左半側無視のある患者を介護する主介護者の「困り事」

The burdens of primary caregivers caring for patients with left unilateral neglect

要旨：在宅生活を営む左半側無視患者の主介護者の「困り事」を知るために，面接調査を行い質的手法にて分析した．その結果，主介護者の「困り事」は(Ⅰ)患者への対応，(Ⅱ)介護者自身の心身のケアやコントロール，(Ⅲ)周囲との対応や調整，以上3種の領域から成ると考えられた．また，患者の人格変化や意欲低下，記憶障害，左半側無視，病識や自己能力認識の低下，状況認識の悪さ，情動的側面の無理解などの神経心理学的障害が介護者の「困り事」に影響していると推察された．さらに患者の症状のわかりにくさや臨床家の説明不足，介護者自身の体調不良，そして医療福祉サービスの不適切さが主介護者の「困り事」の要因となっていることも示された．

　The main purpose of this study was to clarify the burdens of primary caregivers caring for patients with left unilateral neglect and to consider the structure and factors affecting their burdens. I interviewed primary caregivers living in their homes. The data were analyzed with a qualitative method. Three domains emerged as the burdens of the caregivers: (Ⅰ) coping with the patient, (Ⅱ) caring for and controlling their own health and well-being, (Ⅲ) adjusting and harmonizing in relationships with others. In addition, neuropsychological problems of the patients, such as personality change, motivation decline, unilateral neglect, memory deficits, poor insight into their abilities/disabilities, cognitive difficulties, and lack of emotional recognition also affected the caregiver's burdens. Furthermore, the complicated nature of the symptoms, inadequate explanations by the healthcare professionals, caregiver's own health problems and inappropriate health services were indicated to be the factors of the primary caregivers' burdens.