作業参加が健康関連QOLに及ぼす影響の1年間の変化—健康中高年者のコホート研究

A one-year change in the effect of occupational participation on health-related QOL: A cohort study of healthy middle-aged and elderly people

要旨：意味のある作業への従事（作業参加）は，健康・well-beingにとって重要だが，その疫学的根拠は乏しい．本研究では，作業参加が健康関連QOL（SF-36v2で測定）に及ぼす1年間の影響を明らかにすることを目的とし，地域中高年者460名を対象に1年間の追跡調査を実施した．各自の作業参加の変化量により「維持・向上群」と「低下群」を設定し，SF-36v2の各尺度の群間差と群ごとの継時的変化を検討した結果，維持・向上群の方がSF-36v2の全尺度で良好であった（p＜.05）．さらに肯定的影響は早期に発現しその後維持される傾向が，否定的影響は半年以上の期間を経て発現する傾向が見出された．本結果は，健康増進・予防的作業療法の疫学的根拠の一つとなる．

　Occupational participation is important for health and well-being, but epidemiological evidence for this theory has been inadequate. The present study aimed to clarify the influence occupational participation has on health-related QOL for one year. We conducted a one-year follow-up survey of 460 community-dwelling healthy middle-aged and elderly individuals in A Prefecture, Japan. Two groups were established: the maintenance and improvement group, and the deterioration group. Using the one-year survey on occupational participation, the differences between the two groups and the influence occupational participation had during one year on health-related QOL were examined and compared. Results have demonstrated that the maintenance and improvement group performed better on all scales of the SF-36v2 over one year (p<.05) compared to the other group. Moreover, results suggest that positive influences tend to develop early and are maintained thereafter, whereas negative influences tend to develop after 6 months. The results of this study can be used as epidemiological evidence for health promotion and preventive occupational therapy.