原発開放隅角緑内障によるロービジョン患者の体験 (喜多悦子学長 退任記念号)

Translated title of the contribution: Characteristics of the experiences of primary open-angle glaucoma

Research output: Contribution to journalArticle

Abstract

 原発開放隅角緑内障によるロービジョン患者の体験について、その疾病像や患者像を明らかにし、今後の看護介入への手かがりを見出すことを目的に、患者2名に半構成的インタビューを行った。録音したインタビュー内容から逐語記録を作成し、質的記述的分析を行なった。2名に共通するロービジョンの体験には、「光の過剰知覚」、「停止した世界」、「欠けた世界」といった、疾患や生体機能に起因すると考えられるカテゴリーとして【視覚を通じて感じる世界】が挙がった。また、【見えない世界と闘う心】、【社会活動からはずれていく感覚】といった、視覚障害の進行とともに生じる感情が挙がった。さらに、【見えない世界への抵抗】については、A氏では[最後の手段としての手術への抵抗]として、現状を認めたくない気持ちが表現されているのに対し、B氏の場合、[健常者と変わらないことをアピール]することとして、障害を受入れ自分ができることを示そうとする気持ちが表現されていた。結果から、ロービジョン患者は、自身の体験している世界を本人が十分説明できず、周囲も理解できにくい状況であり、このことが早期受診や適切な治療・援助につながりにくい状況であることが推測された。今後の看護介入の方向性として、疾患特有の見え方や見えなくなる過程における予防的介入と、視覚障害に伴う生活上の困難に対する対処的介入、慢性疾患患者にみられる心理プロセスをふまえた支援的介入が必要となることが示唆された。Primary open-angle glaucoma patients face the possibility of gradually losing an important sensory function. The purpose of this study was to understand the significance of these patients' experiences, and to clarify the structure and salient characteristics of their experiences. Two primary open-angle glaucoma patients participated in semi-structured interviews, and the data was analyzed using qualitative descriptive methods. Experiences of low vision that were common in both patients included the category of "world felt through vision", which originates from disorders and bodily functions such as "perceived excess of light", "world that has stopped", and "incomplete world". Moreover, emotions that emerge with the advancement of visual disorders such as "heart that is fighting with the invisible world" and "emotions that gradually moveaway from social activities" were also put forward. In addition, with regard to "resistance to the invisible world", participant A expressed her feelings that she did not want to acknowledge the reality, [resistance to operation, which is the last resort]. In contrast, participant B expressed his feelings that he accepted his disability and he would like to show what he can do [appealing that I am not different from a healthy person]. In all experiences, expressions of the individual patient were very diverse. Therefore, it could not be decided whether they were indicating similar kind of world, which might be because patients themselves are not aware of the world they see or they are not able to express their feelings. Patients themselves could not explain such invisible experience, and people in their surroundings are also not able to understand them.Therefore, it can be inferred that this situation makes early diagnosis and appropriate treatment and aid difficult. Going forward, with regard to visual performance, researchers can enhance their understanding by observing the meaning of what research participants are explaining in words through the same action. In addition, by asking the research participants about visual performance and observing their behavior based on clinical findings, it may be possible to identify common items in the experiences of low vision patients.
Original languageJapanese
Pages (from-to)37-47
Number of pages11
Journal日本赤十字九州国際看護大学紀要 = Bulletin of the Japanese Red Cross Kyushu International College of Nursing
Issue number11
DOIs
Publication statusPublished - 2012

