地域在住中年女性の尿失禁に対する主観的判断と対処に関する質的研究─尿失禁による作業機能障害に対して作業療法が果たす役割

A qualitative study on the objective judgement and coping strategies of middle-aged women with urinary incontinence: The role of occupational therapy on occupational dysfunction due to urinary incontinence

要旨：尿失禁のある地域在住中年女性は，作業機能障害である可能性が高い．そのため，尿失禁に対する主観的判断と対処を明らかにし，作業療法の対象となるか否かを考察した．17名に半構成的面接を行い，修正版グラウンデッドセオリーで分析した．その結果，価値カテゴリー3個，主観的判断カテゴリー8個，対処カテゴリー8個が生成された．尿失禁の対処行動の背景には，中核となる価値観があった．主観的判断の変化に伴い，自己管理的対処から改善志向的対処へと移行していくプロセスが明らかとなった．本研究対象者の尿失禁は軽度であるが，作業機能障害の状態にあったため，排尿機能の知識を有する作業療法士による介入の必要性が示唆された．

　The purpose of this study was to clarify the objective judgement and coping strategies of middle-aged women with Urinary Incontinence (UI). We also examined whether they were suitable for occupational therapy on the basis of occupational dysfunction due to UI. The subjects comprised 17 community-dwelling middle-aged women. Data were collected via semi-structured interviews and analyzed using the modified grounded theory approach. The results suggest that there were 3 categories for worth, 8 for subjective judgment and 8 for behavioral coping. The worth categories lied behind coping of UI. The subjective judgement categories caused a change from ‘self-management of UI' to ‘action for improving UI' in behavioral coping categories. This study described the process of category transitions. The study subjects had mild UI. However improvement in UI may require intervention by an occupational therapist with knowledge of the urinary functions, because there was evidence of occupational dysfunction due to UI.