変形性股関節症患者の保存療法中のセルフマネジメントの概念分析

Concept Analysis of Self-Management During Conservative Treatment in Hip Osteoarthritis Patients

要旨

　目的：変形性股関節症（Hip osteoarthritis：以下，HOA）患者の保存療法中のセルフマネジメントの定義を明確にする．

　方法：43文献を対象にWalker＆Avantの概念分析方法を用いた．

　結果：属性は【意思決定と病気の受容】【治療・養生の知識と技術の獲得】【問題への対処法の洗練】【否定的感情への対処】【社会的役割の調整】【資源・情報の活用】【医療者との協働】が抽出された．

　結論：本概念を「医療者とのパートナーシップに基づく協働により，患者が治療に積極的に参加し，自らの能力を活用しながら個人のニーズに合わせた目標に向けて意図的に継続する日常的な取り組みである．患者が養生に対する責任を持ち，HOAと治療に関する知識と，疾患や感情・社会的役割を管理するためのスキルを習得しながら主体的に対処法を洗練するプロセスである」と定義した．

　Aims: We aimed to clarify the definition of self-management during conservative treatment in patients with HOA.

　Methods: The Walker and Avant's method of concept analysis was performed on 43 articles.

　Results: The following were extracted as attributes of self-management during conservative treatment in patients with HOA: self-determination and acceptance of disease, acquisition of knowledge and skills for treating and coping with problems, refining how to deal with a problem, negative emotional management, adjusting social roles, using resources and information, and cooperation with medical professionals. The antecedents to self-management were personal health issues and perceptions, and influences exerted by the social environment. The consequences of self-management were change to a healthy lifestyle, improving locomotor function, acceptance of HOA and changes to positive emotions, improved self-efficacy, and maintenance and improvement of QOL.

　Conclusion: We defined this concept as "it is a process in which patients, in collaboration with medical professionals, actively participate in their own treatment and make regular, intentional, and continuous efforts toward goals aligned with their individual needs by utilizing their own abilities. Patients acquire knowledge about HOA and its treatment, take responsibility for healthy behaviors, and independently refine coping methods while learning skills to manage the disease, their emotions, and their social roles."