Ogata Y, Hashimoto M, Otosaka K
Department of Health Economics, Graduate School of Medicine, University of Tokyo.
Nihon Koshu Eisei Zasshi. 2000 Apr;47(4):307-19.
The purpose of the study is to measure the subjective burdens of families caring for "frail elderly" in their homes and to clarify the relationships between caregivers' subjective burdens and the health conditions of the "frail elderly", the family's conditions, the use of social services and availability of social supports. The subjects consisted of caregivers of the elderly who also were using nursing services from K Home Visit Nursing Care Station (K-Station). We mailed subjective burden questionnaires to 98 families among users of K-Station from December of 1994 to March of 1995. We used the 12 items developed by Nakatani as a scale to measure subjective burdens. Each item was stratified into 4 grade levels from "agree" to "disagree". We asked nurses at K-Station about "frail elderly" ADL conditions in detail, the extent of medical dependency and the will of families to care for the elderly. A total of 76 questionnaires were returned, of which 73 could be analyzed. The greater part of "frail elderly" were female (n = 42). The average age of the "frail elderly" was 81.1(+/- 7.6) years old. All caregivers were members of the family of the "frail elderly" and most of them were women (n = 63). From the result of principal analysis, 2 principles were extracted from the 12 items used to measure subjective burden of caregivers. We analyzed the first principle as "subjective burden of caregivers". From the result of multiple regression analysis (Stepwise method), "subjective burden of caregivers" was characterized by the caregivers' conditions only (caregivers' health status, the will to care for the elderly and anxiety of providing night care). This result suggested that support for the caregivers of the "frail elderly" was important to sustain in-home care.
本研究的目的是衡量在家照顾“体弱老人”的家庭的主观负担，并阐明照顾者的主观负担与“体弱老人”的健康状况、家庭状况、社会服务的使用情况以及社会支持的可获得性之间的关系。研究对象包括正在接受K家庭访视护理站（K站）护理服务的老年照顾者。1994年12月至1995年3月，我们向K站的98个用户家庭邮寄了主观负担调查问卷。我们使用中谷开发的12个项目作为衡量主观负担的量表。每个项目从“同意”到“不同意”分为4个等级。我们向K站的护士详细询问了“体弱老人”的日常生活活动能力状况、医疗依赖程度以及家庭照顾老人的意愿。共返回76份问卷，其中73份可以进行分析。“体弱老人”中大部分为女性（n = 42）。“体弱老人”的平均年龄为81.1（±7.6）岁。所有照顾者均为“体弱老人”的家庭成员，其中大多数为女性（n = 63）。从主成分分析结果来看，从用于衡量照顾者主观负担的12个项目中提取出2个主成分。我们将第一个主成分分析为“照顾者的主观负担”。从多元回归分析（逐步法）结果来看，“照顾者的主观负担”仅由照顾者的状况（照顾者的健康状况、照顾老人的意愿以及提供夜间护理的焦虑）所决定。这一结果表明，对“体弱老人”照顾者的支持对于维持家庭护理至关重要。
