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Japanese Journal of Speech, Language, and Hearing Research Volume 8, Issue 2 （July 2011）

言語聴覚研究 8巻2号（2011年7月発行）

Japanese English

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在宅失語症者の家族の介護負担感評価 Development of a caregiver burden scale to assess feelings of burden in caregivers of adults with aphasia 小林久子 ¹ , 綿森淑子 ² , 長田久雄 ³ Hisako Kobayashi ¹ , Toshiko Watamori ² , Hisao Osada ³ ¹首都医校言語聴覚学科 ²広島県立保健福祉大学 ³桜美林大学大学院老年学研究科 ¹Department of Speech Therapy, Shuto Iko ²Hiroshima Prefectural College of Health Sciences ³Graduate School of Gerontology, J. F. Oberlin University キーワード：失語症 , 介護負担感評価 , COM-B , 妥当性 , 信頼性 , aphasia , assessment of caregiver burden , COM-B , validity , reliability Keyword: 失語症 , 介護負担感評価 , COM-B , 妥当性 , 信頼性 , aphasia , assessment of caregiver burden , COM-B , validity , reliability pp.104-112

発行日 2011年7月15日 Published Date 2011/7/15

DOI https://doi.org/10.11477/mf.6001100289

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　失語症者を在宅で介護する家族の介護負担感を評価する尺度(COM-B)を開発した．本研究では，まずその妥当性と信頼性を検証した．在宅で失語症者を介護している家族を対象にCOM-Bを用いた調査を行い，353名より得た回答を因子分析により解析した．その結果，COM-Bの29項目から次の4因子が抽出された．第1因子は家族の「生活拘束感」，第2因子は「言語症状関連の負担感」，第3因子は被介護者の言語以外の「感情や認知的症状による負担感」，第4因子は「家庭運営における負担感」であった．これらの下位尺度内の内的一貫性は高く，同条件の異なる対象で実施した再テスト法により比較的高い信頼性が確認された．さらに臨床応用の可能性を探る目的で，家族と言語聴覚士(以下，ST)のCOM-B評価点の相違を分析した．両者の評価点の一致度は低く，家族の感じる負担感は，STの推測とは質的に異なる可能性が示唆された．COM-Bの妥当性信頼性が検証され，臨床上の有用性も確かめられた．

　The Communication Burden Scale (COM-B) was developed to assess feelings of burden in caregivers of adults with aphasia.　The purpose of this study was to examine the validity and reliability of the COM-B and its clinical application as well.

　Three hundred and fifty-three informal caregivers of adults with aphasia participated in the study.　Factor-analytic statistical techniques were used to demonstrate construct validity.　Common variance that represents caregiver burden, was identified by the following four factors.　They were burdens related to:1．caregivers' activity restriction, 2．language impairment of adults with aphasia, 3．cognitive and emotional impairment of adults with aphasia, and 4．responsibility for household management.　Each of these factors consists of a group of items with high internal consistency.

　The test-retest reliability of the COM-B was examined using another group of caregivers with similar background.　The results confirmed a high reliability of r＝.78～.84.　Clinical application of the COM-B was examined by comparing the COM-B ratings of caregivers with those of speech-language-hearing therapists (SLHTs).　It became clear that there was rarely complete agreement between the ratings of the caregivers and the ratings of the SLHTs.　The results can be interpreted as showing the difference between the two groups in the perception of burden felt by caregivers.

　In summary, the COM-B's validity and reliability were confirmed and it was suggested that the use of the COM-B may broaden the view of SLHTs who work with adults with aphasia and their family.