人工肛門造設患者の生活の主観的評価に関連する因子の構造と影響要因

Structure and Factor that Influence Ostomate's Subjective Postoperatively Attitudes

要旨

　人工肛門造設患者の退院後の主観的評価を高めていくために，人工肛門造設患者のQOLモデルを作成し，さらにモデルを構成する因子に関連する要因を明かにした．

　共分散構造分析を行い，有意なパス係数のみで構成した結果，人工肛門造設術の落胆，人工肛門造設術の安堵感，積極的生活姿勢，生活の主観的評価，健康的生活，生活上の苦痛，人工肛門の負担感，食事の満足，自己価値観，ソーシャルサポートの10因子の因果関係が明かになった．

　モデルを構成する10因子に影響を及ぼしていた要因は，婚姻状況，人工肛門装具交換の分担，性生活の満足であり，いずれも家族が関係する3要因であった．

Abstract

　The purpose of this research is to clarify the structure of the quality of life of the ostomate and to clarify the factors that influence the structure. Knowledge the structure of the quality of life will help nurses to enhance ostomates's attitudes about themselve after discharge from the hospital.

　Causal relations of ten factors are clarified by accepting significant path coefficients using the Covariance Structure Analysis in 159 ostomates. The ten factors are (1) discouragement with having a stoma, (2) relief due to effectiveness of stoma surgery,(3) positive attitude toward life,(4) subjective attitudes about life,(5) personal assessment of health,(6) difficulties with living,(7) burden of having a stoma,(8) satisfaction with diet,(9) self-esteem, and (10) social support. The structure of the ostomate's quality of life is gained by displaying each causal relationship.

　The factors that influence the structure are (1) marital status,(2) Independence in changing of a stoma appliance, and (3) sexual satisfaction. These factors are related to the family.