終末期がん療養者の満足な在宅看取りを行った配偶者の介護体験  [in Japanese] Caregiving Experiences of Spouses Who Provided Satisfactory Home-based End-of-life Care to a Terminal Cancer Patient  [in Japanese]

Access this Article

Author(s)

Abstract

<p><b>目的:</b>終末期がん療養者の満足な在宅看取りを行えた配偶者の体験を明らかにするとした.</p><p><b>方法:</b>修正版グラウンデッド・セオリー・アプローチにて分析を行った.研究協力者は,療養者の希望に沿い在宅で看取ったことに満足している配偶者8人とした.</p><p><b>結果:</b>満足な在宅看取りを行った配偶者の介護体験は,3つのプロセスと8つのカテゴリから構成された.≪在宅看取りの選択と意思決定≫の段階は,配偶者は【療養者の望む生き方を尊重できる夫婦関係の構築】と【在宅療養にいたる苦渋の決断】を相互に行っていた.次いで,≪終末期がん療養者の在宅看取りのための主体的介護≫の段階は,【訪問看護師による支援の獲得】と【かかりつけ医による支援の獲得】により,【配偶者として在宅看取りを引き受ける自発的行動】【在宅看取りに向かう負担感限界範囲の拡大】をし,【余命期間内で療養者の望みを実現】する行動を起こしていた.そして,≪看取りの後の成長≫の段階は,【遺された者としての新たな生き方への出発】をしていた.</p><p><b>考察:</b>満足な在宅看取りを行った配偶者の介護体験は,≪在宅療養の選択と意思決定≫と≪終末期がん療養者のための主体的介護≫の段階がみられた.満足な在宅看取りをした配偶者の体験を分析することで,主体的な介護プロセスが結果として浮上した.本結果は,医療依存度の高い療養者の在宅医療推進のための資料になると考えた.</p>

<p><b>Purpose:</b> The objective of this study was to shed light on the experiences of spouses who were able to provide satisfactory home-based end-of-life care to their husband/wife with terminal cancer.</p><p><b>Method:</b> We conducted an analysis using the modified grounded theory approach. The study participants were eight spouses who were satisfied with home-based end-of-life care that they provided in accordance with their husband/wife's wishes.</p><p><b>Results:</b> The caregiving experiences of spouses who provided satisfactory home-based end-of-life care consisted of three processes and eight categories. At the stage of 'home-based end-of-life care selection and decision-making,' spouses were "building a marital relationship that respects the patient's desired way of living", and "making tough decisions leading to home-based care", which are mutually related. Next, at the stage of 'independent caregiving for home-based end-of-life care for a terminal cancer patient,' spouses "spontaneously acted to take on home-based end-of-life care as a spouse" and "expanded the limits of their sense of burden in order to provide home-based end-of-life care." They did this by "obtaining support from visiting nurses" and "obtaining support from their primary care physician." In doing this, spouses took action to "fulfill the wishes of the patient within the time they had left." At the stage of 'growth after end-of-life care,' spouses "embarked on a new way of living as a bereaved person."</p><p><b>Discussion:</b> The caregiving experiences of spouses who provided satisfactory home-based end-of-life care had the stages of 'home-based care selection and decision-making' and 'independent caregiving for end-of-life care for a terminal cancer patient.' By analyzing the experiences of spouses who provided satisfactory home-based end-of-life care, we discovered an independent caregiving process. The results of this study could serve as reference for the promotion of home-based care for patients who are heavily dependent on medical care.</p>

Journal

  • Journal of Japan Academy of Community Health Nursing

    Journal of Japan Academy of Community Health Nursing 20(2), 64-72, 2017

    Japan Academy of Community Health Nursing

Codes

  • NII Article ID (NAID)
    130007437333
  • NII NACSIS-CAT ID (NCID)
    AA11362530
  • Text Lang
    JPN
  • ISSN
    1346-9657
  • NDL Article ID
    028799510
  • NDL Call No.
    Z74-B543
  • Data Source
    NDL  J-STAGE 
Page Top