{"id":158,"date":"2026-08-24T09:00:00","date_gmt":"2026-08-24T00:00:00","guid":{"rendered":"https:\/\/phc-ogikubo.com\/blog\/?p=158"},"modified":"2026-08-19T13:14:59","modified_gmt":"2026-08-19T04:14:59","slug":"post-158","status":"publish","type":"post","link":"https:\/\/phc-ogikubo.com\/blog\/post-158\/","title":{"rendered":"\u3010\u8aa4\u89e3\u3057\u3066\u3044\u307e\u305b\u3093\u304b\uff1f\u3011\u7de9\u548c\u30b1\u30a2\u306f\u300c\u6700\u5f8c\u306b\u884c\u304f\u5834\u6240\u300d\u3067\u306f\u306a\u3044\uff01\u304c\u3093\u6cbb\u7642\u3068\u540c\u6642\u306b\u59cb\u3081\u308b\u300c\u65e9\u671f\u7de9\u548c\u30b1\u30a2\u300d\u3068\u3044\u3046\u65b0\u3057\u3044\u5e38\u8b58"},"content":{"rendered":"\n

\u300c\u7de9\u548c\u30b1\u30a2\u300d\u3068\u805e\u304f\u3068\u3001\u7686\u3055\u3093\u306f\u3069\u3093\u306a\u30a4\u30e1\u30fc\u30b8\u3092\u6301\u3061\u307e\u3059\u304b\uff1f \u300c\u3082\u3046\u6cbb\u7642\u6cd5\u304c\u306a\u304f\u306a\u3063\u305f\u6642\u306b\u884c\u304f\u5834\u6240\u300d\u300c\u5ef6\u547d\u3092\u3042\u304d\u3089\u3081\u3066\u6700\u5f8c\u306b\u884c\u304f\u3068\u3053\u308d\u300d\u2026\u2026\u305d\u3093\u306a\u98a8\u306b\u601d\u3063\u3066\u3044\u308b\u65b9\u304c\u591a\u3044\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002

\u3000\u3057\u304b\u3057\u8fd1\u5e74\u306e\u533b\u5b66\u7814\u7a76\u3067\u306f\u3001\u300c\u304c\u3093\u3068\u8a3a\u65ad\u3055\u308c\u305f\u65e9\u3044\u6bb5\u968e\u304b\u3089\u3001\u901a\u5e38\u306e\u6cbb\u7642\u3068\u4e26\u884c\u3057\u3066\u7de9\u548c\u30b1\u30a2\u3092\u53d7\u3051\u308b\u3053\u3068\uff08\u65e9\u671f\u7de9\u548c\u30b1\u30a2\uff09\u300d\u304c\u3001\u60a3\u8005\u3055\u3093\u3084\u3054\u5bb6\u65cf\u306b\u3068\u3063\u3066\u975e\u5e38\u306b\u5927\u304d\u306a\u30e1\u30ea\u30c3\u30c8\u3092\u3082\u305f\u3089\u3059\u3053\u3068\u304c\u5206\u304b\u3063\u3066\u304d\u307e\u3057\u305f\u3002

\u3000\u4eca\u56de\u306f\u3001\u6d77\u5916\u306e\u6709\u540d\u306a2\u3064\u306e\u533b\u5b66\u8ad6\u6587\uff08Temel\u533b\u5e2b\u3089\u306e\u7814\u7a76\uff0fBruera\u533b\u5e2b\u3089\u306e\u89e3\u8aac\uff09\u3092\u3082\u3068\u306b\u3001\u300c\u65e9\u304f\u59cb\u3081\u308b\u7de9\u548c\u30b1\u30a2\u300d\u304c\u306a\u305c\u5927\u5207\u306a\u306e\u304b\u3001\u305d\u306e\u9a5a\u304d\u306e\u52b9\u679c\u3068\u8eab\u8fd1\u306b\u6349\u3048\u308b\u305f\u3081\u306e\u8003\u3048\u65b9\u306b\u3064\u3044\u3066\u89e3\u8aac\u3057\u307e\u3059\uff01

\u885d\u6483\u306e\u7814\u7a76\u7d50\u679c\uff1a\u7de9\u548c\u30b1\u30a2\u3092\u65e9\u304f\u59cb\u3081\u305f\u3089\u300c\u751f\u304d\u308b\u671f\u9593\u300d\u304c\u5ef6\u3073\u305f\uff01\uff1f<\/strong>

