女性人工股関節全置換術患者の術前後の歩容の自己評価モデルの開発—構造方程式モデリングを用いた分析

Development of Preoperative and Postoperative Self-evaluation of Gait Model for Female Patients who have Undergone Total Hip Arthroplasty: A Structural Equation Modeling Analysis

要旨

　目的：女性人工股関節全置換術（Total Hip Arthroplasty: THA）患者の歩容の自己評価が何に影響され，何に影響を与えるのかを明らかにするために，術前と術後の歩容の自己評価モデルを開発した．

　方法：変形性股関節症が原因でTHA予定の女性患者80名を対象に，無記名自記式質問紙調査を術前と術後6ヶ月の2回行い，構造方程式モデリングで検証した．

　結果：術前の歩容の自己評価が影響を受けたのは年齢，歩行能力と跛行への思いで，影響を与えたのは社会生活への思い，股関節の満足度と術後の公的自己意識であった．術後の歩容の自己評価が影響を受けたのは歩行能力，跛行への思いで，影響を与えたのは全体的健康感，自尊感情，社会生活への思い，股関節の満足度であった．

　結論：女性THA患者の歩容の自己評価は，影響を受ける変数と影響を与える変数のつながりが術前と術後で異なっていると示唆されたため，術前後の各々でアセスメントされるべきであると考えられた．

　Objective: Models for preoperative and postoperative self-evaluation of gait were developed to clarify the effects of the self-evaluation of gait and the factors affecting self-evaluation of gait in women who have undergone total hip arthroplasty (THA).

　Methods: An anonymous self-administered questionnaire survey was conducted twice before and 6 months after the operation in 80 female patients scheduled for THA for the treatment of osteoarthritis of the hip. The pre- and postoperative models were examined through structural equation modeling analysis.

　Results: Age, the ability to walk, and thoughts regarding claudication were found to affect preoperative self-evaluation of gait. Preoperative self-evaluation of gait affected thoughts regarding social life, the level of satisfaction with the hip joint, and postoperative public self-consciousness. The ability to walk and thoughts regarding claudication were shown to affect postoperative selfevaluation of gait. Postoperative self-evaluation of gait affected general health perception, selfesteem, thoughts regarding social life, and the level of satisfaction with the hip joint.

　Conclusion: As influenced and influencing factors were linked differently in preoperative and postoperative self-evaluation of gait in female patients with THA, preoperative and postoperative self-evaluation of gait should be assessed separately.