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要旨:我々は,活動や参加レベルの向上を支援する「生活目標設定手法(Life Goal Setting Technique:LGST)」を導入し,関係多職種が連携する介護予防ケアマネジメントを考案した.これを通所型介護予防教室参加者に実施し,クラスター非ランダム化比較試験を用い,介護予防と主観的健康感の向上に及ぼす効果を12週間の教室開始時,終了時と教室後3ヵ月時,6ヵ月時に調査した.結果,介護予防効果の指標とした基本チェックリストの該当基準による予防事業対象者から非該当者に変化した割合は,介入群は約60%で,対照群の約40%に比べ有意に高く,主観的健康感も高かった.介護予防効果は教室後3ヵ月間持続することも明らかとなった.
Objective: We sought to determine the effects of the Comprehensive Life Goal Setting Technique method of Preventive Care Management (C-LGST-PCM), which supports achievement of life goals regarding Activity and Participation Level (APL) using a multidisciplinary team for preventive care outcomes in a preventive care program for frail community-dwelling elderly. Methods: This was a cluster-nonrandomized controlled trial. Participants were frail older people living in Izumi, Osaka, Japan, all of whom attended weekly 120-min preventive care exercise classes over 3 months. We compared the C-LGST group, which introduced the C-LGST-PCM, and a control group. We introduced the C-LGST-PCM from the assessment stage at a community center and assessed outcomes by comparing baselines and follow up at 3, 6, and 9 months. The primary outcome measure was preventive care outcomes according to the Kihon Checklist for assessment of frailty, which was analyzed by chi-square test. Results: No significant differences were found between the two groups for any variables. Improvement as per the Kihon Checklist for the C-LGST group was approximately 60% from baseline to the 9-month follow up;the control group improved by approximately 40%. The difference between groups was significant both at 3 and 6 months (p=0.039), but not at the 9-month follow up. Conclusion:This study shows that C-LGST-PCM, which supports achievement of life goals for APL by a multidisciplinary team, benefited preventive care outcomes in a preventive care program for frail community-dwelling elderly. Furthermore, the effect of preventive care was maintained after 6 months.
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