乳癌の手術を受けた患者の手術前後の心理的変化

Abstract

Knowledge of breast cancer, anxiety concerning disease, anxiety concerning operation, and anxiety to daily life before and after operation were studied using information gathered from questionnaires which were given to 15 patients who underwent mastectomy in Kyoto University Hospital. About half of the patients had some knowledge of breast cancer before their operations, and almost all of the patients had some knowledge of breast cancer after their operations. There is a statistically significant increase (p=0.0125). The families of the patients also tended to increase their knowledge of breast cancer after the operation. The anxiety of the patients mainly related to the operation, aftereffects of the operation, and recurrence/metastasis (14 in 15 patients). Many patients (13 in 15 patients) were also anxious about operation scars, cure of the disease, and the possibility of death. After their operation, anxiety concerning recurrence/metastasis was significantly relieved (p=0.0277). Anxiety concerning work or household affairs was also significantly relieved after operation (p=0.0244). However, anxiety concerning cure of the disease and the possibility of death continued even after operation. Most of the patients thought that the information given by the doctors was proper, but they wanted the doctors to be tender with them and to give them a better explanation of their condition. Before operation, many patients obtained spiritual satisfaction by pursuing hobbies. However, after operation, they began to communicate more with family members and friend, instead. These results suggest that the patient experienced strong stress about the operation and disease before operation and it was only partly relieved after operation. Doctors and nurses should therefore help them by providing tender care and a sufficient explanation of their condition, and nursing cares need to apply not only to patients, but also to the family members who support them.