<研究ノート>教育入院の経験の語り --T病院に教育入院中のアトピー性皮膚炎患者へのインタビューから

Abstract

アトピー性皮膚炎にて教育入院中の患者の経験を明らかにするため、T 病院の教育入院患者9 名を対象にインタビュー調査を行った。教育入院には、症状悪化のみならず、可視性や同居家族への負担など、精神的苦悩も強い契機となっていた。治療の面では、(1)ステロイド使用への抵抗感の持続、(2)食事の質への満足と量への不満、院内の人間関係について、(3)スタッフの関わり方に対する高い評価、(4)周囲の患者との相互理解が語られた。さらに退院後について、ケアの継続と症状の改善への自信と不安が入り混じって語られた。患者が周囲との関わりをポジティブに捉えていることは、精神的苦悩を入院の契機とした患者にとって教育入院は学習の機会であるだけでなく、相談機関としての機能をも有していることを示している。これらに応じ、退院後のケアの継続に対する不安や症状のコントロールの不安を軽減するためにも、より綿密・長期的なサポートの再考が重要であると考える。

To explore what patients' with atopic dermatitis experience during educational hospitalization, a semi-structured interview was conducted with nine hospitalized patients with atopic dermatitis in T hospital. The following results were obtained. Not only aggravation of their symptoms but also psychological distress such as being stared at by others and receiving too much care from their family members led patients to get hospitalized. Some patients still were reluctant to use steroids, or discontented with the quantity of hospital meals. Patients evaluated how the hospital staff dealt with them, and appreciated mutual understanding with other patients in the hospital. They were simultaneously confident and anxious about whether they could continue their self-care or improve their symptoms after discharge. Patients who decided to be hospitalized because of psychological distress positively interacted with staff and patients around them. This shows that educational hospitalization not only teaches symptom care but also facilitates staff consultation. We suggest that sensitive and longitudinal support is required to deal with such patients to reduce their anxiety of continuing self-care after discharge.