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胃切除後症候群に対する胃がん患者の困難と対処に関する文献研究
Get PDF目的：先行研究の集約により，胃切除後症候群に対する胃がん患者の困難と対処を明らかにする．
研究方法：根治的胃切除術( 幽門側胃切除術・噴門側胃切除術・胃全摘術) による胃切除後症候群
に対する困難・対処について記述されている文献を収集し，メタ統合により，新たな概念を生成す
る．結果：胃切除後症候群に伴う困難は，【食物が消化管を通過する際に苦痛が生じる】【痩せて外
見が変化したことがつらい】【気力・体力・免疫力の低下で活動が思うようにならない】【職場での
食事摂取で仕事に支障が生じる】などの19 のカテゴリー，対処は，【胃を失った自分を受け入れる】
【自然に任せ諦観する】【新しい胃での食事摂取方法を模索し続ける】【体力温存の工夫をする】な
どの8 のカテゴリーに集約された．考察：１）胃切除は，身体的変化（1 段階）が，食生活・日常
生活の変化（2 段階）をもたらし，それらが，人間関係・仕事・将来設計に影響を及ぼす（3 段階）
ことで、全人的苦痛をもたらす．2）胃がん患者は，問題焦点型コーピングを組みわせることで，
胃切除後の身体の変化を感じ取り，様々な対処行動を実践に移し，その実践から学び工夫する．こ
の試行錯誤のプロセスを通して，胃を失った自己を受け入れ，諦観に至る情動焦点型コーピングが
進む．Purpose: This study aims to enhance understanding regarding the challenges faced by patients
with gastric cancer. Simultaneously, it outlines the coping strategies for post-gastrectomy
syndrome through a comprehensive summary of previous studies. Method: We collected
literature delineating the challenges and coping mechanisms associated with post-gastrectomy
syndrome resulting from radical gastrectomy. Subsequently, we conducted a meta-synthesis to
derive innovative conceptual insights. Results: Challenges related to post-gastrectomy syndrome
were classified into 19 categories, exemplified by [1. Pain during food passage through the
digestive tract]. Coping strategies were organized into eight distinct classifications, illustrated by
[a. Embracing self-acceptance without a stomach]. Discussion: (1) Gastrectomy induces physical
discomfort (Stage 1), prompting alterations in eating habits and lifestyle (Stage 2), subsequently
affecting interpersonal relationships and work and potentially influencing future lifestyle choices
(Stage 3). (2) The fusion of problem-focusing coping mechanisms enables patients with gastric
cancer to perceive bodily changes post-gastrectomy. They engage in coping strategies, learning
from these experiences. This iterative process leads to the evolution of emotion-focused coping,
wherein patient gradually accepts the loss of their stomach and adopt a more passive approach,
allowing nature to take its course