Development of a program to alleviate multiple symptoms in recurrent breast cancer outpatients receiving chemotherapy

Research Project

Project/Area Number	16K20775
Research Category	Grant-in-Aid for Young Scientists (B)
Allocation Type	Multi-year Fund
Research Field	Clinical nursing
Research Institution	Tokyo University of Technology (2019) Toho University (2016-2018)
Principal Investigator	ASAUMI Kurumi 東京工科大学, 医療保健学部, 助教 (90735367)
Project Period (FY)	2016-04-01 – 2020-03-31
Project Status	Completed (Fiscal Year 2019)
Budget Amount *help	¥3,900,000 (Direct Cost: ¥3,000,000、Indirect Cost: ¥900,000) Fiscal Year 2018: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000) Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000) Fiscal Year 2016: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Keywords	外来化学療法 / 転移・再発がん / 多重症状 / 外来看護師 / 転移・再発乳がん / 転移再発乳がん / 化学療法 / 再発乳がん
Outline of Final Research Achievements	The purpose of this study was to develop a nursing program to alleviate multiple symptoms in breast cancer outpatients undergoing chemotherapy. The research method consisted of semi-structured interviews conducted one-on-one with six outpatient nurses and seven home-visit nurses. The results indicated that the components of such a program should include (1) the simultaneous implementation of “symptom relief” and “support in anticipation of the prognosis,” (2) the full enhancement of education for outpatient nurses in end-of-life care, and (3) the implementation of systems and information-sharing tools that promote coordination between outpatient and home-visit nurses. Further investigations on the specifics of how to operate such a nursing program are required.
Academic Significance and Societal Importance of the Research Achievements	在院日数の短縮化に伴い、化学療法を受ける場は入院から外来へ移行している。特に、転移再発による化学療法を受けるがん患者は、複数の症状による心身の負担感の増大に加え、人生の最終段階の治療やケアの選択という厳しい問題と向き合う必要があるため、外来看護師に求められるケアは高度かつ複雑になっている。そのような課題に対し、早期から訪問看護を導入することの有効性が示唆されているが、その実態は明らかにされていない。本研究は、化学療法中の再発乳がん患者の多重症状の緩和に向けた外来看護および訪問看護の実践と実践上の困難を明らかにし、病院と在宅のシームレスな連携を見据えた看護の体系化に向けた成果を得た。