訪問サービスを利用する一人暮らし男性高齢者が地域社会から孤立を強めるプロセス

The process of increased isolation from the community of single elderly men who use home-visit services

要旨：訪問サービスを利用しながら都市部で一人暮らしをしている男性高齢者が地域社会から孤立を強めるプロセスを明らかにし，訪問作業療法による支援への示唆を得ることを目的に，対象者11名に面接調査を行い，修正版グラウンデッド・セオリー・アプローチに準拠して分析した．その結果，【一貫した自分を探す】，【人との相互作用から自分を認識する】，【孤立を強める不活発状態】の3つのカテゴリーと8つのサブカテゴリー，26の概念が抽出された．訪問作業療法において社会的孤立を予防するためには，人生の一貫性や諦めた作業についての対象者の認識，経済状態などを評価しながら，心理面や人との繋がりの支援をすることが重要だと考えられる．

　This study aimed to clarify the process of increased isolation from community life of elderly men living alone and using home-care services in urban areas. To clarify the support provided by home care occupational therapy, interviews with 11 subjects were analyzed in accordance with a modified version of the grounded theory approach, and 26 concepts from eight subcategories of the following three main categories were extracted:“searching for coherent self”, “inactive state that intensifies isolation” and “recognizing self from interactions with people”. The “inactive state that intensifies isolation” can be avoided if “searching for coherent self” and “recognizing self from interactions with people” are positively understood; A negative understanding leads to the “inactive state that intensifies isolation”. The subjects can be characterized as having difficulties in daily life while being on the verge of being isolated due to being elderly, chronically ill, and without family or friends to depend upon. Moreover, the subjects were living alone and were confined by poor economic conditions and living environments that alienate people from each other. To prevent social isolation, it is important to support the psychosocial and participative aspects, while home care therapy should consider coherency in life, subjects' attitudes toward work that they have given up on, economic conditions, and other factors.