日本語版便秘評価尺度の検討

A Developmental Study of the Japanese Version of the Constipation Assessment Scale

　McMillanとWilliams（1989）が開発した，Constipation Assessment Scale（CAS）を一部改変して，わが国で広範な対象書利用できる日本語版便秘評価尺度を作成し，その信頼性と妥当性を検討した。健康学生313名（男，86名；女，227名；平均年齢19.7±1.5歳）をフィールド・テストの対象とした。スケールの評価期間は原版と同じ過去1週間（MT版）の他に，当日または過去数日間（ST版）と過去1か月間（LT版）を設けて調査を実施した。その結果，再テスト法書よる信頼性係数rは0.84から0.93（p＜0.001），Cronbachα係数は0.69から0.78で，その信頼性は原版と同程度に高かった。また，対象の中から抽出した便秘群と正常群のCAS得点を比較すると，前者の得点が有意書高く（p＜0.001），スケールの妥当性が示された。また，女性のCAS得点が有意書高く，性ホルモンと排便習慣の関係についても検討した。

　The Constipation Assessment Scale (CAS) was developed originally by McMillan & Williams (1989) to assess the presence and severity of constipation in the clinical setting. The purpose of this study was to reform the CAS partially and prove the validity and reliability of the Japanese version of CAS (J-CAS), in order to make the tool avaliable for constipated patients also in our country. The authors created the three assessment terms of CAS, which are short term (ST, now or during a few days), middle term (MT, during the past week ; the same term as the original CAS) and long term (LT, during the past month) versions, because we consider the effect of the cycle of sexual hormones on gastrointestinal motility and aimed to apply the CAS to general subjects, i. e., from children to the elderly. Instead of the three-point summated rating scale of the original CAS, constructed from “no problem” to “severe problem”, we adopted three rating scales different in each items. The sample consisted of 313 healthy students (86 men and 227 women ; the mean age, 19.7±1.5 yrs). The testretest reliability of the J-CAS was proved by a Pearson product-moment correlation coefficient (r=0.84-0.93, p＜0.001). And Cronbach a coefficients were 0.69-0.78 in three types of J-CAS. A significant difference was seen between the mean LT J-CAS score of the constipated group and that of the normal one (p＜0.001). These values are acceptable and similar to those of the original tool, and support that the J-CAS is valid and reliable for assessment tool of constipation. We also clarified the women's scores of the J-CAS were significantly higher than those of men in younger generation (p＜0.001), and disucuss the reason of it.