高齢慢性透析患者の生きがい意識の関連要因

Factors Related to Well-being Consciousness of Elderly Patients with Chronic Hemodialysis

　本研究の目的は，高齢慢性透析患者の生きがい意識の関連要因を明らかにすることである．対象は，山形市内一施設で維持透析治療を受ける60歳以上の患者43名である．生きがい意識の測定は改訂版PGCモラール・スケールを用い，PGC得点を目的変数として，各調査項目との関連の有無や強さを統計学的に分析した．

　単変量の解析の結果，生きがい意識と有意（p＜0.05）の関連が認められた項目には，入院・職業・白内障の合併の有無，倦怠感の有無と程度，頭痛の有無，日常生活動作の程度，頼りになる家族の存在，相談できる友人の存在があった．有意の関連が認められた各項目を説明変数とした多変量解析では，相談できる友人の存在が，他の変数の影響を除いた後でも，生きがい意識とより強く関連していた．

　以上の知見を高齢透析患者の生きがい意識を高める看護の実践に生かしていくとともに，さらに分析を重ねることで，看護援助の視点をより具体的かつ明確化していくことが必要であると考えられた．

　The purpose of this study was to examine factors related to well-being consciousness of elderly patients undergoing chronic hemodialysis. Fourty three hemodialysis patients, all over 60 years old, were used for the study. Well-being consciousness was measured using the Philadelphia Geriatric Center Morale Scale (PGC) and the data was analyzed statistically.

　The following factors were found out to be significant (p＜0.05) for well-being consciousness : occupation, experience of hospitalization, complications of cataracts, fatigue and its degree, headache, degree of daily movement, supportive family, and having a friend to consult. Further analysis showed that having a friend to consult was the most significant factor, even when we eliminated the influence of the other variables from our analysis.

　These findings enable nursing staff to practically enhance well-being consciousness of elderly patients with chronic hemodialysis. Further investigation of the related factors will help nurses to clearly understand how the support they give to patients can be most effective.