成人期発症1型糖尿病患者におけるセルフケア能力に関連する心理・社会的要因

Psychosocial and social factors related to self-care agency in patients with adult-onset type 1 diabetes

　本研究の目的は，成人期発症1型糖尿病患者のセルフケア能力に関連している心理・社会的要因を明らかにすることである．成人期に1型糖尿病と診断された患者98名を対象に，無記名の自記式質問紙調査を実施し，セルフケア能力と，病気の不確かさ，首尾一貫感覚（SOC），家族サポートとの関連を共分散構造分析で解析した．有効回答者数は92名であった．分析の結果，セルフケア能力に関連する要因は，家族サポート，病気の不確かさの下位尺度＜情報解釈の複雑性＞，SOCであった．また，セルフケア能力には，家族サポートと病気の不確かさの下位尺度＜闘病力への自信の揺らぎ＞＜生活予測不能性＞から，SOCを介した間接効果も認められた．家族サポートからセルフケア能力への直接効果と総合効果が，他のパス係数と比較して高値であったことから，家族サポートがセルフケア能力に及ぼす影響が大きいと考えられ，家族によるサポートを支援する看護ケアの重要性が示唆された．

　This study aims to identify psychological and social factors related to the self-care abilities of patients with adult-onset type 1 diabetes. A self-rating anonymous questionnaire was administered to 98 patients. The inclusion criteria for the study were that participants were diagnosed with type 1 diabetes in adulthood. The relationship between self-care abilities, uncertainty in illness, sense of coherence (SOC), and family support were analyzed using the covariance structure analysis. We collected 92 valid responses. The results showed that factors related to self-care abilities in adult-onset type 1 diabetes are family support and Complexity of interpretation of information, which is a subscale of uncertainty in illness, and SOC. In the family support and instability of self-confidence in carrying on a struggle sufficient concurrent illness and unpredictability of daily life among the subscales for uncertainty in illness, it was suggested that self-care ability indirectly affects the SOC. It may be inferred that family support has a significant influence on self-care ability. Both the direct and total effect of family support on the self-care agency were higher than other pass coefficients, and the importance of the nursing care to support family support was suggested.