在宅高齢者の閉じこもりに関連する心理的要因の検討

Study of Psychological Factors Related to Community-Dwelling Elderly Persons' Becoming Housebound

　本研究では，移動能力があり，身体の障害も軽いにもかかわらず閉じこもっている高齢者には，心理的要因が大きく作用しているとの観点から，その心理的要因の構造を明らかにすることを目的とした．なお日常的な外出頻度が週1回以下の者を「閉じこもり」と定義した．

　A県O村に居住する65歳以上の高齢者を対象に，質問紙調査を行い，252名（男性109名，女性143名，有効回答率は80.5％）の回答から以下の結果を得た.

　1．閉じこもりの有無と関連のある心理的要因は「生活創造志向」「人生達成充足感」「穏やかな高揚感」「外出志向」の4項目であった．閉じこもり群は非閉じこもり群に比べ，この4因子が有意に低かった．

　2．「生活創造志向」の低さを予測する要因は，年齢が高い，1km歩行ができない，日常の時間が決まっていない，手段的サポートがない，の4つであった.

　3.「人生達成充足感」の低さを予測する要因は，年齢が低い，現在の体調が悪い，外出の不安がある，手段的サポートがない，の4つであった.

　4．「穏やかな高揚感」の低さを予測する要因は，現在の体調が悪いことであった．

　5．「外出志向」の低さを予測する要因は，性別が男性であることと，何らかの身体的不自由感があることであった．

　閉じこもり予防を目指した活動では，こうした心理的特徴をふまえた関わりが必要となる．

　The aim of this study was to elucidate the structure of the psychological factors and their associations with basic attributes and physical and social factors considered to be their background factors from the standpoint of the major psychological factors operating in elderly persons who are housebound despite being mobile and having only mild physical impairments. "Housebound" was defined as ordinarily going out no more than once a week.

　A questionnaire survey of elderly persons 65 years of age and over residing in 0 town, A prefecture, was conducted, and the results below were obtained from the replies of 252 of them(109 men, 143 women, valid reply rate : 80.5%).

　1. Four psychological factors were associated with whether housebound or not: "creative orientation toward living", "sense of fulfillment with achievements in life", "calm elation", and "orientation toward going out". These 4 factors were significantly lower in the housebound group than in the nonhousebound group.

　2. Four factors predicted low "creative orientation toward living": older age, inability to walk one kilometer, absence of a daily routine, and no instrumental support.

　3. Four factors predicted low "sense of fulfillment with achievements in life": low age, poor current physical condition, anxiety in regard to going out, and absence of instrumental support.

　4. One factor predicted low "calm elation": poor current physical condition.

　5. Male gender and a physical difficulties of some kind were factors that predicted low "orientation toward going out".

　As for the activities that it aimed at the prevention "Housebound", human relations based on the above-mentioned mental characteristics are necessary.