Cite this

@article{cbe96888ef0645bab8cf4799094e641f,
title = "原発開放隅角緑内障によるロービジョン患者の体験 (喜多悦子学長 退任記念号)",
abstract = " 原発開放隅角緑内障によるロービジョン患者の体験について、その疾病像や患者像を明らかにし、今後の看護介入への手かがりを見出すことを目的に、患者2名に半構成的インタビューを行った。録音したインタビュー内容から逐語記録を作成し、質的記述的分析を行なった。2名に共通するロービジョンの体験には、「光の過剰知覚」、「停止した世界」、「欠けた世界」といった、疾患や生体機能に起因すると考えられるカテゴリーとして【視覚を通じて感じる世界】が挙がった。また、【見えない世界と闘う心】、【社会活動からはずれていく感覚】といった、視覚障害の進行とともに生じる感情が挙がった。さらに、【見えない世界への抵抗】については、A氏では[最後の手段としての手術への抵抗]として、現状を認めたくない気持ちが表現されているのに対し、B氏の場合、[健常者と変わらないことをアピール]することとして、障害を受入れ自分ができることを示そうとする気持ちが表現されていた。結果から、ロービジョン患者は、自身の体験している世界を本人が十分説明できず、周囲も理解できにくい状況であり、このことが早期受診や適切な治療・援助につながりにくい状況であることが推測された。今後の看護介入の方向性として、疾患特有の見え方や見えなくなる過程における予防的介入と、視覚障害に伴う生活上の困難に対する対処的介入、慢性疾患患者にみられる心理プロセスをふまえた支援的介入が必要となることが示唆された。Primary open-angle glaucoma patients face the possibility of gradually losing an important sensory function. The purpose of this study was to understand the significance of these patients' experiences, and to clarify the structure and salient characteristics of their experiences. Two primary open-angle glaucoma patients participated in semi-structured interviews, and the data was analyzed using qualitative descriptive methods. Experiences of low vision that were common in both patients included the category of {"}world felt through vision{"}, which originates from disorders and bodily functions such as {"}perceived excess of light{"}, {"}world that has stopped{"}, and {"}incomplete world{"}. Moreover, emotions that emerge with the advancement of visual disorders such as {"}heart that is fighting with the invisible world{"} and {"}emotions that gradually moveaway from social activities{"} were also put forward. In addition, with regard to {"}resistance to the invisible world{"}, participant A expressed her feelings that she did not want to acknowledge the reality, [resistance to operation, which is the last resort]. In contrast, participant B expressed his feelings that he accepted his disability and he would like to show what he can do [appealing that I am not different from a healthy person]. In all experiences, expressions of the individual patient were very diverse. Therefore, it could not be decided whether they were indicating similar kind of world, which might be because patients themselves are not aware of the world they see or they are not able to express their feelings. Patients themselves could not explain such invisible experience, and people in their surroundings are also not able to understand them.Therefore, it can be inferred that this situation makes early diagnosis and appropriate treatment and aid difficult. Going forward, with regard to visual performance, researchers can enhance their understanding by observing the meaning of what research participants are explaining in words through the same action. In addition, by asking the research participants about visual performance and observing their behavior based on clinical findings, it may be possible to identify common items in the experiences of low vision patients.",
author = "和枝 松尾",
year = "2012",
doi = "10.15019/00000219",
language = "Japanese",
pages = "37--47",
journal = "日本赤十字九州国際看護大学紀要 = Bulletin of the Japanese Red Cross Kyushu International College of Nursing",
issn = "2186-8042",
publisher = "日本赤十字九州国際看護大学",
number = "11",

}

TY - JOUR

T1 - 原発開放隅角緑内障によるロービジョン患者の体験 (喜多悦子学長 退任記念号)

AU - 松尾, 和枝

PY - 2012

Y1 - 2012

N2 -  原発開放隅角緑内障によるロービジョン患者の体験について、その疾病像や患者像を明らかにし、今後の看護介入への手かがりを見出すことを目的に、患者2名に半構成的インタビューを行った。録音したインタビュー内容から逐語記録を作成し、質的記述的分析を行なった。2名に共通するロービジョンの体験には、「光の過剰知覚」、「停止した世界」、「欠けた世界」といった、疾患や生体機能に起因すると考えられるカテゴリーとして【視覚を通じて感じる世界】が挙がった。また、【見えない世界と闘う心】、【社会活動からはずれていく感覚】といった、視覚障害の進行とともに生じる感情が挙がった。さらに、【見えない世界への抵抗】については、A氏では[最後の手段としての手術への抵抗]として、現状を認めたくない気持ちが表現されているのに対し、B氏の場合、[健常者と変わらないことをアピール]することとして、障害を受入れ自分ができることを示そうとする気持ちが表現されていた。結果から、ロービジョン患者は、自身の体験している世界を本人が十分説明できず、周囲も理解できにくい状況であり、このことが早期受診や適切な治療・援助につながりにくい状況であることが推測された。今後の看護介入の方向性として、疾患特有の見え方や見えなくなる過程における予防的介入と、視覚障害に伴う生活上の困難に対する対処的介入、慢性疾患患者にみられる心理プロセスをふまえた支援的介入が必要となることが示唆された。Primary open-angle glaucoma patients face the possibility of gradually losing an important sensory function. The purpose of this study was to understand the significance of these patients' experiences, and to clarify the structure and salient characteristics of their experiences. Two primary open-angle glaucoma patients participated in semi-structured interviews, and the data was analyzed using qualitative descriptive methods. Experiences of low vision that were common in both patients included the category of "world felt through vision", which originates from disorders and bodily functions such as "perceived excess of light", "world that has stopped", and "incomplete world". Moreover, emotions that emerge with the advancement of visual disorders such as "heart that is fighting with the invisible world" and "emotions that gradually moveaway from social activities" were also put forward. In addition, with regard to "resistance to the invisible world", participant A expressed her feelings that she did not want to acknowledge the reality, [resistance to operation, which is the last resort]. In contrast, participant B expressed his feelings that he accepted his disability and he would like to show what he can do [appealing that I am not different from a healthy person]. In all experiences, expressions of the individual patient were very diverse. Therefore, it could not be decided whether they were indicating similar kind of world, which might be because patients themselves are not aware of the world they see or they are not able to express their feelings. Patients themselves could not explain such invisible experience, and people in their surroundings are also not able to understand them.Therefore, it can be inferred that this situation makes early diagnosis and appropriate treatment and aid difficult. Going forward, with regard to visual performance, researchers can enhance their understanding by observing the meaning of what research participants are explaining in words through the same action. In addition, by asking the research participants about visual performance and observing their behavior based on clinical findings, it may be possible to identify common items in the experiences of low vision patients.

