若年女性生殖器がん術後患者の他者との関係における体験
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概要
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本研究の目的は,術後1年未満の若年女性生殖器がん患者が,他者との関係においてどのような体験をしているかを明らかにすることである。半構成的面接調査法と参加観察法を用いて,子宮がんまたは卵巣がんで手術を受けた20～30歳代の患者9名からデータを収集し,質的帰納的分析を行った。その結果,他者との関係における体験は,夫や親の心を推し量り子どもを産めなくなった自分を責める,手術後の自分に対する周囲の人々の過剰な気遣いに気疲れする,手術後の心身の変化に伴い性生活の再開に苦悩する,パートナーの心変わりで心に傷を負う,子宮や卵巣がない自分を蔑む偏見を知覚する,煩わしさを避けるために子宮がんや卵巣がんを隠して人との関わりを保つ,自分と同じがん患者の死を人事と思えず恐怖に襲われる,パートナーの愛情を受け彼らの存在はかけがえのないものであると実感する,将来を見据えつつ家族との絆を深める,がんの体験を通して人を助ける意義を見出す,など18に集約された。これらの体験から,若年女性生殖器がん術後患者が,他者との関係における困難を乗り越えることを支える看護援助は,1)子宮・卵巣の喪失や妊孕性喪失の受容を促し,自己像の再確立を支える,2)性生活を無理なく維持できるようにする,3)パートナーや家族そして社会とのつながりを調整し,困難を乗り越える心の基盤を作る,4)患者の社会復帰を支える,が導かれると考えられる。The purposes of this study were to clarify the experiences of younger patients following gynecological cancer surgery in their relationships with others during their first postoperative year. Subjects were 9 patients in their 20s and 30s who had undergone surgery for gynecological cancer. Dates were collected through semi-structured interviews and participant observation. As a result of qualitative inductive analysis, the experiences of younger patients were categorized into 18 experiences, including "guessing their husbands' and parents' expectations of children and blaming ourselves for not being able to give birth to children", "mental fatigue from the excessive shows of concern after surgery by family and friends", "concern about restarting their sex lives", "anguish of realizing that their partners had lost interest in them sexually", "sensing that others were biased against us as women without a uterus or ovaries", "hiding the fact that they had uterine or ovarian cancer in their relationships with others", "being overcome by fear following the deaths of patients with the same kind of cancer", "realizing that existence of partners was irreplaceable through affections of them", "strengthened bonds with family while looking toward the future", "finding meaning in their lives by helping others", Nursing care for younger gynecological cancer patients to support to get over the difficulty in their relationships with others were considered to be the following: 1) encourage patients to accept the loss of their uterus or ovaries and loss of fertility and support patients in reestablishing their self-image, 2) help patients to maintain a natural sex life; 3) coordinate ties between the patients and their partners, family or society to bring out the strength to get over the distress ; and 4) help patients to return to social life.
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