病む人の生と看護の視点 : 慢性呼吸不全患者と家族の語りから見えてくること
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概要
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People living at home with chronic respiratory failure must struggle to live in the face of various difficulties and distress. But their experience has not been investigated up to now. This study focuses on the experience of people living with this chronic respiratory failure. It is also an experiment in practical nursing research. Four patients and their families agreed to be participants. The patients are sufferers of chronic respiratory failure undergoing long term oxygen therapy at home. The methods used fieldwork at such places as outpatient departments, patient group activity situations and the patients' homes. Several formal and informal interviews were also conducted over a period of six months. Through fieldwork and interviews, I endeavored to come into contact with their actual sense and experience of life. I have described the findings under three headings : "Breathing and Moving", "Living with Suffering", and "Devising Life Strategies". First, I describe the experience of "Breathing and Moving". The participants actually feel that each and every breath supports their life. They must concentrate their consciousness to breathe in order to make each movement, and choose every movement carefully. For those people living with chronic respiratory failure, the simple act of breathing becomes the primary action supporting their life. They cannot entrust their lives to their body's automatic breathing, but must always be conscious of their breath. Second, I describe the experience of "Living with Suffering": The participants find hope and courage for themselves from contact with other patients' lives. When they observe something, they perceive a meaning in it to apply their life. They face the inevitability of life, and make new efforts to live themselves. Thus they maintain their will, and resolve "I want to do this" or "I don't want to become that". Lastly, I looked at the concept of "Devising Life Strategies": There are produced from their earnest desires. The patients devise the strategies themselves through a long groping process. The strategies may be called a technique for living. However, it is important to emphasize that they do not talk freely about the Strategies to medical workers. In conclusion, those living with chronic respiratory failure live in a world experienced through their body. Understanding of their subjective experience is produced through contact between the lives of patients and that of the researcher. The world of meaning and emotion world cannot be approached merely from an objective perspective.
- 日本医学哲学・倫理学会の論文
- 2002-11-10