The Process of Living with Psychological Suffering in Patients with Postoperative Pancreatic Cancer
The objective of this study was to clarify the process of living with psychological suffering in patients with postoperative pancreatic cancer. The semi-structured interviews were conducted with 17 patients and the obtained data was analyzed using the modified grounded theory approach. The outcome s...
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| Published in | Journal of Japanese Society of Cancer Nursing Vol. 35; p. 35_102_yasuda |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japanese Society of Cancer Nursing
12.04.2021
一般社団法人 日本がん看護学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0914-6423 2189-7565 |
| DOI | 10.18906/jjscn.35_102_yasuda |
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| Abstract | The objective of this study was to clarify the process of living with psychological suffering in patients with postoperative pancreatic cancer. The semi-structured interviews were conducted with 17 patients and the obtained data was analyzed using the modified grounded theory approach. The outcome showed that the subjects were upset at the time of diagnosis, wondering if “my life is over or it is too late”, however they thought “I have no choice but to risk my life with surgery”, and underwent surgery. After surgery they realized『I can live more』, whereas they suffered from both surgery and adjuvant chemotherapy, expressing <my body hurts and I hate my appearance>. Although they said, none was effective and they were scared of <dying hopelessly>.During this time, their emotions were torn between life and death and they suffer, wondering if . This process indicates the state of 【being at the mercy of uncertainty over life and death】. As they actually felt <getting better and being able to eat> over time, they shifted to 『look for a way to escape the suffering on their own』, saying . When realizing and 『I have someone to support me』, they felt.In this way, 【regaining a sense of self-control】 helped them determine to. This study suggests that we should support the patients to relieve physical and psychological pain and to have them feel “getting better at eating”. |
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| AbstractList | The objective of this study was to clarify the process of living with psychological suffering in patients with postoperative pancreatic cancer. The semi-structured interviews were conducted with 17 patients and the obtained data was analyzed using the modified grounded theory approach. The outcome showed that the subjects were upset at the time of diagnosis, wondering if “my life is over or it is too late”, however they thought “I have no choice but to risk my life with surgery”, and underwent surgery. After surgery they realized『I can live more』, whereas they suffered from both surgery and adjuvant chemotherapy, expressing <my body hurts and I hate my appearance>. Although they said, none was effective and they were scared of <dying hopelessly>.During this time, their emotions were torn between life and death and they suffer, wondering if . This process indicates the state of 【being at the mercy of uncertainty over life and death】. As they actually felt <getting better and being able to eat> over time, they shifted to 『look for a way to escape the suffering on their own』, saying . When realizing and 『I have someone to support me』, they felt.In this way, 【regaining a sense of self-control】 helped them determine to. This study suggests that we should support the patients to relieve physical and psychological pain and to have them feel “getting better at eating”. The objective of this study was to clarify the process of living with psychological suffering in patients with postoperative pancreatic cancer. The semi-structured interviews were conducted with 17 patients and the obtained data was analyzed using the modified grounded theory approach. The outcome showed that the subjects were upset at the time of diagnosis, wondering if “my life is over or it is too late”, however they thought “I have no choice but to risk my life with surgery”, and underwent surgery. After surgery they realized『I can live more』, whereas they suffered from both surgery and adjuvant chemotherapy, expressing <my body hurts and I hate my appearance>. Although they said, none was effective and they were scared of <dying hopelessly>.During this time, their emotions were torn between life and death and they suffer, wondering if . This process indicates the state of 【being at the mercy of uncertainty over life and death】. As they actually felt <getting better and being able to eat> over time, they shifted to 『look for a way to escape the suffering on their own』, saying . When realizing and 『I have someone to support me』, they felt.In this way, 【regaining a sense of self-control】 helped them determine to. This study suggests that we should support the patients to relieve physical and psychological pain and to have them feel “getting better at eating”. 本研究の目的は，術後膵臓がん患者が苦悩をかかえながら生きるプロセスを明らかにすることである．17名の患者に半構成面接を行い，得られたデータを修正版グラウンデッド・セオリー・アプロ―チに基づき分析した．その結果，対象者は膵臓がん告知後に，〈もう人生終わりなのか，手遅れなのか〉と動揺したが，『手術に命を懸けるしかない』と手術を受けた．術後『これからも生きられる』と実感した一方で，手術と術後補助化学療法によって〈からだも辛いし，見た目もいやだ〉と苦しんだ．〈よくなるために，自分ができることをとにかく試し〉たが効果が得られず，〈このまま死んでしまうのか〉と死に脅えた．この時，感情が生と死の狭間で行き来し，〈生きられるのか，それともやっぱり死んでしまうのか〉と悩み苦しんだ．このプロセスが【生と死の不確実性に翻弄される】を示す．時間の経過とともに〈食べられるようになってきた〉実感をすると〈死にたくない，まだやりたいことがある〉と，『自分の力で苦しみから逃れる方法を探し』た．〈普通に生活できている〉ことと，『生きることを支えてくれる人が身近にいる』ことを実感し，〈大丈夫，まだ生きられそうだ〉と感じた．このように【自己コントロール感覚を取り戻す】ことで〈生と死が不確実な時間を精一杯生きる〉と決意していた．看護支援では，身体的精神的苦痛を緩和し，“食べられるようになってきた”実感を促進することが重要である． |
| Author | Hutawatari, Tamae Horikoshi, Masataka Yasuda, Hiroko |
| Author_FL | 堀越 政孝 二渡 玉江 安田 弘子 |
| Author_FL_xml | – sequence: 1 fullname: 安田 弘子 – sequence: 2 fullname: 二渡 玉江 – sequence: 3 fullname: 堀越 政孝 |
| Author_xml | – sequence: 1 fullname: Hutawatari, Tamae organization: Graduate School of Health Sciences, Gunma University – sequence: 1 fullname: Horikoshi, Masataka organization: School of Nursing, Faculty of Health Sciences, Gunma Paz University – sequence: 1 fullname: Yasuda, Hiroko organization: School of Nursing, Faculty of Health Sciences, Gunma Paz University |
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| DocumentTitleAlternate | 術後膵臓がん患者が苦悩をかかえながら生きるプロセス |
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| Publisher_xml | – name: Japanese Society of Cancer Nursing – name: 一般社団法人 日本がん看護学会 |
| References | 11) 日本膵臓学会 膵臓診療ガイドライン改訂委員会編．膵癌診療ガイドライン2016年版．東京，金原出版，2016, 141 2) 前掲1) ，90 23) 今泉郷子，稲吉光子．「がんサバイバーのコントロール感覚」の概念の特性．日本がん看護学会誌．23 (1), 82—91 (2009 24) 大泉千賀子，佐藤冨美子，佐藤菜保子．治療期膵がん患者の家族が認知する患者の症状・療養支援状況および患者の治療状況と家族のQOLとの関連．日本がん看護学会誌．32，40—50 (2018 1) 財団法人がん研究振興財団．がんの統計’18 資料編．東京，財団法人がん研究振興財団，2018，90 12) 厚生労働省．がん対策推進基本計画 (第3期) 〈平成30年3月〉．厚生労働省2018年． https://www.mhlw.go.jp/file/06-Seisakujouhou-10900000-Kenkoukyoku/0000196975.pdf (参照2020—03—02 5) 前掲1) ，27 4) 前掲1) ，40 6) 吉田みつ子．難治性のがんを生き抜く—膵がん患者の語り—．日本がん看護学会誌．28 (2), 15—21 (2014 20) Morse JM, Penrod J. Linking concepts of enduring, uncertainty, suffering, and hope. Journal of Nursing Scholarship. 31 (2), Second Quarter, 145—150 (1999 19) 木下康仁．ライブ講義M−GTA 実践的質的研究法—修正版グラウンテッド・セオリー・アプローチのすべて．東京，弘文堂，2007 21) 石部愛美，小林久子．消化器系手術を受けたがん患者が術後早期に回復を実感する要因．