\u30002010\u5e74\u3001\u7c73\u56fd\u306e\u6a29\u5a01\u3042\u308b\u533b\u5b66\u8a8c\uff08NEJM\uff09\u306b\u767a\u8868\u3055\u308c\u305f\u7814\u7a76\uff08Temel\u6c0f\u3089\uff09\u306f\u3001\u304c\u3093\u533b\u7642\u306e\u5e38\u8b58\u3092\u5927\u304d\u304f\u8986\u3057\u307e\u3057\u305f\u3002 \u9032\u884c\u3057\u305f\u80ba\u304c\u3093\uff08\u8ee2\u79fb\u6027\u975e\u5c0f\u7d30\u80de\u80ba\u304c\u3093\uff09\u306e\u60a3\u8005\u3055\u3093151\u4eba\u3092\u3001\u4ee5\u4e0b\u306e2\u3064\u306e\u30b0\u30eb\u30fc\u30d7\u306b\u5206\u3051\u3066\u8abf\u67fb\u3092\u884c\u3063\u305f\u306e\u3067\u3059\u3002

\u3000\u2022\tA\uff1a\u901a\u5e38\u306e\u6297\u304c\u3093\u5264\u6cbb\u7642\u306e\u307f\u3092\u884c\u3046\u30b0\u30eb\u30fc\u30d7
\u3000\u2022\tB\uff1a\u6297\u304c\u3093\u5264\u6cbb\u7642\u3068\u540c\u6642\u306b\u300c\u65e9\u671f\u7de9\u548c\u30b1\u30a2\u300d\u3092\u53d7\u3051\u308b\u30b0\u30eb\u30fc\u30d7

\u3059\u308b\u3068\u300112\u9031\u9593\u5f8c\u306b\u660e\u78ba\u306a\u9055\u3044\u304c\u73fe\u308c\u307e\u3057\u305f\u3002

\u3000\u2022\t\u5fc3\u306e\u72b6\u614b\u304c\u7a4f\u3084\u304b\u306b \u75db\u307f\u3084\u5410\u304d\u6c17\u3001\u606f\u82e6\u3057\u3055\u3068\u3044\u3063\u305f\u8eab\u4f53\u75c7\u72b6\u3060\u3051\u3067\u306a\u304f\u3001\u4e0d\u5b89\u3084\u6c17\u5206\u306e\u843d\u3061\u8fbc\u307f\u3068\u3044\u3063\u305f\u5fc3\u306e\u82e6\u75db\u3082\u65e9\u3044\u6bb5\u968e\u304b\u3089\u30b1\u30a2\u3059\u308b\u3053\u3068\u3067\u3001\u3046\u3064\u75c7\u72b6\u3092\u611f\u3058\u308b\u4eba\u306e\u5272\u5408\u304c\u5927\u5e45\u306b\u6e1b\u5c11\u3057\u307e\u3057\u305f\uff0816% \u5bfe 38%\uff09\u3002
\u3000\u2022\t\u751f\u6d3b\u306e\u8cea\uff08QOL\uff09\u304c\u5411\u4e0a \u5fc3\u8eab\u306e\u8ca0\u62c5\u304c\u548c\u3089\u3050\u3053\u3068\u3067\u3001\u81ea\u5206\u3089\u3057\u3044\u751f\u6d3b\u3092\u9001\u308a\u3084\u3059\u304f\u306a\u308a\u307e\u3057\u305f\u3002
\u3000\u2022\t\u7121\u99c4\u3067\u7121\u7406\u306a\u6cbb\u7642\u304c\u6e1b\u5c11 \u4f53\u8abf\u304c\u5b89\u5b9a\u3057\u3001\u4e0d\u5fc5\u8981\u306a\u6551\u6025\u53d7\u8a3a\u3084\u904e\u5270\u306a\u691c\u67fb\u30fb\u51e6\u7f6e\u3092\u907f\u3051\u3089\u308c\u308b\u3088\u3046\u306b\u306a\u3063\u305f\u7d50\u679c\u3001\u4ea1\u304f\u306a\u308b\u76f4\u524d\u306e\u8eab\u4f53\u7684\u8ca0\u62c5\u304c\u5927\u304d\u3044\u6cbb\u7642\u3092\u6e1b\u3089\u3059\u3053\u3068\u306b\u3064\u306a\u304c\u308a\u307e\u3057\u305f\u3002

