Communication Burden Scale(COM-B)の妥当性の検証―失語症に特異的な介護負担感

The validity of the Communication Burden Scale (COM-B) : Aphasia-specific caregiver burden

　コミュニケーション関連の介護負担感尺度であるCommunication Burden Scale(COM-B：小林ら 2008)の基準関連妥当性，および失語症者家族における介護負担感の特徴について検討した．発症6か月以上経過した失語症者の主たる家族介護者51名に対し，自記式質問紙による配票調査を実施した．質問紙は①介護者の属性，②失語症者の属性，③介護者の介護負担感としてCOM-B，Cost of Care Index(CCI)，Zarit Caregiver Burden Interview(ZBI)，④介護者の精神的健康としてGHQ精神健康調査票から構成された．その結果，COM-B得点とCCI，ZBI得点との相関はそれぞれr＝0.60，0.69と有意であった．COM-B得点と失語重症度，GHQ得点との相関はそれぞれr＝0.43，0.49と有意であった．COM-Bの4下位領域の中で「家庭運営」は，他の介護負担感尺度得点との相関は低いが，GHQ得点を有意に予測した．COM-Bは失語症者家族の介護負担感を測定する尺度として妥当性を有しており，中でも「家庭運営」の領域は失語症に特有の負担感を測定するものと考えた．

　We evaluated the criterion-related validity of the Communication Burden Scale (COM-B: Kobayashi et al 2008), which focuses on the communication-related caregiver burden, and examined the characteristics of the burden felt by family members of people with aphasia (PWA).　The subjects were 51 family caregivers of PWA who were more than 6 months post-onset.　The caregivers were asked to fill out a self-assessment questionnaire.　The questionnaire consisted of the following sections: attributes of the family caregiver; attributes of the PWA; three tools for assessing the caregivers' burden, namely, the COM-B, the Cost of Care Index (CCI) and the Zarit Caregiver Burden Interview (ZBI); and the General Health Questionnaire (GHQ), which was used to assess mental health.　The results revealed that the correlation coefficients between the COM-B scores and the CCI and ZBI scores were significant (r=0.60 and 0.69, respectively).　The correlation coefficients between the COM-B scores and the severity of the aphasia of the PWA and the GHQ scores were also significant (r=0.43 and 0.49, respectively).　The correlation coefficients between scores of the "management of family affairs", which was one of the four domains of the COM-B, and the CCI and ZBI scores were relatively low.　However, the "management of family affairs" scores significantly predicted the GHQ scores.　We concluded that the COM-B is valid as a measure of caregiver burden and that the domain of "management of family affairs" reveals the burden specifically related to aphasia.