日本看護医療学会雑誌．19 (1), 37—43 (2017 22) 時山麻美，牧野智恵．ピアサポートを受けたがん患者の体験．石川看護雑誌．14, 35—45 (2017 7) 佐川まさの，勝部隆男，村山実，他．消化器癌手術における周術期栄養管理—栄養スクリーニングの指標を中心にー．日本外科系連合学会誌．37 (4), 760—764 (2012 16) 雲かおり，太湯好子．肝臓がん患者の苦難の体験とその意味づけに関する研究．川崎医療福祉学会誌．12 (1), 91—101 (2002 17) 山田隆子，名越恵美，藤野文代．肝細胞がん患者のがん治療開始時からターミナル期までにおける疾病受容体験と看護支援．日本がん看護学会誌．22 (2), 41—46 (2008 25) 佐藤泰子．苦しみと緩和の臨床人間学—聴くこと，語ることの本当の意味—．京都，晃洋書房，2011, 14 14) 金子眞理子，眞嶋朋子，小泉晋一，他．Suffering調査票の開発．日本看護科学会誌．26 (3), 3—12 (2006 15) 瀬山留加，吉田久美子，神田清子．語りにみる進行がん患者の社会的側面の変化と苦痛．群馬保健学紀要．26, 61—70 (2005 3) 前掲1) ，23 10) Clark KL, Loscalzo M, Trask PC, et al. Psychological distress in patients with pancreatic cancer — an understudied group. Psycho-Oncology. 19 (12), 1313—1320 (2010 13) Rogers BL, Cowles KV. A conceptual foundation for human suffering in nursing care and research. Journal of Advanced Nursing．25 (5), 1048—1053 (1997 8) 今泉俊秀．膵頭十二指腸切除術・術後合併症とその対策．日本消化器外科学会雑誌．29 (1), 127—131 (1996 18) 黒田寿美恵，佐藤禮子．終末期がん患者の選択する生き方とその本質．県立広島大学保健福祉学部誌．8 (1) ，89—100 (2008 9) 坂尾雅子，永川宅和，真田弘美．膵切除術後長期生存例の栄養状態と看護介入．金沢大学つるま保健学会誌．26 (1), 65—73 (2002 |
| References_xml | – reference: 11) 日本膵臓学会 膵臓診療ガイドライン改訂委員会編．膵癌診療ガイドライン2016年版．東京，金原出版，2016, 141 – reference: 16) 雲かおり，太湯好子．肝臓がん患者の苦難の体験とその意味づけに関する研究．川崎医療福祉学会誌．12 (1), 91—101 (2002) – reference: 21) 石部愛美，小林久子．消化器系手術を受けたがん患者が術後早期に回復を実感する要因．日本看護医療学会雑誌．19 (1), 37—43 (2017) – reference: 24) 大泉千賀子，佐藤冨美子，佐藤菜保子．治療期膵がん患者の家族が認知する患者の症状・療養支援状況および患者の治療状況と家族のQOLとの関連．日本がん看護学会誌．32，40—50 (2018) – reference: 10) Clark KL, Loscalzo M, Trask PC, et al. Psychological distress in patients with pancreatic cancer — an understudied group. Psycho-Oncology. 19 (12), 1313—1320 (2010) – reference: 15) 瀬山留加，吉田久美子，神田清子．語りにみる進行がん患者の社会的側面の変化と苦痛．群馬保健学紀要．26, 61—70 (2005) – reference: 2) 前掲1) ，90 – reference: 7) 佐川まさの，勝部隆男，村山実，他．消化器癌手術における周術期栄養管理—栄養スクリーニングの指標を中心にー．日本外科系連合学会誌．37 (4), 760—764 (2012) – reference: 5) 前掲1) ，27 – reference: 20) Morse JM, Penrod J. Linking concepts of enduring, uncertainty, suffering, and hope. Journal of Nursing Scholarship. 31 (2), Second Quarter, 145—150 (1999) – reference: 18) 黒田寿美恵，佐藤禮子．終末期がん患者の選択する生き方とその本質．県立広島大学保健福祉学部誌．8 (1) ，89—100 (2008) – reference: 3) 前掲1) ，23 – reference: 9) 坂尾雅子，永川宅和，真田弘美．膵切除術後長期生存例の栄養状態と看護介入．金沢大学つるま保健学会誌．26 (1), 65—73 (2002) – reference: 17) 山田隆子，名越恵美，藤野文代．肝細胞がん患者のがん治療開始時からターミナル期までにおける疾病受容体験と看護支援．日本がん看護学会誌．22 (2), 41—46 (2008) – reference: 14) 金子眞理子，眞嶋朋子，小泉晋一，他．Suffering調査票の開発．日本看護科学会誌．26 (3), 3—12 (2006) – reference: 4) 前掲1) ，40 – reference: 8) 今泉俊秀．膵頭十二指腸切除術・術後合併症とその対策．日本消化器外科学会雑誌．29 (1), 127—131 (1996) – reference: 25) 佐藤泰子．苦しみと緩和の臨床人間学—聴くこと，語ることの本当の意味—．京都，晃洋書房，2011, 14 – reference: 13) Rogers BL, Cowles KV. A conceptual foundation for human suffering in nursing care and research. Journal of Advanced Nursing．25 (5), 1048—1053 (1997) – reference: 12) 厚生労働省．がん対策推進基本計画 (第3期) 〈平成30年3月〉．厚生労働省2018年． https://www.mhlw.go.jp/file/06-Seisakujouhou-10900000-Kenkoukyoku/0000196975.pdf (参照2020—03—02) – reference: 22) 時山麻美，牧野智恵．ピアサポートを受けたがん患者の体験．石川看護雑誌．14, 35—45 (2017) – reference: 23) 今泉郷子，稲吉光子．「がんサバイバーのコントロール感覚」の概念の特性．日本がん看護学会誌．23 (1), 82—91 (2009) – reference: 1) 財団法人がん研究振興財団．がんの統計’18 資料編．東京，財団法人がん研究振興財団，2018，90 – reference: 6) 吉田みつ子．難治性のがんを生き抜く—膵がん患者の語り—．日本がん看護学会誌．28 (2), 15—21 (2014) – reference: 19) 木下康仁．ライブ講義M−GTA 実践的質的研究法—修正版グラウンテッド・セオリー・アプローチのすべて．東京，弘文堂，2007 |
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| SubjectTerms | adjuvant chemotherapy patient with pancreatic cancer psychological suffering surgical treatment of cancer がん手術療法 膵臓がん患者 苦悩 術後補助化学療法 |
| Title | The Process of Living with Psychological Suffering in Patients with Postoperative Pancreatic Cancer |
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