在宅酸素療法患者の活動量に関する検討

Physical Activity Assessed by Pedometer in Patients under Home Oxygen Therapy

要旨

　歩数計を用いて計測した一日の歩数を活動量と定義し，在宅酸素療法患者の活動量と心理社会的，身体的要因との関連について検討した．その結果，活動量は抑うつ状態の評価のために用いたCES-D得点と相関し，活動量が少ない患者の抑うつ状態は強かった．また，活動量は6分間歩行距離とも相関し，活動量が多い患者の6分間歩行距離は長かった．活動量と家族アプガースコアとの間には関連を認めなかった．以上の結果から，在宅酸素療法患者の活動量は心肺機能とともに抑うつ状態と関連していることが明らかになった．在宅酸素療法患者への生活援助では，活動量を増加させることが，抑うつ状態を軽減し心肺機能の低下を防ぐために重要であることが示唆された．

Abstract:

　Most of the patients under home oxygen therapy(HOT-patient) tend to stay inside because of their poor cardiopulmonary function, change of the physical and the cosmetic appearances brought about by oxygen supply apparatuses and weakening of the muscle power. Daily decrease in the physical activities possibly causes sleeplessness, further reduction of the cardiopulmonary function and depressive feeling. In order to solve these interrelating problems, it is necessary to help HOTpatients go out of home and gain some social roles. In this regard, elevation of the physical activities of patients themselves and family supports to encourage them are important.

　The present study was performed to elucidate the relation between daily physical activities as measured by a pedometer and family function and psychosocial factors including depressive state and emotional supports. The depressive state was assessed using Center for Epidemiologic Studies Depression Scale(CES-D) and the family function was measured by Family APGAR score. Pedometer score was recorded everyday for a month and the values were averaged. The averaged score was assumed to represent the patient's physical activity. Six-minutes walking test was done on the plain isle in hospitals. CES-D score was well correlated with pedometer score, i.e., more depressive patients had less pedometer scores. Patients with longer six-minute walking distance had more pedometer scores. Physical activity had nothing to do with Family APGAR score in this study.

　It was demonstrated that the physical activity was related with depressive state as well as with cardiopulmonary function assessed from six-minute walking distance. The result suggests that supports to expand the HOT-patients' territory of action may improve their depressive state and inhibit cardiopulmonary function from deteriorating.