胃術後患者の職場復帰に伴う症状の変化と食行動に関する研究

Investigation of Changes in Symptoms and Eating Behavior Associated with the Return to the Workplace of Postgastrectomy Patients

要旨

　本研究は，胃術後患者の職場復帰に伴う症状の変化と症状の変化に関連する食行動，食行動に影響する要因について明らかにすることを目的として，職場復帰した男性胃術後患者34例を対象に自記式質問紙調査を行った．

　その結果，ダンピング症候群様症状（全身症状と，下痢を除く腹部症状），後発性低血糖様症状は，職場復帰前に比べ，復帰後に症状が不変，増強，新たに出現することが多かった．また，職場復帰後に症状の不変，増強，新たに出現のいずれかに該当した人は，ダンピング症候群様症状の全身症状では，職場で食後に臥位をとりにくいことや摂食時の注意の程度が減少していることが多く，腹部症状では，摂食量や小胃症状が食事終了の目安になっておらず，摂食量が増加していることが多かった．後発性低血糖様症状では，職場で食後に臥位をとりにくいこと，食後休息時間の減少，小胃症状が食事終了の目安になっていること，食事間隔が開くことが多かった．

　職域における健康管理の一貫として，復帰後には職場でも食後の休息をとったり，食事の間隔が開かないようにするなどの具体的な行動の指導ならびに気兼ねなく休息がとれるようにするなどの職場環境調整の必要性が示唆された．

Abstract

　The purpose of this study was to elucidate changes in symptoms, eating behavior related with changes in symptoms and principal factors influencing eating behavior associated with the return to the workplace of postgastrectomy patients. A self-administered questionnaire survey was conducted among 34 male postgastrectomy patients.

　The results showed that dumping-syndrome-like symptoms (systemic symptoms and abdominal symptoms excluding diarrhea) and late hypoglycemia-like symptoms tended to persist, worsen, or occur anew after returning to the workplace. Many such patients complained that it was difficult to assume the supine position after meals at work and that their degree of caution during meals decreased. They also reported that the quantity ingested and small-stomach symptoms did not serve as a guide as to when to stop eating, and that they had been eating more. Late hypoglycemialike symptoms after returning to the workplace tended to be associated with difficulty in assuming the supine position after meals, a decrease in rest time after eating, small-stomach symptoms that served as a guide as to when to stop eating, and a longer interval between meals.

　The results of the survey suggested that support for health maintenance after postgastrectomy patients return to the workplace requires specific behavioral instructions, such as to take rests after meals, even at work, and not to allow the intervals between meals to increase, as well as to adjust the workplace environment by making it possible to take rests without feeling uncomfortable doing so.