精神科病院における入院長期化の予測因子に関する研究—精神科リハビリテーション行動評価尺度(REHAB)を用いた社会機能における後方視的研究

Predictive Factors on Long-term Hospitalization in a Psychiatric Hospital:A retrospective study of social function for Schizophrenia by Rehabilitation Evaluation Hall and Baker(REHAB)

抄録　本研究は，1年以上の長期入院を予測するための指標を社会機能の観点より後方視的に探索することを目的とする。精神科病院入院中にRehabilitation Evaluation Hall and Baker(REHAB)の評定対象となった統合失調患者174人を，1年未満群(n＝39)と1年以上群(n＝135)の2群に分け，属性およびREHAB逸脱行動，全般的行動の合計5因子，16項目についてt検定を行った。次に，t検定で有意差がみられた変数を説明変数，入院1年後の転帰(入院の有無)を目的変数として多重ロジスティック回帰分析を行った結果，「社会生活の技能」因子において有意な関連が認められた。さらにROC曲線を用いた検討により，カットオフ値は13.7点となり，「社会生活の技能」が長期入院を予測する因子となり得ることが示唆された。

　The purpose of this study was to retrospectively examine the predictive factors of more than one year's long-term hospitalization in a psychiatric hospital in terms of social function. 174 schizophrenic inpatients in a psychiatric hospital who were evaluated by Rehabilitation Evaluation Hall and Baker(REHAB)were assigned into two groups of “less than one-year group”(n＝39)and “over one-year group”(n＝135). A t-test was performed with two groups on the demographic data, REHAB Deviant Behavior subscales, REHAB total score, 5 factors and 16 items of General Behavior. As a result of multiple logistic regression analysis which was conducted using with the variables significant difference in t-test as explanatory variables and outcome after one year in hospitalization as objective variables, only “Community skills” factor indicated the significant association with outcome as objective valuables. Furthermore, a receiver operating characteristic(ROC)curve analysis showed 13.7 point as the cut-off values for over a year hospitalization. The paper concludes with the recommendation that the factor of “Community skills” could be a predictive factor for long-term hospitalization.