在宅で終末期を迎える人を介護する家族の予期悲嘆尺度の開発

Development of an Anticipatory Grief Scale for Family Caregivers of a Person Dying at Home

要旨

　目的：在宅で終末期を迎える人を介護する家族の予期悲嘆尺度を作成し，その信頼性，妥当性を検証することである．

　方法：文献検討と予備調査を基に，尺度の質問原案51項目を作成した．終末期の家族を介護する「ターミナル家族」 99名から有効回答が得られ，比較群として「非ターミナル家族」（68名）にも調査し分析した．

　結果：項目分析，因子分析の結果，19項目4因子「お別れ準備へのスピリチュアルペイン」「身体と生活の疲労感度」「死別への先行不安」「消耗状態」からなる尺度を作成した．本尺度は，Cronbach's α係数（0.87）など複数の信頼性係数が0.85以上で十分な内的整合性が確認できた．外的基準としたGHQ28により基準関連妥当性，また，ターミナル家族と非ターミナル家族の比較により構成概念妥当性が確認できた．

　結論：本尺度は信頼性と妥当性が確認でき，在宅で終末期を迎える人を介護する家族に活用できる可能性が示唆されたが，さらに尺度を洗練させる必要がある．

Abstract

　Purpose: To develop an Anticipatory Grief Scale for Family Caregivers (AGSFC) of a person dying at home and analyze its reliability and validity.

　Methods: Based on a review of the literature and our previous study, a temporary scale consisting of 51 items was prepared. The scale was conducted on 99 families who were caring for a family member dying at home. As a control group, the scale was also conducted on 68 families who were providing care for a family member with a non-terminal disease.

　Results: As a result of factor analysis, 4 factors (spiritual pain in preparing for a loss, physical and mental fatigability in daily life, precedent anxiety regarding bereavement, and exhaustion) comprised of 19 items were extracted. The reliability of the scale was confirmed by a Cronbach's alpha internal consistency reliability coefficient of 0.87 (0.70-0.85 for subscales). The criterion-related validity was confirmed by comparison with the 28-item General Health Questionnaire (GHQ28) scores. Construct validity was confirmed by comparison between families caring for a family member in the terminal stage and families providing care for a family member with a non-terminal disease.

　Conclusion: The reliability and validity of the AGSFC were confirmed. Therefore, this scale may be suitable for use with family caregivers of a person dying at home. Further, it is necessary to refine this scale.