進行期パーキンソン病患者の在宅生活の継続および中断に関連する重要因子—質問紙調査による検討

Important Factors Pertaining to Continuation and Discontinuation of Home Care in Patients With Advanced Parkinson's Disease: A Questionnaire Survey

要旨

　目的：進行期パーキンソン病（APD）患者の在宅生活の継続および中断に関連する要素の重要度を明らかにし，潜在する重要因子を探索すること．

　方法：文献を用いた質的帰納的分析から生成した質問紙により，全国のパーキンソン病患者会会員とAPDケアに携わる医師・看護師に調査を実施した．

　結果：有効回答数は158であった．記述統計と因子分析の結果，進行期PD患者の在宅生活を継続する重要因子は［多職種アプローチ］［セルフケア］［専門医へのアクセス］の3因子14要素，中断する重要因子は［介護者支援］［介護ニーズ］［精神症状］［転倒経験］［排泄動作］の5因子20要素で構成された．因子のクロンバックα係数は0.736〜0.956で，概ね良好だった．

　結論：APD患者の在宅生活の継続および中断に関連する重要因子が8因子34要素明らかになり，APD患者の在宅生活支援に向けた評価指標に活用できると考えられた．

　Aim: To elucidate the importance of elements related to continuation and discontinuation home care in patients with advanced Parkinson's disease(APD) and explore the factors present among these important elements.

　Methods: A survey was conducted among PD self-help group patients and doctors and nurses providing APD care in Japan using a questionnaire created through qualitative analysis of literature.

　Results: The survey received 158 responses. Descriptive statistics and factor analysis revealed three important factors and 14 elements of home care continuation for patients with APD, including multidisciplinary management, self-care, and access to specialized doctors, and five important factors and 20 elements of home care discontinuation, including caregiver support, nursing care needs, psychiatric symptoms, fall experience, and difficulty with excretory movements. Furthermore, the Cronbach alpha coefficients of the factors were generally good, falling between 0.736 and 0.956.

　Conclusion: This survey revealed eight important factors and 34 elements related to home care continuation or discontinuation for patients with APD. These findings can be used as an assessment tool for supporting home care.