ICFを用いた要介護高齢者の生活機能の評価―「活動と参加」領域に着目して─

Assessment of activities and the participation domain based on the ICF for the elderly requiring care

要旨：ICFの「活動と参加」の評価を通して，要介護高齢者における生活機能低下の全体像を把握することを目的に調査を実施した．要介護高齢者672名を対象に，ICFの「活動と参加」の第2レベル73項目について，「実行状況」と「能力」の両面から評価点を評価し，Item Indexとしてそれぞれの困難度を求めた．「活動と参加」における領域ごとの比較では第5領域「セルフケア」のItem Indexが最も低くなり，「実行状況」で37.7，「能力」で34.4となった．逆に高くなったのは第6領域「家庭生活」であり，それぞれ89.6，77.7となった．本研究の結果は要介護高齢者の生活機能低下の現状と評価手段としてのICF活用の可能性を示すものである．

　The purpose of this study was to understand the degree of functioning and disability level in elderly requiring care through the evaluation of each domain of “activity and participation” in ICF. The study investigated 672 elderly requiring care. In the investigation, regarding the 2nd level of 73 “activity and participation” domains in the ICF, the elderly were evaluated from “performance” and “capacity”, and then converted to the Item Index. Subsequently, each item was evaluated, and the degree of difficulty for both performance and capacity was determined. In the comparison of both performance and capacity, the Item Index of Chapter 5 “SELF-CARE” was the lowest, while “performance” was 37.7, and “capacity” was 34.4. Conversely, the Item Index of Chapter 6 “DOMESTIC LIFE” became higher; it was 89.6 and 77.7 respectively. The results indicate the degree of both dysfunction and disability of the elderly requiring care, and also demonstrate the possibility of the ICF as an assessment tool.