「冷え症」の概念分析

“Sensitivity to Cold”: A Concept Analysis

要旨

　目的：「冷え症」の概念分析を行い，冷え症の定義を明確にすることを目的とする．

　方法：Rodgersの概念分析のアプローチ法を用いた．データの収集方法は5つのデータベース，CINHAL Plus with Full Text(1982-2008)，MEDLINE(1966-2008)，Web of Science(1999-2008)，医中誌Web(1983-2008)，J-stage(1966-2008)を使用し，検索用語は，「chilliness」「chilly」「Hiesho」「poor circulation」「sensitivity to cold」とした．日本語では「冷え症」のみとした．その結果41文献全部を対象に概念分析を行った．

　結果：3つの属性，①「冷えている」という自覚がある，②温度較差が大きい，③寒冷刺激暴露後の皮膚温の回復が遅いと，2つの先行要件，①生体的要因(内的因子)，②環境的要因(外的因子)が抽出された．さらに4つの帰結，①マイナートラブル，②苦痛，③対処行動，④病気の誘因が導き出された．分析の結果，本概念を「中枢温と末梢温の温度較差がみられ，暖かい環境下でも末梢体温の回復が遅い病態であり，多くの場合，冷えの自覚を有している状態」と定義した．

　結論：冷え症は先行要件から，生活環境の乱れなどが誘引となるため，予防医療の視点からも，生活環境の見直しへのケアに有用であるといえる．しかし，研究対象に民族的な偏りがあったため，今後は民族的側面からの研究が必要である．

Abstract

　Aim：The purpose of this study was to conduct a concept analysis and specific definition of “sensitivity to cold.”

　Method：Relevant literature was identified from five databases：CINHAL Plus with Full Text (1982-2008), MEDLINE (1966-2008), specialist in Web of Science (1999-2008), Ichushi Web (1983-2008), J-stage (1966-2008), using the “Chilliness”“Chilly”“Hiesho (chilly disposition)” “Poor circulation”“Sensitivity to cold.”Forty-one articles were retrieved. Meeting the criteria were 41, which were analyzed using Rodgers's concept analysis model.

　Results：Three attributes of the concept “sensitivity to cold”were identified：1)awareness of “sensitivity to cold”；2)large differences in core and extremity temperature and 3)slow recovery of skin temperature after a low temperature stimulus revelation. Two antecedents were identified：1) an internal biologic factor and 2) an external environmental factor . Four consequences were identified：1)minor discomfort, 2) pain, 3) coping behavior and 4) illness motive. As a result of analysis, this concept was defined as：a state where there existed a temperature range from core temperature and extremities temperature, and slow recovery of the tip body temperature in a warm environment with the subject usually having an awareness of cold sensation.

　Conclusions：A prophylactic medical viewpoint would indicate that the antecedent most accessible to intervention is the client's living environment and that it be reviewed in detail. However,ethnicity as a possible factor was also detected in the study,therefore research focusing on an ethnic level of analysis is important.