AB -  原発開放隅角緑内障によるロービジョン患者の体験について、その疾病像や患者像を明らかにし、今後の看護介入への手かがりを見出すことを目的に、患者2名に半構成的インタビューを行った。録音したインタビュー内容から逐語記録を作成し、質的記述的分析を行なった。2名に共通するロービジョンの体験には、「光の過剰知覚」、「停止した世界」、「欠けた世界」といった、疾患や生体機能に起因すると考えられるカテゴリーとして【視覚を通じて感じる世界】が挙がった。また、【見えない世界と闘う心】、【社会活動からはずれていく感覚】といった、視覚障害の進行とともに生じる感情が挙がった。さらに、【見えない世界への抵抗】については、A氏では[最後の手段としての手術への抵抗]として、現状を認めたくない気持ちが表現されているのに対し、B氏の場合、[健常者と変わらないことをアピール]することとして、障害を受入れ自分ができることを示そうとする気持ちが表現されていた。結果から、ロービジョン患者は、自身の体験している世界を本人が十分説明できず、周囲も理解できにくい状況であり、このことが早期受診や適切な治療・援助につながりにくい状況であることが推測された。今後の看護介入の方向性として、疾患特有の見え方や見えなくなる過程における予防的介入と、視覚障害に伴う生活上の困難に対する対処的介入、慢性疾患患者にみられる心理プロセスをふまえた支援的介入が必要となることが示唆された。Primary open-angle glaucoma patients face the possibility of gradually losing an important sensory function. The purpose of this study was to understand the significance of these patients' experiences, and to clarify the structure and salient characteristics of their experiences. Two primary open-angle glaucoma patients participated in semi-structured interviews, and the data was analyzed using qualitative descriptive methods. Experiences of low vision that were common in both patients included the category of "world felt through vision", which originates from disorders and bodily functions such as "perceived excess of light", "world that has stopped", and "incomplete world". Moreover, emotions that emerge with the advancement of visual disorders such as "heart that is fighting with the invisible world" and "emotions that gradually moveaway from social activities" were also put forward. In addition, with regard to "resistance to the invisible world", participant A expressed her feelings that she did not want to acknowledge the reality, [resistance to operation, which is the last resort]. In contrast, participant B expressed his feelings that he accepted his disability and he would like to show what he can do [appealing that I am not different from a healthy person]. In all experiences, expressions of the individual patient were very diverse. Therefore, it could not be decided whether they were indicating similar kind of world, which might be because patients themselves are not aware of the world they see or they are not able to express their feelings. Patients themselves could not explain such invisible experience, and people in their surroundings are also not able to understand them.Therefore, it can be inferred that this situation makes early diagnosis and appropriate treatment and aid difficult. Going forward, with regard to visual performance, researchers can enhance their understanding by observing the meaning of what research participants are explaining in words through the same action. In addition, by asking the research participants about visual performance and observing their behavior based on clinical findings, it may be possible to identify common items in the experiences of low vision patients.

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DO - 10.15019/00000219

M3 - 記事

SP - 37

EP - 47

JO - 日本赤十字九州国際看護大学紀要 = Bulletin of the Japanese Red Cross Kyushu International College of Nursing

JF - 日本赤十字九州国際看護大学紀要 = Bulletin of the Japanese Red Cross Kyushu International College of Nursing

SN - 2186-8042

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