外来通院にて保存的療法を受けている変形性膝関節症患者のセルフケア能力

Self-Care Agency in Knee Osteoarthritis Patients Receiving Conservative Treatment in Ambulatory Practice

要旨

　目的：本研究の目的は，保存的療法を受けている外来通院中の変形性膝関節症患者が膝OAの病勢を強める因子を除去もしくは軽減し，症状や機能障害を上手くコントロールしながら望ましい生活を送るために必要なセルフケア能力を明らかにすることである．

　方法：変形性膝関節症患者18名に半構造化面接を実施し，分析には内容分析を用いた．

　結果：患者のセルフケア能力として，【自己への責任と意思に基づく判断】【自己の病気に関する知識を身につけていく力】【治療の遵守の必要性を把握する力】【自己の弱い部分を分析し自覚する力】【自己のペースを大切にする力】【自己の現状を肯定的に捉え受け入れていく力】【理想自己をモチベーションに変える力】【自己の取り組みを継続し効果を待つ力】【自己の病気の管理に必要となる情報に関心を向ける力】【病気・症状悪化予防のための方略の能動的な取り入れ】【関節への負担軽減のための調整】【自分が頼りにする人へ助けを求める力】が抽出された．

　結論：本研究結果は，看護職者における変形性膝関節症患者の視点に立脚したセルフケア能力への理解を深め，セルフケア能力を高めるための看護援助への示唆を与えるものと考える．

Abstract

　Objectives: The purpose of this study was to characterize the self-care agency that knee osteoarthritis patients receiving conservative treatment in ambulatory practice need in order to remove or relieve factors that may worsen the disease course and to improve the quality of life by appropriately managing symptoms and disease-associated dysfunction.

　Methods: Data were collected from 18 outpatient participants with primary osteoarthritis of the knee through semi-structured interviews and content analysis was performed.

　Results: Self-care agency in patients with primary osteoarthritis of the knee can be classified into the following 12 categories: “responsibility for oneself and self-determination,” “ability to acquire knowledge about the disease,” “understanding the necessity of adherence to treatment,” “ability to be aware of and analyze one's weakness,” “prioritizing going at one's own pace,” “ability to recognize and accept the positives in one's current situation,” “ability to motivate oneself to achieve a better life,” “ability to continue self-care and be patient while waiting for its effects,” “paying attention to information necessary for disease management,” “maintaining an active approach to prevent deterioration,” “adjusting one's life style to reduce joint loading,” and “ability to request support from dependable sources in one's life.”

　Conclusions: These findings inform the nurse's understanding of self-care agency in patients with primary osteoarthritis of the knee and contribute to efforts to improve self-care agency in patients.