壮年期から中年期の就労者における初回急性心筋梗塞の体験に関する現象学的研究

Experiences of middle-aged individuals with a first acute myocardial infarction:a phenomenological study

Creators Kawamura Atsuko

Creators Inagaki Junko

本研究の目的は,壮年期から中年期の就労している初回急性心筋梗塞患者が発症から退院後3ヵ月の期間において,精神的にどのように感じ,患者の意識がどのようなプロセスをたどっていくのか,そのありのままの体験世界を明らかにすることである.研究方法は,現象学的アプローチを用いて入院後1週間,退院時,確認カテーテル検査のための再入院時の3回,非構成的面接を実施した.研究参加者は男性10名,女性1名の計11名で,平均年齢は58.3±7.4歳であった.研究参加者の入院後1週間から退院3ヵ月後までの体験におけるテキストを分析した結果,局面1:生の不確かさを感じ動揺する,局面2:生を前向きに受け入れ,自己コントロールを考える,局面3:今後の人生と自分の死生観とを統合し,終局を迎えた時に後悔がないように生きるという局面へと意識が変遷していく過程が明らかになった.本研究の結果,急性心筋梗塞を初回発症し死に直面した患者に対して,自己エンパワメントを促進するようなスピリチュアル･ケアが必要である可能性が示唆された.

The precise emotional process of middle-aged individuals after the onset of a first acute myocardial infarction(AMI)is not known. We sought to clarify the contents of middle-aged individuals’experience of having a first AMI. I interviewed with 11 individuals(10 men, 1 woman, aged 39 to 64 yrs)who had a first AMI about their AMI experience in the way of unstructured face-to-face interview. A qualitative phenomenological approach was used to clarify their experiences. Each individual described their psychological process from the point of experiencing the AMI through their recovery. They described facing their own potential death calmly. Their experiences could be classified as progressing through the following three phases over the course of their AMI onset, treatment and recovery. Phase 1:feeling of uncertain about their life and being upset, Phase 2:accepting life prospectively and thinking about self-control, and Phase 3:integrating their outlook for the future and their newly expanded view of life and death. The process of middle-aged individuals from onset to 3 months after a first AMI was very emotionally unstable. The results indicated a necessity for spiritual care promoting self-empowerment for patients with AMI.

[ISSN]0513-1731

[NCID]AN00243156