatment concerns, early diagnosis was found to be consistent with existing treatment protocols promoting early diagnosis to have timely support, including respecting the patient and their family’s values. It is important to understand the situation of patients and their families.