ADL能力によるホームエバリュエーション施行の必要性の判別に関する研究—脳卒中片麻痺患者における検討

Discriminant analysis of the necessity for home evaluation based on activities of daily living in hemiplegic stroke patients

要旨：研究仮説を，「脳卒中患者におけるホームエバリュエーションの必要性の有無は，総合的なADL評価に基づいて判別がある程度可能である」とし，研究を行った．1994年から1999年に関東労災病院に入院した片麻痺を伴った94例の脳卒中患者のカルテより，FIMによるADL能力評価とホームエバリュエーション施行の有無を調べた．FIMデータを説明変数，ホームエバリュエーション施行の有無を目的変数とし，施行の必要性の判別を多変量解析にて行った結果，79.8％の判別精度を持つ判別関数式の算出が可能であった．判別分析を利用した判別関数式は，ホームエバリュエーションを行うにあたり，ある程度まで有用な指標になり得るものと考えられた．

　There is a need for empirically derived models that can discriminate the necessity of a home evaluation. However, presently only a few reports are available. In the present study, we investigated whether or not we were able to discriminate the necessity of the home evaluation based on the data of activities of daily living (ADL) in stroke patients.

　The subjects included 94 hospitalized hemiplegic patients with stroke at the Kanto-Rosai Hospital between 1994 and 1999, who were discharged to their home after reaching the rehabilitation goal. Forty patients underwent the home evaluation during hospital stay, while the remaining 54 patients did not. Data on the Functional Independence Measure (FIM) score were collected from the chart of patients for assessing ADL. There were significant differences in the length of hospital stay and the total score of the FIM between the two groups. Linear discriminant analysis was performed regarding home evaluation and the FIM score as a dependent variable and an independent variable, respectively. Validation of 79.8% was obtained from the elicited linear discriminant function, implying that the necessity of home evaluation can be discriminated based on the FIM score.

　These results suggest that the linear discriminant function may become a useful tool for applying the home evaluation to disabled patients.