骨粗鬆症患者における主観的幸福感と心理的側面からみたQOLの検討

Subjective Well-being and Psychological Aspects of Quality of Life in Patients with Osteoporosis

要旨

　骨粗鬆症患者のQOLを，主観的幸福感と幸福感や精神的健康の基盤をなす不安，抑鬱，自尊感情から明らかにし，心理面に対する看護援助の必要性について検討することを目的として，心理学的スケールを用いた自己記入方式の質問紙を作成し，調査を行った．調査対象者は，大阪府内の骨粗鬆症専門外来に通院中の女性患者230名である．心理学的スケールは，生活満足度評価，状態不安尺度，鬱状態尺度，自尊感情尺度を用いた．

　骨粗鬆症患者のQOLは，主観的幸福感からみるとやや低い傾向がみられ，不安や抑鬱傾向にあった．しかし，自尊感情については約90％の患者が高い値を示した．また，脊椎骨折のある患者と日常生活動作に障害のある患者は，抑鬱性がみられ，骨粗鬆症の人が身近にいる患者は，不安傾向がみられた．重回帰分析の結果，自尊感情，不安，罹病期間，健康満足感，鬱状態が，主観的幸福感に影響する要因であることが明らかとなった．心理面に対する援助としては，自尊感情を高める看護援助が重要であることが示唆された．

Abstract

　The aim of the present study was to examine the necessity for nursing care with psychological consideration, through the investigation of the quality of life in patients with osteoporosis by assessing their subjective well-being, including their anxiety, depression and self-esteem, which may influence their happiness and mental health. The study had subjects themselves fill in questionnaires utilizing four psychological scales; Life Satisfaction Index A (LSIA) to assess the subjective well-being, Self-Esteem Scale (SES) to assess psychological aspects, The State-Trait Anxiety Inventory (STAI), and Self-Rating Depression Scale (SDS). Subjects were 230 females aged 64.9 on average, and who were osteoporosis outpatients visiting clinics in Osaka prefecture.

　The level of quality of life of osteoporosis patients was found to be relatively low in terms of subjective well-being, and those patients were in the state of anxiety or mild depression. However, approximately 90% of the subjects showed high scores of the Self-Esteem Scale (SES). Patients with vertebral fractures and those faced impaired activities in daily life appeared to be depressive. An inclination of anxiety was found in most subjects having an acquaintance and/or family members who had osteoporosis disease as well. It turned out from the results obtained by multiple regression analysis that self-esteem, anxiety, disease duration, health satisfaction and depression are major factors that affect the subjective well-being of osteoporosis patients. The study has indicated that it is important for nursing care to raise the self-esteem of osteoporosis patients.