身体障害を有する地域在住高齢者における作業的挑戦，作業参加，作業機能障害，抑うつ，健康関連QOLの構造的関連性の検証

Analysis of structural relationships among occupational challenge, occupational participation, occupational dysfunction, depression, and health-related QOL in community dwelling elderly with physical disabilities

要旨：本研究では，身体障害を有する地域在住高齢者164名を対象に作業的挑戦，作業参加，作業機能障害，抑うつ，健康関連QOLの構造的関連性を検証した．方法は横断研究を用い，仮説モデル1（作業的挑戦が作業参加を促進し，作業機能障害を軽減し，抑うつを改善する），および仮説モデル2（作業的挑戦が作業参加を促進し，作業機能障害を軽減し，健康関連QOLを改善する）を共変量の有無で評価した．その結果，いずれも共変量なしの仮説モデルが採択された．作業的挑戦は作業参加を促進，作業機能障害を軽減し，抑うつや健康関連QOLの改善に関与した．作業的挑戦への介入は，身体障害を有する地域在住高齢者の抑うつや健康関連QOLを改善する可能性がある．

　This study examined the structural relationship of occupational challenges, occupational participation, occupational dysfunction, depression, and health-related QOL for 164 elderly with physical disabilities living in the community. This study examined two hypothesis models in a cross-sectional study. Hypothesis model 1 assumed that occupational challenge promotes occupational participation, reduces occupational dysfunction, and alleviates depression. Hypothesis model 2 assumed that occupational challenge promotes occupational participation, reduces occupational dysfunction, and improves health related QOL. Each hypothesis model compared the case with and without covariates. As a result, all hypothesis models were adopted without covariates. We found that occupational challenge promotes occupational participation, reduces occupational dysfunction, alleviates depression, and improves health-related quality of life. Occupational therapists will contribute to the lifestyle redesign by intervening in an occupational challenge.