壮年期2型糖尿病患者における食事関連QOLの関連要因

Factors That Influence Diet-Related Quality of Life in Middle-Aged Patients with Type 2 Diabetes

要旨

　糖尿病患者の食事に関連したQOL(以下，食事関連QOL)の関連要因探索を目的とし，外来通院中の壮年期患者を対象に自記式質問紙調査を実施した．238名から調査同意を得て，231名より有効回答を得た(有効回答率97.1％)．食事関連QOLの測定には糖尿病用食事関連QOL尺度を使用し，各下位尺度得点を目的変数とした重回帰分析を実施した．QOLが高いことに対する主な関連要因は，「食事全般の主観的満足感」では食事療法の実施方法を理解している，「食事療法の負担」はHbA1cが低い，「食事療法からの受益感」は自己管理行動を実施している，家族や友人のサポートがある，「全般的食事感」は自己管理行動を実施している，家族や友人のサポートがある，HbA1cが低いであった．さらに「社会的機能の制限」は調理担当者に該当しない，家族や友人のサポートがない，「活力」「心の健康」ではHealthLocus of ControlのInternal傾向が強いだった．

　以上より，食事関連QOL向上の視点から，食事療法の実施方法に対する理解の向上や自己管理促進を目指した援助の重要性，家族や友人を含めた援助の必要性が示唆された．

Abstract

　With the aim of exploration of the factors affecting the diet-related quality of life (QOL) of diabetic patients, a self-administered questionnaire survey was conducted among diabetic patients in middle age followed up at the outpatient clinic.Among 238outpatients who consented to participate in the survey, effective responses were obtained from 231(effective response rate; 97.1％). The Diabetes Diet-Related QOL (DDRQOL) scale was used for determination of the diet-related QOL,and multiple regression analysis was conducted using the subscale scores as the criterion variables. The major factors associated with a better QOL were as follows：a good understanding of the purpose and method of the diet therapy was related to the subscale score for “satisfaction with diet,”low HbA1c values were related to the subscale score for “burden of diet therapy,”implementation of self-management behaviors and support from family and friends were related to the subscale score for“perceived merits of diet therapy,”and implementation of self-management behaviors, support from family and friends, and low HbA1c values were related to the subscale score for “general perception of diet.”In addition, the score for “restriction of social functions”was associated with lack of the need to be in charge of the cooking and lack of support from family and friends. Scores for “vitality”and “mental health”were affected by the stronger tendency of internal locus of control in the Health Locus of Control.

　These results suggest that improvement of the understanding of all aspects of diet therapy, as well as care for the promotion of self-management behaviors are important, and that support from family and friends is necessary from the point of view of improvement of the diet-related QOL.