運動療法に取り組む心筋梗塞患者における不確かさの認知とアドヒアランス行動の関連について

Relationship Between Perceived Uncertainty and Adherence in Patients Joining Physical Training Program after Myocardial Infarction

要旨

　本研究は，運動療法に取り組む心筋梗塞患者における不確かさの認知とアドヒアランス行動の関連について調査した．研究デザインは横断的相関関係探索型であり，測定用具には，アドヒアランス行動質問紙，The Mishel Uncertainty in Illness Scale，A型行動判別表，簡易版支援ネットワーク尺度を用いた．対象者は31～80歳（平均年齢64.0歳）までの冠動脈形成術を受けた心筋梗塞患者93名であった．

　重回帰分析の結果，アドヒアランス行動は，曖昧さ，複雑さ，有職者，男性，心筋梗塞の既往歴のある者，トレッドミル実施者，運動習慣のある者という7つの変数によって43％が説明されることとなった．運動療法に取り組む心筋梗塞患者は，自分の置かれている状況に対する認知的評価を通して不確かさを認知している．不確かさの認知が高い者ほど，能動的な対処行動であるアドヒアランス行動が低くなるというような認知―対処の過程が示された．

Abstract

　This study has been carried out to the relationship between perceived uncertainty and adherence in patients joining physical training program after myocardial infarction. The cross-sectional, correlational research design was selected, data were collected by the instruments which were consisted of the Mishel Uncertainty in Illness Scale and the Adherence Behavior Questionnaire. The subject consisted of 93 patients with myocardial infarction who had been undergone coronary angioplasty. Their ages ranged from 31 to 81 years, with an average of 64.0 years (SD=9.9 years).

　Multiple regression analysis indicated that ambiguity, complexity, employed, male, a history of myocardial infarction, treadmill user, and exercise habit accounted for 43% of the variance in adherence. Patients with myocardial infarction have perceived uncertainty through the process of cognitive appraisal in a cardiac event. It is suggested that high levels of perceived uncertainty are directly related to low levels of adherence.