女性慢性関節リウマチ患者におけるトイレ動作困難度とその予測因子の検討

Difficulty in Toilet Activities with Female RA Patients and Its Predicting Factors

　外来通院中の女性慢性関節リウマチ患者のトイレ動作困難の実態を明らかにし，外来で簡便に得られ，トイレ動作困難度を予測できる指標を検討する目的で，一大学病院の外来に通院中の50歳以上の女性慢性関節リウマチ患者51名に対して，調査票を用いた面接調査を実施した．通院患者の88％に何らかの困難がみられ，困難な動作として頻度の高かったのは「和式トイレでしゃがむ」「衣類・下着を上げる」「衣類・下着を下ろす」であった．予測因子として，年齢，院内での移動状況，手の変形・腫脹の程度，ペインスコア，起立テスト，握力をあげ，各トイレ動作項目の困難度，およびトイレ動作困難度の総点との関連を見た．困難度総点に対しては，起立テストが最も関連が強く，ペインスコア，移動状況も有意な関連を示した．各トイレ動作に関しては，困難な患者の多かった「和式トイレでしゃがむ」「衣類の上げ下げ」の困難度と握力との関連が強かった．

　The purpose of this study was to describe the frequency of difficulty in toilet activities with female rheumatoid arthritis patients and examine the relationship between the degree of difficulty and six predicting variables. We conducted the structured interview and physical examinations to 51 female RA outpatients who were 50 years old and over in an university hospital. 88% of these patients were having some kind of difficulty in a series of toilet activities. The most difficult movement was "bending over the Japanese-style toilet", and then "putting on the clothes", "taking off the clothes" was also the difficult movement. The degree of difficulty in each movement and the total score of difficulty in toilet activities was examined with the 6 predicting factors of age, mobility in the outpatient unit, degree of deformity and swelling in hands, pain score, standing up test, and grip strength. The total score of difficulty was significantly related with standing up test, pain score and mobility. Three of the most difficult movements described above was significantly related with the grip strength.