治療可能だが治癒できないがん患者による事前ケア計画に対する認識と理解を調査する定性研究
Ruth Board1, Sean Hughes2, Katherine Stewart1
1Lancashire Teaching Hospitals NHS Foundation Trust, Lancashire, UK.
Palliative medicine
|August 31, 2025
まとめ
治療可能だが治らないがんの患者は,治療の不確実性のために事前のケア計画に困難に直面します. 診察室での議論を 計画として認識せず 将来の計画に 家族の関与を好む人もいます
科学分野:
- 腫瘍学
- 緩和ケア
- 定性的な研究
背景:
- 治療可能な治癒不可能な癌の患者にとって,治療革新による不確実な予後が不可欠です.
- これらの患者の将来の計画に対する理解は限られている.
研究 の 目的:
- 患者の認識と事前ケア計画 (ACP) の理解を探求する.
- 治療可能な がんではなく 治療可能な がんを患う患者に焦点を当てる
主な方法:
- 治療可能な治癒不可能な癌と診断された20人の患者を対象に 質的・詳細なインタビューが行われました
- データ分析は,社会的構成主義的なパラダイムの中で反射的なテーマアプローチを採用しました.
- インタビューには家族も参加しました
主要な成果:
- 生存を延ばす新しい治療法が 不確実性を生み出し ACPを阻害しました
- 患者が経験した生存上の課題は 癌と人生の終わりを考えるバランスです
- ほとんどの参加者は,DNR命令を含む臨床的議論をACPとして識別せず,社会的および葬儀の取り決めのための家族の議論を好みました.
- 介護者の役割を持つ患者も数人いるが,ACPには積極的に参加している.
結論:
- 治療可能で不治の癌の患者にとって 病気の進行の不確実性は大きな課題です
- 医療計画に関する議論を 社会的/個人的な将来のケアに関する会話から 切り離す必要があるかもしれません
- 生存の不確実性がACPの慣行にどのように影響するかについては,さらなる研究が推奨されています.
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