訪問看護を利用する慢性疾患高齢者へのセルフモニタリング教育のヘルスリテラシー向上に関する効果：非ランダム化試験

Effect of Self-Monitoring Education on Health Literacy Among Older Adults With Chronic Disease Who Use Home Visiting Nursing Services: A Non-randomized Study

要旨

　目的：訪問看護を利用する慢性疾患高齢者にセルフモニタリング教育プログラムを実施し，ヘルスリテラシー（HL）向上効果を明らかにする．

　方法：対象者は訪問看護を利用する慢性疾患療養高齢者，介入群40名，対照群42名であり，非ランダムに割りつけた．介入群に教育介入を実施し，ベースライン，介入終了1週間後，3カ月後，6カ月後に自記式質問紙調査と訪問看護書類から情報収集した．HLはFCCHL尺度，健康関連QOLはSF-12を用い，反復測定による共分散分析，入院期間は日数で把握し，Mann-WhitneyのU検定にて評価した．

　結果：HLは合計得点に群と時間の交互作用を有意に認めたが（F（3,71）＝7.53，p＜.001），健康関連QOLは交互作用を認めなかった．介入終了6カ月間の入院日数は介入群は対照群に比べ有意に短かった（U＝3.50，p＜ .001）．

　結論：訪問看護を利用する慢性疾患高齢者へのセルフモニタリング教育は，HL 向上効果と入院期間短縮の可能性が示唆された．

　Aim: This study implemented a visiting nursing services self-monitoring education program for older adults with chronic diseases and examined its effectiveness in improving their health literacy.

　Methods: The participants were older adults aged 65 years and above who had a chronic disease and used home-visit nursing care. They were non-randomly assigned to the intervention group(n=40) and control group(n=42). The self-monitoring education program was conducted with the intervention group. Self-administered questionnaire surveys were conducted and visiting nursing documents were examined at baseline and at, one week, three months, and six months after the program. Health literacy was examined using the Functional Communicative Critical Health Literacy Scale, and health-related quality of life was examined using the Medical Outcomes Study 12Item Short-Form Health Survey. The duration of hospitalization was also recorded. Health literacy and health-related QOL were analyzed using covariance analysis, and duration of hospitalization was evaluated using the Mann-Whitney U test.

　Results: A significant group by time interaction was observed for the total health literacy score(F(3, 71)=7.53, p＜.001), but no interaction was observed for health-related quality of life. The number of days of hospitalization at six months after intervention was significantly shorter in the intervention group than in the control group(U=3.50, p＜.001).

　Conclusion: The results suggest that self-monitoring education for older adults with chronic diseases using visiting nursing services may be effective in improving their health literacy and shortening the hospitalization duration.