\u5b9f\u306f\u300c\u9577\u751f\u304d\u300d\u306b\u3064\u306a\u304c\u308b\u53ef\u80fd\u6027\u3082<\/strong>

\u3000\u305d\u3057\u3066\u6700\u3082\u9a5a\u304f\u3079\u304d\u3053\u3068\u306b\u3001\u300c\u65e9\u671f\u7de9\u548c\u30b1\u30a2\u3092\u53d7\u3051\u305f\u30b0\u30eb\u30fc\u30d7\u306e\u65b9\u304c\u3001\u5e73\u5747\u3057\u3066\u7d042.7\u304b\u6708\u9577\u304f\u751f\u5b58\u3057\u305f\uff08\u751f\u5b58\u671f\u9593\u306e\u4e2d\u592e\u5024\uff1a11.6\u304b\u6708 \u5bfe 8.9\u304b\u6708\uff09\u300d\u306e\u3067\u3059\u3002 \u3064\u3089\u3055\u3092\u548c\u3089\u3052\u308b\u30b1\u30a2\u3092\u65e9\u304f\u53d6\u308a\u5165\u308c\u308b\u3053\u3068\u304c\u3001\u7d50\u679c\u3068\u3057\u3066\u547d\u3092\u5ef6\u3070\u3059\u3053\u3068\u306b\u3064\u306a\u304c\u308a\u307e\u3057\u305f\u3002

\u306a\u305c\u65e9\u671f\u7de9\u548c\u30b1\u30a2\u3067\u300c\u9577\u751f\u304d\u300d\u3084\u300cQOL\u5411\u4e0a\u300d\u304c\u3067\u304d\u308b\u306e\uff1f<\/strong>

\u3000\u306a\u305c\u3001\u65e9\u304f\u59cb\u3081\u308b\u3053\u3068\u3067\u3053\u306e\u3088\u3046\u306a\u826f\u3044\u5909\u5316\u304c\u751f\u307e\u308c\u308b\u306e\u3067\u3057\u3087\u3046\u304b\uff1f Bruera\u533b\u5e2b\u3089\u306e\u89e3\u8aac\u8ad6\u6587\uff082012\u5e74\uff09\u3067\u306f\u3001\u305d\u306e\u7406\u7531\u3068\u4ed5\u7d44\u307f\u304c\u5206\u304b\u308a\u3084\u3059\u304f\u8aac\u660e\u3055\u308c\u3066\u3044\u307e\u3059\u3002

1. \u75db\u307f\u3084\u5410\u304d\u6c17\u3092\u6211\u6162\u305b\u305a\u3001\u6cbb\u7642\u306b\u5c02\u5ff5\u3067\u304d\u308b<\/strong>

\u3000\u304c\u3093\u306f\u75c5\u6c17\u305d\u306e\u3082\u306e\u306e\u75db\u307f\u3060\u3051\u3067\u306a\u304f\u3001\u6297\u304c\u3093\u5264\u3084\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u526f\u4f5c\u7528\uff08\u5410\u304d\u6c17\u3001\u5f37\u3044\u3060\u308b\u3055\u3001\u606f\u5207\u308c\u306a\u3069\uff09\u3092\u4f34\u3044\u307e\u3059\u3002 \u65e9\u3044\u6bb5\u968e\u304b\u3089\u5c02\u9580\u30c1\u30fc\u30e0\uff08\u7de9\u548c\u30b1\u30a2\u533b\u3001\u770b\u8b77\u5e2b\u3001\u5fc3\u7406\u30ab\u30a6\u30f3\u30bb\u30e9\u30fc\u306a\u3069\uff09\u304c\u95a2\u308f\u308b\u3053\u3068\u3067\u3001\u75c7\u72b6\u3092\u30b9\u30d4\u30fc\u30c7\u30a3\u30fc\u306b\u548c\u3089\u3052\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059\u3002\u4f53\u304c\u697d\u306b\u306a\u308c\u3070\u4f53\u529b\u304c\u7dad\u6301\u3055\u308c\u3001\u6297\u304c\u3093\u5264\u6cbb\u7642\u3082\u8a08\u753b\u901a\u308a\u7d9a\u3051\u3084\u3059\u304f\u306a\u308a\u307e\u3059\u3002

