集団治療場面での行動観察に基づく生活類型の評価尺度（第1報）—尺度の作成と信頼性の検討

Discriminating “Seikatsu Ruikei” or Life Trait of Schizophrenics in Group Psychotherapy Situation (Part 1): Establishment of the scale and confirmation of the reliability

【抄録】　生活類型（能動型・受動型）の概念は精神分裂病圏患者の援助活動の指針となるが，その具体的判別基準は存在しなかった。我々は集団治療場面での生活行動観察に基づき生活類型を判別する尺度の開発を行った。典型的な生活類型を示す東大病院精神神経科デイホスピタル（DH）終了症例の生活行動特徴の記述内容をKJ法でまとめ，予備的検討で項目を整理して，4つの下位尺度（新奇性・持続安定性・競争性・不適切性），8項目の生活類型評価尺度が作成された。本尺度を用いてDH在籍者の評価を行い，尺度の内的整合性，再検査信頼性，評価者間信頼性の検討を行った。Cronbachαが0.859，Spearmanの順位相関係数が0.831，ANOVA ICCが0.886と尺度の信頼性が確認された。

　Seikatsu Rinsho, or treatment according to observed life patterns, is a Japanese theory about the aberrant patterns of social life exhibited by schizophrenics. The characteristic approaches to life shown by schizophrenics have been differentiated into two clusters: 'active' and 'passive' traits. The concept of life traits, or Seikatsu Ruikei. provides a useful therapeutic guideline for psychosocial rehabilitation. However, the concrete criteria for discrimination of life traits remain to he established.

　So we make a scale discriminating life traits by assessing the behavior of schizophrenics observed in a psychiatric day treatment center at Tokyo University Hospital, so called Day Hospital (DH). The experienced therapists (two psychiatric doctors and five nurses) selected 56 cases with typical life traits who finished DH treatment, and described their characteristic behaviors relating to life traits. We sorted and rearranged those descriptions, using the Kawakita Jiro method. and selected items according to the preliminary results. We finally established a life trait discrimination scale with four subscales (novelty, durability/stability, competitive tendency, inappropriate behavior) composed of eight items.

　We assessed the scale for internal consistency, test-retest reliability and interrater reliability, and confirmed the high reliability of the scale (Cronbach α=0.859, Spearman's rank correla-tion=0.831, ANOVA intraclass correlation coefficients=0.886).