在宅脳卒中後遺症者の心理的適応の構造

Adjustment of disorder on stroke survivors:A structural model

要旨：地域生活における障害者の再適応の心理的過程について実証的な研究は少ない．本研究では在宅脳卒中後遺症者を対象として心理的適応の構造モデルを構築し，共分散構造分析によりその妥当性の検証を行った．その結果，モデルの妥当性が検証された．在宅脳卒中後遺症者では，ADLの向上によって自分で実際に行動を起こし，様々な成功体験などをもつことにより自分に対する自己価値が高くなり，障害に対して受容し肯定的となることが実証された．ADLの獲得は間接的に本人の心理面に大きく影響を及ぼしており，心理的適応において重要な要素であることが示されたが，ADL向上が心理的適応に及ぼす限界も示唆された．

　Purpose : To clarify the relationships between characteristics of stroke and psychological variables such as "acceptance of disorder," "self-efficacy," and, "self-esteem" in stroke survivors. Subjects : Stroke survivors who are living at home. Method : The model was structured by psychological factors related to adjustment, ability to perform activities of daily living (ADL). Result : Higher self-efficacy subjects have higher self-value, lower anxiety and depression, and have a positive image of their disability. Independence in ADL works at the psychological phase, resulting in change of behavior. Discussion : In this study, we clarified that the ADL independence is an important variable leading to the acceptance of the disorder. Acceptance of disorder is not influenced directly by other factors except inner self-value. To improve self-value would improve the Adjustment of the disorder.