都市部多世代交流型デイプログラム参加者の12か月間の効果に関する縦断的検証─Mixed methodsによる高齢者の心の健康と世代間交流の変化に焦点を当てて

Effectiveness of an Intergenerational Day Program on Mental Health of Older Adults and Intergenerational Interactions in an Urban Setting: A Twelve Month Prospective Study Using Mixed Methods

　都市部在住高齢者と小中学生を対象とした多世代交流型デイプログラム（IDP）を創設し，mixed methodsにより参加効果を縦断的に示した．初回・6・12か月後の高齢者の心の健康の量的変化，および参加者間に生じた世代間交流の参加観察による質的記述の両者を分析した．反復測定分散分析の結果，IDP群（n＝12，平均年齢74.4歳）と比較群（n＝10，同70.8歳）間で全体QOLに有意な主効果が認められた（p＜.001）．また，IDP群の初回参加時うつ傾向群は，初回と比べ，12か月後は有意に低下していた（p＜.05）．高齢者と小学生（n＝4，同8.5歳），地域ボランティア（n＝10，同69.2歳），学生ボランティア（n＝4，同22.5歳）等に生じた世代間交流の様相は，【高齢者が子どもの居場所をつくり迎え入れる】等12カテゴリー，70サブカテゴリーが抽出された．本プログラムは両世代間のコミュニケーションと仲間意識による連帯を中心とした相互交流により各世代に意味ある居場所となり，特に高齢者の孤立を防ぎ，心の健康に良い効果があることが示唆された．

　The effectiveness of an intergenerational day program in an urban community for older adults and school age children was evaluated by using mixed methods in a longitudinal study. Quantitative measure were the elder's quality of life (QOL) and depression examined using statistical composed design. Qualitative ethnographic methods were used to describe the intergenerational interactions among the elderly, children and volunteer's support over the course of the program during the first twelve months of program implementation. The subjects were intergenerational day program (IDP) participant elderly group (n =12, mean age 74.4), a children's group (n = 4, mean age 8.5), community volunteers (n = 10, mean age 69.2), student volunteers (n = 4, mean age 22.5), and an elderly comparison group (n = 10, mean age 70.8).

　Analysis of variance with repeated measures suggested there was a significant main effect between both elders groups in the overall QOL. Their depression scores of IDP group were significantly decreased between first involvements and after twelve month in the more depressive elderly group. The intergenerational interactions between children and elders were described in twelve categories like ‘Elders make a place for the children and welcome them to the session,’ and seventy sub-categories observed in different months. Our intergenerational health promotion nursing program represents a meaningful place based on communication, the mutual beneficial exchange and solidarity between both generations, and it prevents elder's isolation and provision of positive effects in mental health.