ktk2002007

A Consideration of Outpatient Nursing from the Viewpoint of Self-Care Agency and Sense of Difficulty Regarding Chronic-Disease Patients : Based on a Consciousness

仲沢, 富枝

慢性病者/セルフケア能力/困難感/外来看護/Chronic-disease patient/elf-care agency/ense of difficulty/outpatient nursing

慢性病の多くは長い間の生活習慣が影響して発症している。従って慢性病のある人の殆どが成人、老年といえる。それだけに社会的な役割を優先させたり、健康に対する価値や信念また生活習慣を変更させるのに困難が伴う。一方で、判断力、理解力、実行力、適応力等をもち合わせており、日々の生活の中で様々な折り合いをつけセルフケアをしていると考えられる。このように慢性病の予後は病者自身のセルフケア能力の発揮のしかたに左右されると言える。そこで慢性病をもち入院経験があり、受診行動を定期的に行っている病者を対象に、本庄のＳＣＡＱ （Self-Care Agency Question) を活用しセルフケア能力を査定した。本尺度は１:健康管理法の獲得と継続（６項目）、２:有効な支援の獲得（６項目）、３:体調の調整（８項目）、４:健康管理への関心（９項目）、の合計29の下位尺度を用いて質問項目を設定している。また、先行研究から筆者がセルフケア能力の発揮の際に抱くであろう困難感を７項目の要因として抽出し、意識調査した。その結果成人期と老年期の慢性病者のセルフケア能力は高かった。しかし、成人は老年よりセルフケア能力発揮に際し、困難感を抱いていた。 慢性病者への外来における看護には、１）支援的看護、２）対象のセルフケア能力の発揮に対する個別的な係わり、が必要であることが示唆された。

Many chronic diseases are generated due to lifestyle in which patients have lived for many years. As such, most chronic-disease patients are adults or elderly. They tend to place a higher priority on their social role rather than on health, and it is difficult to change their values and belief toward health or lifestyle. On the other hand, they have abilities to judge, understand, takeaction, and adapt, and they can conduct self-care by finding some balance in their daily life. As such, the prognosis for a chronic-disease patient can be said to depend on how the patient displays personal self-care agency. In this survey, the writer assessed self-care agencies of chronic-disease patients who have experienced hospitalization and regularly see a doctor, by using Honjo's SCAQ ( Self-Care Agency Questions). In this method, four main scales (29 subordinate scales) are set for questions,as follows: (1) Acquisition and maintenance of health management method (6 items), (2) Acquisition of effective support (6 items), (3) Adjustment of physical condition (8 items), and (4) Interest in health management (9 items). In addition, the writer extracted seven factors, regarding the sense of difficulty predicted by the writer that the patients would have in displaying self-care abilities, from previous studies, and conducted a consciousness survey. The results revealed high self-care agencies of chronic-disease patients in their adulthood and old age, but the younger adult patients showed a greater sense of difficulty in displaying self-care agencies compared with the elderly patients. It was indicated that nursing care for outpatients with chronic disease requires 1) supportive nursing and 2) individual involvement in patients' displaying self-care agencies.

山梨県立看護大学短期大学部

Departmental Bulletin Paper

1342-0097

AA11404594

紀要（Bulletin of Yamanashi Junior College of Nursing）

8

1

77

87

2003/3/1

jpn