がん患者の呼吸困難感に影響する要因
目的：がん患者の呼吸困難感に影響する要因を明らかにする。方法：279名に質問紙調査を実施，241名の回答を得た（有効回答率92.3％）。呼吸困難感（TDSC）と，身体状態要因（PS・Stage・呼吸器質変化・その他症状等），心理社会的要因（BCWI・FACT-G），対処基盤要因（対処行動・対処方法に関する指導を受けた経験・相談相手）との関連を重回帰分析および共分散構造分析により解析した。結果：重回帰分析の結果，TDSC総得点においてPS・Stage・呼吸器質変化・心配・QOL・対処方法に関する指導を受けた経験の６項目と有意差を認め，共分散構造分析では，Stage を除く５項目が適合した。結論：...
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| Published in | 日本看護研究学会雑誌 Vol. 46; no. 2; pp. 2_153 - 2_164 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本看護研究学会
20.07.2023
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 2188-3599 2189-6100 |
| DOI | 10.15065/jjsnr.20220812194 |
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| Abstract | 目的：がん患者の呼吸困難感に影響する要因を明らかにする。方法：279名に質問紙調査を実施，241名の回答を得た（有効回答率92.3％）。呼吸困難感（TDSC）と，身体状態要因（PS・Stage・呼吸器質変化・その他症状等），心理社会的要因（BCWI・FACT-G），対処基盤要因（対処行動・対処方法に関する指導を受けた経験・相談相手）との関連を重回帰分析および共分散構造分析により解析した。結果：重回帰分析の結果，TDSC総得点においてPS・Stage・呼吸器質変化・心配・QOL・対処方法に関する指導を受けた経験の６項目と有意差を認め，共分散構造分析では，Stage を除く５項目が適合した。結論：がん患者の呼吸困難感の発生や増悪には，PS，呼吸器質変化，心配，QOL，対処方法に関する指導を受けた経験が影響し，特に心配との関連が最も強いため心身両側面からの包括的な看護支援の必要性が示唆された。 |
|---|---|
| AbstractList | 目的：がん患者の呼吸困難感に影響する要因を明らかにする。方法：279名に質問紙調査を実施，241名の回答を得た（有効回答率92.3％）。呼吸困難感（TDSC）と，身体状態要因（PS・Stage・呼吸器質変化・その他症状等），心理社会的要因（BCWI・FACT-G），対処基盤要因（対処行動・対処方法に関する指導を受けた経験・相談相手）との関連を重回帰分析および共分散構造分析により解析した。結果：重回帰分析の結果，TDSC総得点においてPS・Stage・呼吸器質変化・心配・QOL・対処方法に関する指導を受けた経験の６項目と有意差を認め，共分散構造分析では，Stage を除く５項目が適合した。結論：がん患者の呼吸困難感の発生や増悪には，PS，呼吸器質変化，心配，QOL，対処方法に関する指導を受けた経験が影響し，特に心配との関連が最も強いため心身両側面からの包括的な看護支援の必要性が示唆された。 |
| Author | 橋本, 晴美 今井, 洋子 京田, 亜由美 本多, 昌子 神田, 清子 藤本, 桂子 |
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| References | Bruera, E., Sala, R., Spruyt, O., Palmer, J.L., Tao, Z., Willey, J. (2005). Nebulized versus subcutaneous morphine for patients with cancer dyspnea: A preliminary study. Journal of Pain and Symptom Management, 29(6), 613-618. https://doi.org/10.1016/j.jpainsymman.2004.08.016 Cella, D.F., Tulsky, D.S., Gray, G., Sarafian, B., Linn, E., Bonomi, M., Silberman, A., Yellen, S.B., Winicour, P., Brannon, J. (1993). The functional assessment of cancer therapy scale: development and validation of the general measure. Journal of Clinical Oncology, 11(3), 570-579. https://doi.org/10.1200/JCO.1993.11.3.570 Hirai, K., Shiozaki, M., Motooka, H., Arai, H., Koyama, A., Inui, H., Uchitomi, Y. (2008). Discrimination between worry and anxiety among cancer patients: Development of a brief cancer-related worry inventory. Psycho Oncology. 17(12), 1172-1179. https://doi.org/10.1002/pon.1348. Bredin, M., Corner, J., Krishnasamy, M., Plant, H., Bailey, C., A'Hern, R. (1999). Multicentre randomised controlled trial of nursing intervention for breathlessness in patients with lung cancer. British Medical Journal, 318(7188), 901-904. https://doi.org/10.1136/bmj.318.7188.901 Hashimoto, H., Kanda, K. (2019). Development and validation of the total dyspnea scale for cancer patients. European Journal of Oncology Nursing, 41, 120-125. https://doi.org/10.1016/j.ejon.2019.05.007 Zigmend, A.S., & Snaith, R.P. （1983）. