高齢者のセルフ・ネグレクト状態の類型化

Classification of the Self-Neglect Cases Among Community-Dwelling Elderlies

要旨

　目的：高齢者のセルフ・ネグレクト状態を類型化することである．

　方法：近畿6府県の地域包括支援センターと社会福祉協議会でセルフ・ネグレクト事例を担当した専門職者に自記式質問紙調査を実施した．

　結果：セルフ・ネグレクト状態や行為に関する調査項目への回答151部を主成分分析し，不衛生な生活環境，不適切な保健医療行動，不衛生な家屋環境，金銭の管理不足，稀薄な対人関係の5側面の指標を抽出した．その指標を用いてクラスタ分析し，対人関係稀薄群（34％），金銭管理困難群（26％），全体低群（23％），家屋環境劣悪群（14％）の4群に類型化された．4群間で差異が見られたのは，障害高齢者および認知症高齢者の日常生活自立度，セルフ・ネグレクトのタイプと深刻度，高齢者の他者受容であった．

　結論：高齢者のセルフ・ネグレクト状態は4群に類型化することができ，その類型化のクラスタ間の特徴から，それらに応じた介入や支援の必要性が示唆された．

　Objective: To identify the state of self-neglect among elderly and classify.

　Methods: A self-administered questionnaire survey was conducted among professionals with experience in dealing with self-neglect cases at comprehensive community support centers and social welfare councils in six Kinki prefectures. Responses were obtained for 151 self-neglect cases.

　Results: A principal component analysis was conducted on responses to 34 items describing self neglect conditions and behaviors. Five components were extracted: unsanitary living environment, inappropriate healthcare behaviors, unhygienic housing environment, poor money management, and poor interpersonal relationships. A cluster analysis using these components revealed four self neglect types: poor interpersonal relationships (34%), money management difficulties (26%), overall low group (23%) and poor living environment group (14%). There were differences between the clusters in the degree of independence in daily living of the disabled elderly and the elderly with dementia, the type and severity of self-neglect, and the older people's own acceptance of others.

　Conclusion: The self-neglect status of older people can be typified into four groups, and the characteristics between the clusters of typologies suggest the need for interventions and support accordingly.