要旨：就労年齢におけるがん罹患者の増加に伴い、医療機関と企業や労働機関が連携する包括的な就労支援が2016年に始まった。そこで、本研究はがん相談に従事する看護師の就労支援とその困難の実態を明らかにすることを目的とした。 がん診療連携拠点病院426施設の看護師を対象として質問紙調査を実施し、106名（回収率24.9%）の回答を得た。 就労先との情報共有や就労可否の判断の調整など連携する支援内容、進行・再発・転移時や緩和ケア移行時など身体状況が変化する支援時期は、他の支援内容・時期と比べて困難を感じる割合が高かった。 困難を感じる理由を分析した結果、就労先との連携に関する支援の困難の要因は、看護師の知識・経験不足、就労先の就労支援に対する理解不足、就労支援の体制整備・連携不足と考えられた。身体状況が変化する時期の就労支援の困難の要因は、先の見通しの不確かさの中で時期に応じた就労可否の判断や多様で個別性の高い対応が求められることに加えて、医療者の病状認識と就労者の就労意欲とのズレがあることが考えられた。 がん就労支援の課題解決で重要なのは、就労がん患者自身の症状のセルフケア能力と職場との調整能力が向上するよう支援することである。そのためには、就労がん患者自身が疾患・治療に伴う症状や生活の障壁となるものを具体的にアセスメント・対処ができ、今後の治療や病状管理の見通しをイメージできるよう支援することが必要である。Abstract：With the increasing number of patients with cancer within the working-age population, a comprehensive working support system was initiated in 2016 as a collaborative effort between medical institutions, companies and labour organizations. This study aimed to discuss and clarify the working support system provided by nurses and the difficulties they face while engaging in cancer consultations.A questionnaire survey that included nurses at 426 core hospitals that deliver collaborative cancer treatment was conducted, and answers were collected from 106 respondents（collection rate, 24.9%）.Based on the survey, nurses were found to have relatively more difficulties in terms of providing assistance such as sharing information with employers, coordinating assessment on patients’ ability or inability to work and the timing of providing assistance when physical condition changes including progression, recurrence, metastasis or transition to palliative care were involved compared to other types of assistance.In the analysis, factors that have contributed to the difficulties in cooperating with employers were a lack of knowledge and experience of nurses, a lack of understanding of the working support system by employers, the inadequacy of the working support system and insufficient cooperation. Conversely, factors that influenced the difficulties of the working support system, regarding the timing of providing assistance were assessment of patients’ working ability or inability while facing an uncertain future and the requirement of providing highly personalized assistance. In addition, it was suggested that there is a gap between medical personnel’s ability to recognize the disease condition and the patient’s motivation to work.To resolve these difficulties, it is important to provide assistance in order to improve the self-care agency of working patients with cancer, as well as their ability to adjust to workplaces. To this end, it is necessary to support working patients with cancer by assessing specific symptoms of their disease and symptoms post treatment, and helping them cope with obstacles of daily life to ensure that they can anticipate future treatment and disease management
