排便障害を生じる直腸がん前方切除術後患者への看護ケアに関する文献的研究  [in Japanese] Review of the Nursing Care for Rectal Cancer Patients with Defecation Disorder Following Anterior Resection  [in Japanese]

Access this Article

Author(s)

    • 佐藤 正美 Sato Masami
    • 筑波大学医学医療系保健医療学域 Division of Health Innovation and Nursing, Faculty of Medicine, University of Tsukuba
    • 日高 紀久江 Hidaka Kikue
    • 筑波大学医学医療系保健医療学域 Division of Health Innovation and Nursing, Faculty of Medicine, University of Tsukuba

Abstract

本研究の目的は,直腸がん前方切除患者の排便障害軽減に効果が期待できる看護援助方法を検討するために,前方切除患者へのケアに関連する研究を分析し考察することである.13件(日本語11件,英語2件)の看護論文と5件の医学論文(日本語2件,英語3件)を分析対象とした.分析の結果,予測不能な排便と便漏れに苦悩し,試行錯誤しながら対処している様相が明らかとなった.少数例ではあるが,骨盤底筋体操により排便回数が減少する効果が示された.またバイオフィードバックは,効果的に骨盤底筋体操を実施する一つの有効な方法であることが示唆された.看護成果として,症状改善だけではなく,適切な排便行為を導く認知や判断を含めたコントロール感の獲得も必要な視点である.今後は,バイオフィードバックも含めた効果的な骨盤底筋体操の検討,セルフケアを促進する方法の検討,看護支援の成果を示すアウトカムの検討,看護支援の検証研究を進めることが課題である.

The purpose of this study was to investigate nursing care of patients who have undergone anterior resection for rectal cancer, concerning reduction of defecation disorder. Analysis of 13 nursing studies (11 Japanese, 2 English) and 5 medical studies (2 Japanese, 3 English) elucidated aspects whereby difficulties with unpredictable defecation and fecal incontinence were dealt with by trial and error. Although only a small number of cases were reported, the effect of reduced defecation frequency due to pelvic floor muscle training was indicated. Furthermore, biofeedback was indicated as an effective method for conducting pelvic floor exercises. For nursing outcome, focus is necessary not only on symptoms improvement, but also on acquisition of feelings of control including awareness and judgment leading to appropriate defecation. Future issues include methods of pelvic floor muscle including biofeedback and how to promote self-care, discussion of nursing outcome, and progress in research validating nursing care.

Journal

  • Journal of Japan Academy of Nursing Science

    Journal of Japan Academy of Nursing Science 32(2), 2_64-71, 2012

    Japan Academy of Nursing Science

Codes

  • NII Article ID (NAID)
    130004565338
  • Text Lang
    JPN
  • ISSN
    0287-5330
  • Data Source
    J-STAGE 
Page Top