地域在住高齢者の健康関連QOLに対する作業参加，環境因子，運動量の影響—構造方程式モデリングを用いた検討

Effects of occupational participation, environmental factors, and amount of exercise on health related QOL for community-living elderly: A structural equation modeling approach

要旨：本研究の目的は，地域在住高齢者の健康関連QOLに対して，作業参加，環境因子，運動量がどのように影響するか統計学的に検証することである．対象は，地域活動などに参加している高齢者105名とした．横断研究デザインを用い，先行研究に基づいて作成した仮説モデルを構造方程式モデリングで検討した．結果，最終モデルの適合度は基準を満たし，標準化係数は環境因子から作業参加が0.574，作業参加から健康関連QOLが0.574，運動量から健康関連QOLが0.312となり，全て有意となった．地域在住高齢者の健康関連QOLに対して，環境因子と因果関係にある作業参加を促進することが，運動量のみに焦点を当てるよりも強い影響を与えることが明らかとなった．

　The purpose of this study was to statistically examine the effects of occupational participation, environmental factors and amount of exercise on the health related quality of life (QOL) of community-dwelling elderly. A cross-sectional survey of 105 community-dwelling elderly individuals participating in community activities and others was carried out. Our data were analyzed using structural equation modeling to estimate hypothetical models in accordance with previous studies. As a result, the appropriateness of the final model met the criteria. The standardized coefficients were 0.574 for occupational participation from environmental factors, 0.574 for health related QOL from occupational participation, and 0.312 for health related QOL from amount of exercise, all of which were significant. Therefore, it is clear that the promotion of occupational participation, which is causally related to environmental factors, has a stronger effect on health related QOL of elderly people living in the community than the focus on amount of exercise alone.