2. \u300c\u8eca\u306e\u30b7\u30fc\u30c8\u30d9\u30eb\u30c8\u3084\u30a8\u30a2\u30d0\u30c3\u30b0\u300d\u3068\u540c\u3058\u5f79\u5272<\/strong>

\u3000\u8ad6\u6587\u3067\u306f\u3001\u7de9\u548c\u30b1\u30a2\u3092\u300c\u8eca\u306e\u5b89\u5168\u30fb\u5feb\u9069\u88c5\u5099\u300d\u306b\u4f8b\u3048\u3066\u3044\u307e\u3059\u3002

\u3000\u2022\t\u6297\u304c\u3093\u5264\u6cbb\u7642\u306a\u3069\uff1a \u300c\u76ee\u7684\u5730\u3078\u30c9\u30e9\u30a4\u30d6\u3059\u308b\uff08\u4ed5\u4e8b\u3092\u7d9a\u3051\u308b\u3001\u65c5\u884c\u306b\u884c\u304f\uff09\u300d
\u3000\u2022\t\u7de9\u548c\u30b1\u30a2\uff1a \u300c\u30b7\u30fc\u30c8\u30d9\u30eb\u30c8\u3084\u30a8\u30a2\u30d0\u30c3\u30b0\u3001\u30a8\u30a2\u30b3\u30f3\u300d\u3092\u5099\u3048\u3066\u304a\u304f\u3053\u3068

\u3000\u300c\u4e07\u304c\u4e00\u306e\u4e8b\u6545\u306b\u5099\u3048\u3066\u30b7\u30fc\u30c8\u30d9\u30eb\u30c8\u3092\u7de0\u3081\u308b\u300d\u304b\u3089\u3068\u3044\u3063\u3066\u3001\u300c\u4e8b\u6545\u3092\u8d77\u3053\u3059\u3064\u3082\u308a\u3067\u8eca\u306b\u4e57\u308b\u4eba\u300d\u306f\u3044\u307e\u305b\u3093\u3088\u306d\u3002 \u305d\u308c\u3068\u540c\u3058\u3067\u3001\u300c\u6cbb\u7652\u3084\u5ef6\u547d\u3092\u76ee\u6307\u3059\u6cbb\u7642\uff08\u30c9\u30e9\u30a4\u30d6\uff09\u300d\u3092\u5168\u529b\u3067\u7d9a\u3051\u306a\u304c\u3089\u3082\u3001\u300c\u4f53\u306e\u82e6\u75db\u3084\u4e0d\u5b89\u3092\u548c\u3089\u3052\u308b\uff08\u30b7\u30fc\u30c8\u30d9\u30eb\u30c8\u3084\u30a8\u30a2\u30b3\u30f3\uff09\u300d\u6e96\u5099\u3092\u540c\u6642\u306b\u304a\u3053\u306a\u3063\u3066\u304a\u304f\u306e\u304c\u65e9\u671f\u7de9\u548c\u30b1\u30a2\u306e\u8003\u3048\u65b9\u3067\u3059\u3002 \u300c\u8ae6\u3081\u308b\u305f\u3081\u306e\u3082\u306e\u300d\u3067\u306f\u306a\u304f\u3001\u300c\u5feb\u9069\u306b\u6cbb\u7642\u3092\u7d9a\u3051\u308b\u305f\u3081\u306e\u5b89\u5168\u88c5\u7f6e\u300d\u306a\u306e\u3067\u3059\u3002

3. \u4e3b\u6cbb\u533b\u3068\u30c1\u30fc\u30e0\u3067\u60a3\u8005\u3055\u3093\u3092\u652f\u3048\u308b\uff08\u7d71\u5408\u30b1\u30a2\u30e2\u30c7\u30eb\uff09<\/strong>

