就労者の定期的・継続的な受診の中断に影響を及ぼす要因と健康認識に関する調査

A Survey on the Factors Influencing Interruption of Periodical and Continual Medical Consultation of Workers, and Their Health Awareness

要　　旨

　目的：慢性的な経過の疾患等を持ち、定期的な受診を1ヶ月以上継続した経験のある就労者の受診中断に影響する要因を明らかにし、健康支援のあり方についての示唆を得る。

　対象と方法：1,000人以上の製造系企業3社で働く、20歳以上の就労者2,400名に自記式質問紙調査を行った。

　結果：仕事をしながら慢性的な経過の疾患等を持ち、定期的な受診を1ヶ月以上継続した経験のある就労者388名を研究対象とし、無回答や記入漏れのあったデータを除いた367名を分析対象とした（有効回答率94.6％）。χ²検定にて中断群、非中断群間に有意差を認められた項目を独立変数として、ロジスティック回帰分析（ステップワイズ法、有意水準は5％）を行った結果、「性別」、「日常的な家族支援者の有無」、「自分の健康管理より優先することの有無」、「健康管理はできている」で統計学的有意差がみられた。

　結論：就労者が日常的に支援をしている家族の影響など、生活背景を考慮したセルフマネジメント支援が必要である。家庭的役割の大きい女性の疾患管理に目を向け、職場の環境を整える必要性があることが示唆された。また、自分の健康管理は優先される必要性があるとの認識を高めるような教育支援が必要である。

　Aims: The purpose of this study was to clarify the factors that influence interruption of medical consultation in workers with chronic diseases who had experienced continual medical consultation for more than one month and, then, to obtain some suggestions for health support.

　Materials and Methods: A self-completed questionnaire survey was conducted on 2,400 workers aged 20 or above who are working for three manufacturing companies of the size of 1,000 people or more.

　Results: The number of workers with chronic diseases who had experienced, in parallel with doing a job, periodical and continual medical consultation one month or more was 388. Out of them, 367 workers (94.6%) excluding those who did not complete the questionnaire were statistically analyzed. The items for which a significant difference was observed by chi-square test between the interruption group and the non-interruption group were treated as independent variables for logistic regression analysis (stepwise way, 5% as significance level). As results, a statistically significant difference was observed in “gender”, “presence or absence of a family member(s) to whom daily support is needed”, “presence or absence of things that are prioritized over health control of own”, and “whether own health is controlled or not”.

　Conclusions: Support for women's self-management is necessary taking into consideration their life-style background such as the influence of the family where the worker is daily providing support. It was suggested that creation of better working conditions is necessary paying special attention to health- and disease control of women who take on important at-home roles. In addition, educational support is necessary to enhance their awareness that health control of own should be prioritized.