在宅要介護高齢者の介護者における家族・身内とのかかわりと介護負担感との関連

The Affect of the Care Burden on Relationships between Family Caregivers and the Relatives of the Elderly Person Cared for at Home in the Urban Community

　本研究では，在宅要介護高齢者の介護者における『家族・身内とのかかわり』，すなわち「家族・身内のポジティブサポート（以下，家族・身内のサポート）」と介護についての「家族・身内との不一致」の2側面が介護負担感に及ぼす影響を明らかにすることを目的とした．対象は都市部の在宅要介護高齢者の介護者55名である．データ収集は質問紙を用いて訪問面接による聞き取り調査を実施した．介護者は，平均年齢55.4歳（標準偏差11.6)であり，要介護者との続柄では妻17名，娘20名，および嫁18名であった．分析には統計学パッケージHALBAUを用い，変数間の関連をみた．その結果，以下のことが示された．(1)介護者における『家族・身内とのかかわり』のうち，「家族・身内との不一致」が「介護負担感」に影響を及ぼしていた．(2)介護者の続柄別と「家族・身内のサポート」の程度との関連では，有意な差はみられなかった．(3)介護者の続柄別と「家族・身内との不一致」の程度との関連では有意な差がみられ，嫁が最も高く，次に娘，妻の順であった．以上より，介護をとりまく人間関係が介護者の介護負担感に影響することが示された．特に介護者における家族や身内との関係は緊密であり，ポジティブサポートがあることよりもネガティブサポートである「家族・身内との不一致」が介護負担感に影響を及ぼし，続柄別介護者において有意な差がみられた．介護者の介護負担感をアセスメントする際には専門家の立場からのみでなく，対象となる介護者やその家族の立場で捉えている家族や身内とのかかわりを含めた介護状況を把握することの重要性が示唆された．

　The purpose of this study is to clarify the relationship between the family caregiver, who is responsible for most of the care burden, and the relatives of the elderly person cared for at home in the urban community. The subujects were comprised of 55 family caregivers of elderly persons at home. The Care Burden Scale (by Nakatani, et al.) was employed to assess the care burden of each family caregiver. The Social support of the Elderly Scale (by Noguchi) was used to assess the degree of positive support in the relationship as perceived by each family caregiver and The Relatives Discord Scale (by Yuki) was used to assess the degree of negative support as perceived by each family caregiver. The results ware as follows: (1) Data documenting perceived positive support showed no significant difference among wife caregivers, daughter caregivers, and daugher-in-law caregivers. (2) The daughter-in-law caregiver group showed significantly higher points, among the three groups in perceived negative support. (3) The relatives discord data demonstrated that as discord among the relatives increased, the care burden for the caregivers also increased. We believe that, in the future, it is necessary to establish a system to support and develop home care for the elderly. The assessment for home care will also be necessary, not only for the care recipient and the care giver, but also to evaluate the family dynamics among the relatives of the elderly.