高齢慢性心不全患者のセルフケア評価尺度の開発

Development of a Self-care Evaluation Scale for Older Adults with Chronic Heart Failure

抄録

　本研究の目的は，高齢慢性心不全患者のセルフケア状況を評価できる尺度を開発し，尺度の信頼性，妥当性を検討することである．作成した尺度原案について，慢性心不全看護認定看護師への質問紙調査とプレテストを実施し，その後，高齢慢性心不全患者340人を対象に質問紙調査を行い，尺度の信頼性・妥当性を検討した．その結果，本尺度は30項目4因子構造となり，第Ⅰ因子は「必要な知識と実践」，第Ⅱ因子は「生活のなかで獲得される管理の習慣化と継続」，第Ⅲ因子は「身体徴候の変化に対する認識と対応」，第Ⅳ因子は「自ら獲得する支援体制」と命名した．尺度全体のクロンバックα係数は0.84，下位尺度は0.55〜0.80であった．本尺度と相関があると想定されたSCAQ，Self-care confidenceとの間に有意な正の相関を認めた．開発した尺度は，内的整合性，構成概念妥当性がある程度確認された尺度であり，高齢者のセルフケア支援への活用可能性が示唆された．

　The purpose of this study was to develop a self-care evaluation scale for older adults with chronic heart failure and to examine its reliability and validity. A questionnaire survey about the scale, which was created by the authors, was distributed to certified nurses in chronic heart failure nursing; subsequently, a pretest for the patients was conducted. Next, a questionnaire that included the scale was distributed to 340 older adults with chronic heart failure. The reliability and validity of the scale were verified. According to the analysis, this scale was constructed based on 4 factors with 30 items; the factors considered for constructing the scale were “necessary knowledge and practice,” “continual habits of management,” “recognition and correspondence pertaining to any changes in physical symptoms,” and “acquisition of support.” Cronbach's α for the overall scale was 0.84; the corresponding values for the subscales ranged from 0.55 to 0.80. As expected, there was a significant correlation between this scale and SCAQ as well as Self-care confidence. These results suggest that the self-care evaluation scale for older adults with chronic heart failure has a fairly good reliability and validity. Furthermore, the possibility of it being used for self-care support was indicated.