@article{oai:sapmed.repo.nii.ac.jp:00016277,
 author = {小坂, 美智代 and 皆川, 智子 and 住吉, 蝶子 and 門間, 正子},
 journal = {札幌医科大学保健医療学部紀要 = Bulletin of School of Health Sciences Sapporo Medical University, Bulletin of School of Health Sciences Sapporo Medical University},
 month = {Mar},
 note = {胃癌術後患者が社会復帰に至るまでに体験したストレスと用いたコーピングを把握することを目的として、半構成的面接を行った。社会復帰を予定している胃癌術後患者７名を対象として、退院時・退院後約１ヶ月・退院後約３ヶ月の計３回の面接を実施し、面接内容について質的分析を行った。その結果、胃癌術後患者が社会復帰に至るまでに体験したストレスとして、１）胃機能の変調に伴う不快・苦痛、２）食行動の再構築における心理的負担、３）手術創がもたらす不快・苦痛、４）生活拡大によって生じる負担、５）入院・治療経過における負担・苦痛、６）癌罹患がもたらす苦悩・懸念、７）心身の衰えに伴う症状、８）胃切除やその回復過程がもたらす不安の８つのカテゴリーが抽出されたが、時期によりストレスの様相に違いがみられた。コーピングとしては、１）現在ある問題への取り組み、２）予想される問題への取り組み、３）健康管理に向けての取り組み、４）情報を探求する、５）食行動を再構築する、６）受容への行動の６つのコーピング様式が抽出された。得られた結果から、胃癌術後患者は退院後も持続するストレスと退院後に顕在化するストレスを抱えていることを認識し、情報提供の拡充や個別性を考慮した支援の検討、さらに長期的視野にたった他職種との連携を含めた看護の必要性が示唆された。Objectives: The objectives of the present study were １）to describe the characteristics of stress in gastric cancer patients and ２）to identify their way of coping from post?surgery to the time of returning to work. Methods: The participants were seven gastric cancer patients who received gastric surgery and were thinking of returning to work. Semi?structured interviews were used to undertake qualitative analysis. The interviews were conducted before discharge, one month and three months after discharge. Results: The data revealed eight categories : １）uncomfortableness and pain due to the impairment of gastric function, ２）mental burden due to reconstruction of dietary habits, ３）uncomfortableness and pain caused by the wound, ４）burden caused by enforcement of activities after discharge, ５）residual pain due to treatment or anxiety about the treatment and mental burden in the hospital environment, ６）distress and anxiety caused by the fact of having cancer, ７）symptoms based on the decline of physical and mental abilities, and ８）mental vulnerability associated with gastorectomy or the recovery process after surgery. Six coping strategies associated with stress were classified as follows: １）coping to relieve and solve the present problem, ２）coping to prevent the problem, ３）coping to have good health, ４）seeking information about the problem, ５）coping to reconstruct the dietary habit, ６）acting with the aim of acceptance. Conclusions: It is suggested that increases of opportunities to provide information to patients to help them cope with stress are needed. Establishment of a support system for individual patients and to collaborate with other medical personnel to support cancer survivors is essential.},
 pages = {77--84},
 title = {胃癌術後患者の社会復帰に至るまでのストレス・コーピングに関する研究},
 volume = {4},
 year = {2001}
}