がん患者の就労状況に関する文献検討

本研究の目的は，がん患者の就労に関する研究の動向とともに就労状況における特徴を明らかにし，医療職者の立場からがん患者の就労に対する支援体制の方向性を検討していくことである．文献は，医学中央雑誌Web 版（Ver．５）を用いて，「がん」and「就労」，「がん」and「就労支援」，「がん」and「仕事」をキーワードに原著論文に限定し文献検索を行った．がん患者を対象とした就労に関連する文献に限定し，小児がん患者・小児がん経験者を対象とした論文，医療職者が対象である論文，症例報告については除外し，２５論文を分析対象とした．がん患者の就労状況の実態，がん患者の就労継続を左右する要因について着目し整理した．結果，がん患者の就労状況の特徴として，がんの診断から治療開始前までの早い時期に離職する傾向にあった．がん患者の就労継続を左右する要因として，【身体調整】【情報獲得】【就労への価値】【支援体制】【職場の配慮】【経済状況】が明らかになった．医療職者は，社会の動向や施策，就労の場で行われている取り組みを理解し，患者の治療と就労の調整役として，就労継続を左右する要因である【身体調整】【情報獲得】【就労への価値】【支援体制】【職場の配慮】【経済状況】の６視点を持ち，離職が多い診断時から支援する介入プログラムを構築する必要性が示唆された．

The purpose of this study was to clarify the characteristics of the working situation derived from the findings of research studies on cancer patients, and to explore the possibilities of support systems towards employment of patients with cancer from the viewpoint of the health care staff.
The literature review used the Ichushi-Web（Ver .５）, limiting the search to only original papers using the following keywords : “cancer” and “working”, “cancer” and “working support”, “cancer” and “job”. Moreover, the review included dissertation studies and excluded papers focused on pediatric patients with cancer, papers designed for medical staff, and case reports.
From these inclusion and exclusion criteria, only ２５ research papers remained. These were all focused on the actual conditions of working situations of patients with cancer, and the factors affecting the continuation of working by the patients with cancer. An astounding finding was that actual status of employment for patients with cancer was dictated by the status of their cancer treatments. They tended to leave their employment early, often before cancer treatment began. Factors that were found crucial to the characteristics are［Physical adjustment］［Information acquisition］［Value for working］［Support system］ ［Consideration of workplace］［Economic situation］influencing the viewpoint for the continuation of work for patients with cancer. Health care professionals need to understand that the social trends and policies, including the activities being carried out at places of employment are important towards the coordination of treatment and further employment of the patient with cancer. It is suggested that it is necessary to construct an intervention program that supports many types of workers, but most especially those patients with cancer.