食道がんのために食道切除術を受けた患者が抱える生活上の困難と対処に関する研究

本研究の目的は,食道がん切除術を受け,自宅で生活する患者が直面している生活上の困難及びそれらへの対処の実態を明らかにすることである｡対象は,研究参加へ同意が得られた12名の外来通院中の患者とした｡対象12名の食道再建経路は, 6名が胸壁前皮下経路,6名が後縦隔経路であった｡患者の許可を得て録音した面接内容を逐語訳し,内容分析の手法を用いて質的･帰納的分析を行った｡その結果,患者は術式に関係なく,【予想をはるかに超えて苦痛と化した摂食行動】および【生活圏の狭小化】の2つの困難を抱えていることが明らかとなった｡患者は,前者には≪生きるために自分に見合った食べ方を体得する≫ ことで,後者には,≪命と引き換えに変化を受け入れる≫≪時間をかけて変化に慣れる≫ ことで対処し,術後の生活を再構築していた。

The purpose of this study is to clarify the difficulties faced in daily life by patients who have undergone esophagectomy due to esophageal cancer and now reside at home, as well as the actual conditions how to cope with such difficulties. 12 patients gave their consent to participate in the study, and semi-structured interview was conducted using open-ended questions. 6 of them had undergone reconstruction of the esophagus via the subcutaneous route anterior to the thoracic wall, and the other 6 via the posterior mediastinal route. The contents of the recorded interviews were transcribed into verbatim record, and a qualitative, inductive analysis was conducted using the content analysis method. As a result, it was found that the patients were suffering from two difficulties: "that eating activities had become a far greater hardship than had been expected" and "the narrowing of social life". Patients experiencing the former difficulty dealt with it by "learning eating methods suited to them personally in order to survive" and patients experiencing the latter difficulty dealt with it by "accepting the change to save their life" or "becoming accustomed to the change slowly", and then restructure their postoperative lives.