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavia, 67（6）, 361-370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x Kamal, A.H., Maguire, J.M., Wheeler, J.L., Currow, D.C., Abernethy, A.P. (2011). Dyspnea review for the palliative care professional: assessment, burdens, and etiologies. First in two-part series. Journal of Palliative Medicine, 14(10), 1167-72. https://doi.org/10.1089/jpm.2011.0109 Smith, E.L., Hann, D.M., Ahles, T.A., Furstenberg, C.T., Mitchell, T.A., Meyer, L., Maurer, L.H., Rigas, J., Hammond, S. （2001）. Dyspnea, anxiety, body consciousness, and quality of life in patients with lung cancer. Journal of Pain and Symptom Management, 21（4）, 323-329. https://doi.org/10.1016/s0885-3924（01）00255-x 宮坂仁美, 石井三由紀, 池田奈保, 坂口 唯, 山崎由真. （2013）. 呼吸困難がある肺がん患者と関わる看護師の苦悩. 長野赤十字病院医誌, 27, 61-65. Corner, J., Plant, H., A'Hern, R., Bailey, C. (1996). Non-pharmacological intervention for breathlessness in lung cancer. Journal of Palliative Medicine, 10(4), 299-305. https://doi.org/10.1177/026921639601000405 Larson, P.J., Carrieri-Kohlman, V., Dodd, M.J., Douglas, M., Faucett, J., Froelicher, E., Gortner, S., Halliburton, P., Janson, S., Lee, K.A., Miaskowski, C., Savedra, M., Stotts, N., Taylor, D. & Underwood, P. (1994). A model for symptom management, Image: the Journal of Nursing Scholarship, 26, 272-276. Abernethy, A.P., &Wheeler, J.L. (2008). Total dyspnoea. Current Opinion in Supportive and Palliative Care, 2(2), 110-113. https://doi.org/10.1097/SPC.0b013e328300cad0 Tanaka, K., Akechi, T., Okuyama, T., Nishiwaki, Y., Uchitomi, Y. （2002）. Prevalence and screening of dyspnea interfering with daily life activities in ambulatory patients with advanced lung cancer. Journal of Pain and Symptom Management, 23（6）, 484-489. https://doi.org/10.1016/s0885-3924（02）00394-9 橋本晴美, 神田清子. （2011）. 呼吸困難を抱える治療期進行肺がん患者の体験, 日本看護研究学会雑誌, 34（1）, 73-83. Ben-Aharon, I., Gafter-Gvili, A., Leibovici, L., Stemmer,S., M. (2012).Interventions for alleviating cancer-related dyspnea: A systematic review and meta-analysis. Acta Oncologica, 51(8), 996-1008. https://doi.org/10.3109/0284186X.2012.709638 日本緩和医療学会緩和医療ガイドライン委員会（編）（2016）. がん患者の呼吸器症状の緩和に関するガイドライン（2016年版）. 23, 東京：金原出版. 橋本晴美, 吉田久美子, 神田清子. （2017）. 「がん患者の呼吸困難感」の概念分析, 日本看護研究学会雑誌, 40（1）, 45-56. Dudgeon, D.J., Lertzman, M., Askew, G.R. (2001). Physiological changes and clinical correlations of dyspnea in cancer outpatients. Journal of Pain Symptom Management, 21(5), 373-379. 東あかね, 八城博子, 清田啓介, 井口秀人, 八田宏之, 藤田きみゑ, 渡辺能行, 川井啓市（1996）. 消化器内科外来におけるhospital anxiety and depression scale （HAD尺度）日本語版の信頼性と妥当性の検討. 日本消化器学会雑誌, 93（12）, 884-892. Fumimoto, H., Kobayashi, K., Chang, C.H., Eremenco, S., Fujiki, Y., Uemura, S., Ohashi,Y., Kudoh,S. (2001). Cross-cultural validation of an international questionnaire, the general measure of the functional assessment of cancer therapy scale (FACT-G), for Japanese. Quality of Life Research. 10(8), 701-9. https://doi.org/10.1023/a:1013851216181 角甲 純, 關本翌子, 小川朝生, 宮下光令. （2015）. 