閉じこもり高齢者への訪問型介護予防複合プログラムによる介入効果の検討

Study of the Intervention Effects of a Combination Program for the Prevention of Home-visit Care on the Homebound Elderly

抄録

【目的】閉じこもり高齢者に対する訪問型介護予防複合プログラムの介入効果を検討した．

【方法】閉じこもり高齢者8人を対象に運動器・口腔機能向上，栄養改善を併用した複合プログラムによる訪問，電話介入を各4回実施した．介入前後，介入終了3か月後に生活機能測定，外出に対する自己効力感，精神健康状態，主観的健康感，外出状況に関して評価した．

【結果】運動器機能の開眼片足立ち（左・右），口腔機能の反復唾液嚥下テスト，オーラルディアドコキネシス（/pa/・/ta/・/ka/）は介入後改善した（p＜0.01）．外出に対する自己効力感（p＜0.05），精神健康状態（p＜0.05），主観的健康感（p＜0.01）も介入後上昇した．外出頻度は8人中5人（62.5％）が上昇，介入終了3か月後も維持できた．握力，栄養評価のBMIは介入後の有意な変化がなかった．

【結論】訪問型介護予防複合プログラムによる介入にて運動器・口腔機能，心理社会的側面で維持・向上が図れた．

Purpose: This study was conducted for the purpose of examining the intervention effects of a combination program for the prevention of home-visit care on the homebound elderly.

Method: Home visits and telephone intervention were conducted on four occasions with eight homebound elderly subjects using a combination program combining improvement of motor and oral function and improvement of nutritional status. The subjects were evaluated before and after intervention and three months after completion of intervention based on measurement of vital functions, self-efficacy with respect to going outside, mental health status, subjective health status and frequency of going out.

Results: Results for standing on one leg (left・right) with the eyes open as an indicator of motor function and a repetitive saliva swallowing test and oral diadochokinesis (/pa/・/ta/・/ka/) as indicators of oral function improved following intervention (p＜0.01), and oral diadochokinesis (/pa/・/ta/) also improved three months after completion of intervention (p＜0.05). Self-efficacy with respect to going outside (p＜0.05), mental health status (p＜0.05) and subjective health status (p＜0.01) improved following intervention. Frequency of going out increased in 5 of 8 of the subjects (62.5%), and that frequency was able to be maintained three months after completion of intervention. There were no significant changes in grip strength and BMI used to evaluate nutritional status after intervention.

Conclusion: Motor, oral functions and psychosocial aspects could be maintained and improved through intervention using a combination program for the prevention of home-visit care.