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Japanese Occupational Therapy Research Volume 37, Issue 3 （June 2018）

作業療法 37巻3号（2018年6月発行）

Japanese English

◆研究論文

乳がん術後患者の健康関連QOL関連因子の解明—肩関節可動域と術後自覚症状の影響について Clarification of health-related QOL-related factors for breast cancer patients: Influence on the range of shoulder joint movement and subjective postoperative symptoms 佐野哲也 ^1,2 , 泉良太 ³ , 小川元大 ⁴ , 能登真一 ⁵ Tetsuya Sano ^1,2 , Ryota Izumi ³ , Motohiro Ogawa ⁴ , Shinichi Noto ⁵ ¹すずかけヘルスケアホスピタルリハビリテーション技術部 ²新潟医療福祉大学大学院医療福祉学専攻（博士後期課程） ³聖隷クリストファー大学リハビリテーション学部作業療法学科 ⁴浜松医科大学医学部附属病院リハビリテーション部 ⁵新潟医療福祉大学医療技術学部作業療法学科 ¹Department of Rehabilitation, Suzukake Health Care Hospital ²Doctor Course, Major in Health and Welfare, Graduate School of Niigata University of Health and Welfare ³Department of Occupational Therapy, Seirei Christopher University ⁴Department of Rehabilitation, Hamamatsu University School of Medicine ⁵Department of Occupational Therapy, Niigata University of Health and Welfare キーワード：乳がん , 健康関連QOL , 肩関節 , Breast cancer , Health-related QOL , Shoulder joint Keyword: 乳がん , 健康関連QOL , 肩関節 , Breast cancer , Health-related QOL , Shoulder joint pp.276-284

発行日 2018年6月15日 Published Date 2018/6/15

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要旨：入院中に作業療法を実施した乳がん術後患者52名を対象に，術前から術後3ヵ月の経時的変化を肩関節可動域（肩関節屈曲・外転角度），術後自覚症状（術部の痛み・つっぱり感・病気に対する不安感），健康関連QOL（HRQOL）尺度のFACT-BとEQ-5D-5Lを調査し，HRQOLの関連要因の検討を行った．その結果，肩関節可動域は術前から術後3ヵ月時点でも有意に低下し，術後自覚症状は，術後から3ヵ月目で有意な改善を認めた．重回帰分析の結果からFACT-B，EQ-5D-5Lに影響を与える因子として，術後1ヵ月・術後3ヵ月における不安感が有意な因子として抽出された．HRQOL改善には機能面のみでなく術後自覚症状が影響を与える可能性があると考えられた．

　52 post-operative breast cancer patients undergoing occupational therapy during hospitalization were investigated. Temporal changes for 3 months from pre-operation to post-operation in terms of the range of shoulder joint movement (flexion of shoulder joint/abduction angle), postoperative subjective symptoms (pain of surgical site/stretched feeling/feelings of anxiety), and health-related QOL (HRQOL) scale: FACT-B and EQ-5D-5L, were examined, along with HRQOL-related factors. As a result, the range of shoulder joint movement was significantly decreased even from pre-operation to 3 months after surgery, but the subjective symptoms were significantly improved in the third month after surgery. Considering the results from a multi-regression analysis, anxiety during the first and third month after surgery was extracted as a significant variable in terms of factors influencing on FACT-B/EQ-5D-5L. Thus, functional aspects and postoperative subjective symptoms could possibly influence the improvement of HRQOL.