Kamitani Hiroko, Umegaki Hiroyuki, Okamoto Kazushi, Kanda Shigeru, Asai Atsushi, Shimojima Takuya, Nomura Hideki, Hattori Ayako, Kimata Takaya, Suzuki Yusuke, Ohshima Hiroko, Kuzuya Masafumi
Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine.
Department of Public Health, Aichi Prefectural College of Nursing and Health.
Nihon Ronen Igakkai Zasshi. 2018;55(1):98-105. doi: 10.3143/geriatrics.55.98.
We developed quality-of-life (QOL) scales for patients receiving home medical care. The objective of this study was to examine the agreement between the scores of the scales answered by patients and those answered by their proxy, as cognitive decline may interfere with one's ability to understand complex topics, such as the QOL.
Participants were pairs of patients receiving home medical care and their proxy. The patients were asked to complete self-reported QOL scales (QOL-HC), and their proxies were asked to complete proxy-reported versions of the QOL scales (QOL-HC for caregivers). We then statistically examined the extent of agreement between the self- and proxy-reported QOL-HC scores using contingency tables and Spearman's rank correlation coefficient. The SPSS software program, version 24, was used for all statistical analyses.
The concordance rate between patients and caregivers for questions 1 ( "Do you have peace of mind?" ), 2 ( "Do you feel satisfied with your life when you reflect on it?" ), 3 ( "Do you have someone that you spend time talking with?" ), and 4 ( "Are you satisfied with the home care service system?" ) were 52.3%, 52.3%, 79.5%, and 81.8%, respectively. The total scores for the patients and caregivers were significantly correlated (Spearman's ρ=0.364*).
We created the first QOL scale for patients receiving home-based medical care and for caregivers. The findings of this study suggest that the QOL-HC can be used in clinical practice for the assessment of patients receiving professional home care.
我们为接受居家医疗护理的患者制定了生活质量（QOL）量表。本研究的目的是检验患者回答的量表得分与其代理人回答的得分之间的一致性，因为认知能力下降可能会干扰一个人理解复杂主题（如生活质量）的能力。
参与者是接受居家医疗护理的患者及其代理人。要求患者完成自我报告的生活质量量表（QOL-HC），并要求其代理人完成生活质量量表的代理人报告版本（照顾者用QOL-HC）。然后，我们使用列联表和Spearman等级相关系数对自我报告和代理人报告的QOL-HC得分之间的一致程度进行了统计学检验。所有统计分析均使用SPSS软件程序24版。
患者与照顾者在问题1（“你内心平静吗？”）、问题2（“当你反思生活时，你对自己的生活感到满意吗？”）、问题3（“你有人可以一起聊天吗？”）和问题4（“你对家庭护理服务系统满意吗？”）上的一致率分别为52.3%、52.3%、79.5%和81.8%。患者和照顾者的总分显著相关（Spearman's ρ=0.364*）。
我们为接受居家医疗护理的患者及其照顾者创建了首个生活质量量表。本研究结果表明，QOL-HC可用于临床实践中评估接受专业居家护理的患者。