終末期がん患者の呼吸困難に対する送風の有効性についてのケースシリーズ研究. Palliative Care Research, 10（1）, 147-152. Oken, M.M., Creech, R.H., Tormey, D.C., Horton, J., Davis, T.E., McFadden, E.T., Carbone, P.P. （1982）. Toxicity and response criteria of the Eastern Cooperative Oncology Group. American Journal of Clinical Oncology, 5（6）, 649-655. Wong, S.L., Leong, S.M., Chan, C.M., Kan, S.P., Cheng, H.W. B. （2017）. The effect of using an electric fan on dyspnea in Chinese patients with terminal cancer: A randomized controlled trial. American Journal of Hospice & Palliative Medicine, 34（1）, 42-46. https://doi.org/10.1177/1049909115615127 Dodd, M., et al. (2001). Advancing the science of symptom management. Journal of Advanced Nursing, 33(5), 668-676. |
| References_xml | – reference: Tanaka, K., Akechi, T., Okuyama, T., Nishiwaki, Y., Uchitomi, Y. （2002）. Prevalence and screening of dyspnea interfering with daily life activities in ambulatory patients with advanced lung cancer. Journal of Pain and Symptom Management, 23（6）, 484-489. https://doi.org/10.1016/s0885-3924（02）00394-9 – reference: Wong, S.L., Leong, S.M., Chan, C.M., Kan, S.P., Cheng, H.W. B. （2017）. The effect of using an electric fan on dyspnea in Chinese patients with terminal cancer: A randomized controlled trial. American Journal of Hospice & Palliative Medicine, 34（1）, 42-46. https://doi.org/10.1177/1049909115615127 – reference: Abernethy, A.P., &Wheeler, J.L. (2008). Total dyspnoea. Current Opinion in Supportive and Palliative Care, 2(2), 110-113. https://doi.org/10.1097/SPC.0b013e328300cad0 – reference: Bruera, E., Sala, R., Spruyt, O., Palmer, J.L., Tao, Z., Willey, J. (2005). Nebulized versus subcutaneous morphine for patients with cancer dyspnea: A preliminary study. Journal of Pain and Symptom Management, 29(6), 613-618. https://doi.org/10.1016/j.jpainsymman.2004.08.016 – reference: Cella, D.F., Tulsky, D.S., Gray, G., Sarafian, B., Linn, E., Bonomi, M., Silberman, A., Yellen, S.B., Winicour, P., Brannon, J. (1993). The functional assessment of cancer therapy scale: development and validation of the general measure. Journal of Clinical Oncology, 11(3), 570-579. https://doi.org/10.1200/JCO.1993.11.3.570 – reference: Ben-Aharon, I., Gafter-Gvili, A., Leibovici, L., Stemmer,S., M. (2012).Interventions for alleviating cancer-related dyspnea: A systematic review and meta-analysis. Acta Oncologica, 51(8), 996-1008. https://doi.org/10.3109/0284186X.2012.709638 – reference: Hirai, K., Shiozaki, M., Motooka, H., Arai, H., Koyama, A., Inui, H., Uchitomi, Y. (2008). Discrimination between worry and anxiety among cancer patients: Development of a brief cancer-related worry inventory. Psycho Oncology. 17(12), 1172-1179. https://doi.org/10.1002/pon.1348. – reference: Bredin, M., Corner, J., Krishnasamy, M., Plant, H., Bailey, C., A'Hern, R. (1999). Multicentre randomised controlled trial of nursing intervention for breathlessness in patients with lung cancer. British Medical Journal, 318(7188), 901-904. https://doi.org/10.1136/bmj.318.7188.901 – reference: 橋本晴美, 神田清子. （2011）. 