保健学におけるcapabilityの概念分析

Conceptual Analysis of Capability in Health Sciences

要旨

　目的：保健学におけるcapabilityについて記述された文献から概念の特徴を識別し，再定義することである．

　方法：Rodgersの概念分析アプローチの手法を用い，30文献を分析対象とした．

　結果：【利用可能な機会に基づく達成可能な健康上の機能】【価値基準に基づいて健康上の機能を選択する能力】【機会を活用し機能を達成する能力】の3つの属性，【健康の選択に関わる社会的資源】【個人の特性】【健康状態と生活への影響】の3つの先行要件，【望んだ健康状態の達成によるQOLの向上】【生活の充実】【自らの価値基準に基づいた健康】の3つの帰結を抽出し，利用可能な機会と達成する可能性のある機能から，自らの価値基準に基づいた健康状態を選択し，達成する能力と定義した．

　結論：capabilityは，患者の価値観に合わせた療養行動や生活に向けた意思決定支援という点において有効な概念であることが示唆された．

　Objective: This research aimed to differentiate and redefine the concept of capability in health science by reviewing the literature on capability in healthcare.

　Methods: By using the method of concept analysis described by Rodgers, a total of 30 literature references were assessed.

　Results: We extracted [achievable health functionings based on available opportunities], [ability to select health functionings according to values], and [ability to utilize opportunities to achieve functionings] as attributes. [Social resources related to health choices], [individual characteristics], and [health status and impact on life] were extracted as antecedents. As consequences, we extracted [improvement of QOL by achieving desired health condition], [enrichment of life], and [health based on one's own value standard]. Capability in health science is available and can be achieved. From the achievable health functionings, the ability to select and achieve a desired health condition on the basis of one's own value standard was defined.

　Conclusion: Concept analysis showed that capability in health science is the ability to select and achieve health status according to one's own value standards on the basis of the available opportunities and functionings that may be achieved. Additionally, our results suggested that capability is also a valid concept in nursing science, in terms of health professionals' understanding of the effects of diseases and disorders on patient functionings, as well as in terms of health professionals' support for patients in making decisions on the basis of that understanding.