2018 Fiscal Year Final Research Report

Construction of Nursing Support Model in Outpatient Department for Patients with Rectal Cancer who Receive Multidisciplinary Therapy

Research Project

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Project/Area Number	15K11625
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Clinical nursing
Research Institution	Kyushu University
Principal Investigator	Yumiko Kinoshita 九州大学, 医学研究院, 講師 (30432925)
Co-Investigator(Kenkyū-buntansha)	壬生隆一国際医療福祉大学, 臨床医学研究センター, 教授 (20200107) 金岡麻希産業医科大学, 産業保健学部, 講師 (50507796) 宮園真美福岡看護大学, 看護学部, 教授 (10432907) 中尾久子九州大学, 医学研究院, 教授 (80164127) 樗木晶子九州大学, 医学研究院, 教授 (60216497)
Project Period (FY)	2015-04-01 – 2019-03-31
Keywords	QOL / 症状マネジメント / 機能障害 / 集学的治療 / 直腸がん / 外来 / 看護モデル
Outline of Final Research Achievements	The QOL of patients with rectal cancer who underwent sphincter-saving surgery decreased most at 1 month after surgery. They recovered to preoperative levels by 12 months. Female's global health QOL (GHS) at one month after surgery was affected by fatigue, weight loss, defecation problems and future perspective. Male's GHS was affected by fatigue, weight loss and role functioning. In the elderly group, GHS was affected by low cognitive functioning, and the cognitive functioning was affected by pain, financial difficulties and defecation problems. By type of surgery, the intersphincteric resection group's mental and social functioning was poor and correlated with defecation problems. The chemotherapy group had poor physical functioning which caused pain and insomnia, and social functioning which caused financial difficulties, pain, fatigue, and low future prospective at 12 months after surgery. It was suggested that nursing care based on these differences was important.
Free Research Field	がん看護
Academic Significance and Societal Importance of the Research Achievements	下部直腸がんに対して、近年では技術の発達と永久的人工肛門を造設する心理的負担が考慮され、内肛門括約筋切除術や超低位前方切除術が行われている。これらの手術では、便失禁・排便の不規則性などの排便障害の重症化や遷延化が懸念されている。本研究では、肛門温存手術を受けた患者のQOLとその影響要因について、性別・年齢・術式・術後化学療法の有無別に分析し、その看護支援の方策について考察した。