A family's positioning and background of the patients who are suffering from hepatic cancer resulting from hepatitis C : resulting from hepatitis C
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概要
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This study was carried out for the purpose of clarifying the existence and meaning of the family in the experience of patients suffering from hepatic cancer resulting from hepatitis C who are aware of their approaching death. A qualitative analysis was conducted on 21 patients and 9 families taking care of patients. Results revealed that while the patients with hepatic cancer resulting from hepatitis C are receiving dedicated treatment from the specialists with the most advanced medical information and skills and are encouraged by other patients with the same illness and fate, which works to relieve anxiety about the disease, they do not want to discuss it with their families and have a strong desire to live out the remainder of their lives as normal people would. In addition, because they tend to hold out hope for the chance of an extension of their life expectancy through treatment, they continue to put off saying farewell to their families. Therefore, patients families are excluded from involvement with the patients illness until they have reached the terminal phase. The patients families respect their wish to avoid discussing the illness to prevent a feeling of regret after death and leave everything related to treatment to the doctors. However, in the terminal phase, they feel anxious about not being able to find the best option for the patient, conflicted between respecting the patient s desire to live longer and avoiding pain from the realization that the patient cannot be cured. This study suggested the importance of medical staff involving the family in the illness before the terminal phase to prepare to part from their families. 本研究は、死を意識するＣ型肝炎由来肝癌患者の病の体験における家族の存在とその意味を明らかにすることを研究目的とした。患者２１名と患者を持つ家族９名を対象に質的分析を行った。Ｃ型肝炎由来肝癌患者は、自分の死を先延ばすために最新の医療情報と特別な治療技術を持つ専門医による熱心な治療を受け、自分と同じ病の運命を持つ同病者によって一人で病気を背負う辛さを支えられている一方、家族には自分の病に関わることを求めず、残された時間を普通の人としての自分と共に生きることを強く望んでいることが表された。また、終末期に至っても、患者は特別な医師の治療によるわずかな延命を期待し、今すぐは死なないだろうと思うことができるため、家族への別れを先送りしていることが表された。そのため、家族は終末期まで患者の闘病においては蚊帳の外になっていた。家族は死別後に後悔しないように患者の思いに沿い治療を医師に任せるが、終末期になり、生き延びたい患者の思いと、治らないのに患者に痛い思いをさせたくないという自分の思いに挟まれて、よりよい治療法の選択ができず、思い悩んでいた。したがって、患者が家族との死別に向かう準備のためには、終末期より前に、医療者が家族を治療に巻き込むケアが必要であることが示唆された。
- 2010-07-30
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