呼吸困難を抱える治療期進行肺がん患者の体験, 日本看護研究学会雑誌, 34（1）, 73-83. – reference: Corner, J., Plant, H., A'Hern, R., Bailey, C. (1996). Non-pharmacological intervention for breathlessness in lung cancer. Journal of Palliative Medicine, 10(4), 299-305. https://doi.org/10.1177/026921639601000405 – reference: Hashimoto, H., Kanda, K. (2019). Development and validation of the total dyspnea scale for cancer patients. European Journal of Oncology Nursing, 41, 120-125. https://doi.org/10.1016/j.ejon.2019.05.007 – reference: 東あかね, 八城博子, 清田啓介, 井口秀人, 八田宏之, 藤田きみゑ, 渡辺能行, 川井啓市（1996）. 消化器内科外来におけるhospital anxiety and depression scale （HAD尺度）日本語版の信頼性と妥当性の検討. 日本消化器学会雑誌, 93（12）, 884-892. – reference: Zigmend, A.S., & Snaith, R.P. （1983）. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavia, 67（6）, 361-370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x – reference: 日本緩和医療学会緩和医療ガイドライン委員会（編）（2016）. がん患者の呼吸器症状の緩和に関するガイドライン（2016年版）. 23, 東京：金原出版. – reference: Kamal, A.H., Maguire, J.M., Wheeler, J.L., Currow, D.C., Abernethy, A.P. (2011). Dyspnea review for the palliative care professional: assessment, burdens, and etiologies. First in two-part series. Journal of Palliative Medicine, 14(10), 1167-72. https://doi.org/10.1089/jpm.2011.0109 – reference: Fumimoto, H., Kobayashi, K., Chang, C.H., Eremenco, S., Fujiki, Y., Uemura, S., Ohashi,Y., Kudoh,S. (2001). Cross-cultural validation of an international questionnaire, the general measure of the functional assessment of cancer therapy scale (FACT-G), for Japanese. Quality of Life Research. 10(8), 701-9. https://doi.org/10.1023/a:1013851216181 – reference: 角甲 純, 關本翌子, 小川朝生, 宮下光令. （2015）. 終末期がん患者の呼吸困難に対する送風の有効性についてのケースシリーズ研究. Palliative Care Research, 10（1）, 147-152. – reference: 橋本晴美, 吉田久美子, 神田清子. （2017）. 「がん患者の呼吸困難感」の概念分析, 日本看護研究学会雑誌, 40（1）, 45-56. – reference: 宮坂仁美, 石井三由紀, 池田奈保, 坂口 唯, 山崎由真. （2013）. 呼吸困難がある肺がん患者と関わる看護師の苦悩. 長野赤十字病院医誌, 27, 61-65. – reference: Smith, E.L., Hann, D.M., Ahles, T.A., Furstenberg, C.T., Mitchell, T.A., Meyer, L., Maurer, L.H., Rigas, J., Hammond, S. （2001）. Dyspnea, anxiety, body consciousness, and quality of life in patients with lung cancer. Journal of Pain and Symptom Management, 21（4）, 323-329. https://doi.org/10.1016/s0885-3924（01）00255-x – reference: Oken, M.M., Creech, R.H., Tormey, D.C., Horton, J., Davis, T.E., McFadden, E.T., Carbone, P.P. （1982）. Toxicity and response criteria of the Eastern Cooperative Oncology Group. American Journal of Clinical Oncology, 5（6）, 649-655. – reference: Dudgeon, D.J., Lertzman, M., Askew, G.R. (2001). Physiological changes and clinical correlations of dyspnea in cancer outpatients. Journal of Pain Symptom Management, 21(5), 373-379. – reference: Dodd, M., et al. (2001). Advancing the science of symptom management. Journal of Advanced Nursing, 33(5), 668-676. – reference: Larson, P.J., Carrieri-Kohlman, V., Dodd, M.J., Douglas, M., Faucett, J., Froelicher, E., Gortner, S., Halliburton, P., Janson, S., Lee, K.A., Miaskowski, C., Savedra, M., Stotts, N., Taylor, D. & Underwood, P. (1994). A model for symptom management, Image: the Journal of Nursing Scholarship, 26, 272-276. |
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| ispartofPNX | 日本看護研究学会雑誌, 2023/07/20, Vol.46(2), pp.2_153-2_164 |
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