在宅における要介護者の摂食・嚥下障害の有無と身体機能,主介護者の介護負担感および介護時間との関連

The Relationship of Physical Function, Subjective Burden and Time of Care between Main Caregivers with Dysphagic Family Members and Main Caregivers without Dysphagic Family Members in the Home Care Setting

要旨

【研究目的】在宅における要介護者のうち摂食・嚥下障害の有無と身体機能および主介護者の介護負担感，介護時間との関連を明らかにした．【研究方法】滋賀県の2施設の訪問看護ステーションを利用している介護度2以上の者178名から，摂食・嚥下障害者（摂食・嚥下障害者群）とそれを持たない者（対照群）を性，年齢，要介護度を1対1にマッチングを行って33ペアを抽出し，両群の主介護者および本人から面接調査を行った．調査項目は，主介護者の介護負担感，介護時間，要介護者の日常生活動作能力（ADL），経皮的酸素飽和度（SpO₂），窒息経験の有無などであった．【結果・考察】摂食・嚥下障害者群は対照群に比べて有意にSpO₂が低く，窒息の経験も対照群に比べて有意に多かった．重回帰分析の結果，介護時間は摂食・嚥下障害の有無に正の相関があった．このことから，要介護者が摂食・嚥下障害を伴うことが主介護者の介護時間の延長につながることが示唆された．

Abstract

　The purpose of this study was to find out the relationship of physical function, subjective burden and time of care between main caregivers with dysphagic family members and main caregivers without dysphagia members.

　Thirty-three pairs of patients were randomized from a total of 178 patients with a Japanese care insurance rank of 2 or more, living in homes visited by nurses in Shiga Prefecture by one-to-one matching, i. e. according to gender, age and care rank. One group was for patients with dysphagia (experimental group) and the other was for patients without dysphagia (control group). The main caregivers and patients of both groups were interviewed. Outcome variables were questions about subjective burden and time of care for the main caregivers, and for care receivers, activity of daily living (ADL), pulse circulation and blood oxygen (SpO₂), and experience of suffocation or not.

　Dysphagia patients in the experimental group had a significantly lower score for SpO₂ compared with the controls. They also had significantly more experience with suffocation. Multiple regressions for time of care had a positive correlation between main caregivers in both the experimental and control groups. Therefore, it was suggested that main caregivers with dysphagia had the longest time of care.