統合失調症をもちながら地域で暮らす当事者に対して訪問看護師が行うレジリエンス支援の有用性評価

Effectiveness of Resilience Support for Community-Dwelling Patients With Schizophrenia by Visiting Nurses

要旨

　目的：本研究の目的は，地域で暮らす統合失調症をもつ当事者に対して訪問看護師が行うレジリエンス支援の有用性を評価することである．

　方法：訪問看護ステーションおよびデイケアを利用している統合失調症をもつ当事者を対象に，本支援を実施した23名を介入群，通常の支援のみを実施した21名を対照群として，3時点（介入前，介入開始2か月後，介入開始3か月後）において自記式質問紙調査をおこなった．

　結果：精神障害者のレジリエンスの帰結である治療への取り組み，主観的幸福感，病気の予防と悪化の防止，健康状態の改善は，介入前より介入開始2か月後および介入開始3か月後において介入群が有意に改善を認めた．

　結論：本支援は地域で暮らす統合失調症をもつ当事者の服薬意識や薬に対する構え，主観的幸福感，地域生活に対する自己効力感，精神機能の改善を促すための一つの支援になり得る可能性が示唆された．

　Purpose: To evaluate the effectiveness of resilience support for community-dwelling patients with schizophrenia by visiting nurses.

　Methods: We conducted a self-administered questionnaire survey before and 2 and 3 months after the initiation of intervention. The patients were divided into an intervention group using home-visit nursing facility and daycare services(23: regular support provided in psychiatric homevisit nursing + resilience support) and a control group(21: regular support only).

　Results: The intervention group showed improvement in terms of attitudes toward treatment, subjective well-being, and disease and deterioration prevention as consequences of resilience support for people with mental disorders, and the health status was markedly improved at 2 and 3 months after the initiation of intervention than before it.

　Conclusion: Resilience support by visiting nurses may be effective in helping communitydwelling patients with schizophrenia by improving attitudes(e.g. readiness, awareness) toward treatment, subjective well-being, self-efficacy within the community, and mental function.