小児がんの子どもの闘病体験に関するメタ統合

Abstract

目的:小児がんの子どもの闘病体験に関する研究論文をメタ統合することで、小児がん発症の初期から治療が終了するまでの子どもの闘病体験での新たな知見を見出し、看護実践への示唆を得る。方法:医学中央雑誌、PubMedで検索し、選定基準に合致した7文献を対象に、Noblit, G.W et a1 (1988)のメタ統合の手法を参考にして分析した。結果:小児がんの子どもの闘病体験は、【突然起こった現状に思いを巡らす】【治療や処置に苦悩する】【自分の将来に思いを巡らす】【入院生活での辛さと楽しみを実感する】【自分を奮起させる】【家族との絆の強さを実感する】【健康な友達に羨望を抱きつつ友情に感請ける】【病棟で出会う人に思いを巡らす】8の体験が抽出された。考察:小児がんの子どもの闘病体験では、治療や処置を乗りこえる子ども自身の「がんばり」と「がんばりの支え」となる他者の支援があることが明らかとなった。子どものがんばりを十分理解した医療者の支えの大切さが示唆された。

Objectives: We examined the experiences of children with cancer fighting the disease from onset to treatment completion through meta-synthesis of research articles. We developed recommendations for nursing practice. Methods: The Japanese medical literature database and PubMed were used to search the literature. Seven articles met the selection criteria. The data from these articles were analyzed using the meta-synthesis method developed by Noblit, G.W et al (1988). Results: The following eight types of experiences were extracted from the children's data: "thinking of the sudden occurrence of present conditions," "feeling the anguish of treatments and procedures," "thinking of my future," "realizing discomforts and pleasures specific to hospitalization," "motivating myself," "realizing the strength of family bonds," "experiencing friendship and envy through healthy friends," and "thinking of someone met in a hospital." Discussion: In children with experiences of cancer fighting the disease, two items were found: the "perseverance" of children who overcome treatments and procedures and "support of perseverance" through encouragement from other people. Support by medical staff who adequately understood children's perseverance was important.