慢性病者の医療ケア上における自己決定に関する認識と行動および影響要因の検討

Investigation of Recognition and Behavior Concerning Self-Determination, and Effect Factors on Medical Care of Chronic Patients

要旨

　本研究は, 慢性的な症状を抱えながら生活している, 日本人中高年者の医療ケア上の自己決定の認識と行動および影響要因を検討することを目的として実施した. 調査は, 現在通院中の30歳～75歳までの慢性病患者310名を対象とした自記式質問紙調査で, 自己決定の認識と行動の実際, またその影響要因を探索するため統計学的検討を行った. 医療ケア上の自己決定に関する認識は, 情報希求と意思決定希求の2側面で測定した. その結果, 全体に高い情報希求度が示された. 年齢による有意差はみられなかったが, 性別では, 女性のほうが情報希求度は高いことがわかった. また, External 傾向な人ほど, 情報希求が高く, 情報に依存しやすい傾向が示唆された. 一方, 意思決定希求に関しては, 年齢や教育年数, 医療者との関係性等において統計的有意差がみられ, 影響が示唆された. 自己決定行動は, 生活の実際的な調整が生じるような機会では, 女性が決定者となることが多いことが明らかになった. しかし, 自己決定行動と自己決定に関する認識を示す得点との間には, 統計的関連はみられなかった．

Abstract

　This study was for investigating recognition and behavior concerning self-determination and effect factors on medical care of the middle-aged Japanese living with chronic symptoms. Self-describing type questionnaires were used for research on 310 chronic patients of 30 to 75 years of age, and demographical investigation was conducted for searching actual state of recognition and behavior concerning self-determination and its effect factors. Recognition concerning self-determination on medical care was measured in two aspects of desires for information and decision making. As a result, high degree of desires for information was shown as a whole. Although significant difference among ages was not noted, differences between genders showed higher degree of desires for information in women. And tendency that more external persons have higher degree of desires for information and depend upon information was suggested. In regard to desires for decision making, statistical significant differences among ages, educational years or relationships with medical staffs were shown, and the effects were suggested. In behavior concerning self-determination, it became clear that women often became deciders in the case of practical adjustment in life. However, statistical relation between scoring points registering behavior and recognition concerning self-determination was not noted.