\u3000\u4e3b\u6cbb\u533b\u306e\u5148\u751f\u3072\u3068\u308a\u3067\u300c\u304c\u3093\u306e\u6cbb\u7642\u300d\u300c\u75db\u307f\u306e\u7ba1\u7406\u300d\u300c\u5fc3\u306e\u30b1\u30a2\u300d\u300c\u3054\u5bb6\u65cf\u306e\u76f8\u8ac7\u300d\u3092\u3059\u3079\u3066\u3053\u306a\u3059\u306e\u306f\u975e\u5e38\u306b\u5927\u5909\u3067\u3059\u3002 \u65e9\u671f\u7de9\u548c\u30b1\u30a2\u3067\u306f\u3001\u4e3b\u6cbb\u533b\u304c\u300c\u304c\u3093\u306e\u6cbb\u7642\u300d\u306b\u96c6\u4e2d\u3057\u3001\u7de9\u548c\u30b1\u30a2\u30c1\u30fc\u30e0\u304c\u300c\u751f\u6d3b\u3068\u5fc3\u306e\u30b1\u30a2\u300d\u3092\u62c5\u5f53\u3059\u308b\u300c\u7d71\u5408\u30b1\u30a2\u30e2\u30c7\u30eb\uff08Integrated Care Model\uff09\u300d\u3092\u3068\u308a\u307e\u3059\u3002\u5c02\u9580\u30c1\u30fc\u30e0\u304c\u5354\u529b\u3057\u5408\u3063\u3066\u652f\u3048\u308b\u3053\u3068\u3067\u3001\u6f0f\u308c\u306e\u306a\u3044\u624b\u539a\u3044\u30b5\u30dd\u30fc\u30c8\u304c\u53ef\u80fd\u306b\u306a\u308a\u307e\u3059\u3002

\u300c\u30b5\u30dd\u30fc\u30c6\u30a3\u30d6\u30b1\u30a2\uff08\u652f\u6301\u7642\u6cd5\uff09\u300d\u3068\u3044\u3046\u8003\u3048\u65b9<\/strong>

\u3000\u300c\u7de9\u548c\u30b1\u30a2\u300d\u3068\u3044\u3046\u8a00\u8449\u81ea\u4f53\u306e\u30a4\u30e1\u30fc\u30b8\u306b\u62b5\u6297\u304c\u3042\u308b\u65b9\u3082\u591a\u3044\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002 \u7c73\u56fd\u306e\u3042\u308b\u6709\u540d\u304c\u3093\u30bb\u30f3\u30bf\u30fc\u3067\u306f\u3001\u5916\u6765\u306e\u540d\u79f0\u3092\u300c\u7de9\u548c\u30b1\u30a2\u300d\u304b\u3089\u300c\u30b5\u30dd\u30fc\u30c6\u30a3\u30d6\u30b1\u30a2\uff08\u652f\u6301\u7642\u6cd5\uff09\u300d\u306b\u5909\u66f4\u3057\u305f\u3068\u3053\u308d\u3001\u60a3\u8005\u3055\u3093\u304c\u76f8\u8ac7\u3057\u3084\u3059\u304f\u306a\u308a\u3001\u7d39\u4ecb\u3055\u308c\u308b\u4ef6\u6570\u304c41%\u3082\u5897\u3048\u305f\u305d\u3046\u3067\u3059\u3002

\u3000\u300c\u3064\u3089\u3055\u3092\u652f\u3048\u3066\u3082\u3089\u3046\uff08\u30b5\u30dd\u30fc\u30c8\uff09\u300d\u3068\u3044\u3046\u6349\u3048\u65b9\u306a\u3089\u3001\u3082\u3063\u3068\u6c17\u8efd\u306b\u76f8\u8ac7\u3067\u304d\u305d\u3046\u3067\u3059\u3088\u306d\u3002\u540d\u524d\u306e\u30a4\u30e1\u30fc\u30b8\u3060\u3051\u3067\u9060\u3056\u3051\u3066\u3057\u307e\u3046\u306e\u306f\u3001\u975e\u5e38\u306b\u3082\u3063\u305f\u3044\u306a\u3044\u3053\u3068\u3067\u3059\u3002

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\"\"<\/figure>\n\n\n\n



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\u53c2\u8003\u8cc7\u6599:
\u3000\u2022\tTemel JS, et al. “Early palliative care for patients with metastatic non-small-cell lung cancer.” N Engl J Med. 2010;363(8):733-742.
\u3000\u2022\tBruera E, et al. “Palliative Care in Advanced Cancer Patients: How and When?” The Oncologist 2012;17:267\u2013273.

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