食事管理の自己効力感を維持している糖尿病患者の自己管理体験

Self-management Experience of the Patients with Diabetes Mellitus Who is Maintaining Dietary Self-efficacy

　本研究の目的は，食事管理の自己効力感を維持している糖尿病患者の自己管理体験を分析し，自己管理やその気持ち，背景となる要因を明らかにすることである．研究方法は，質問紙調査において自己効力感得点が高かった研究参加者6名に，同意を得て面接調査を行った．面接内容は質的帰納的方法で分析した．その結果，自己効力感を維持している糖尿病患者は，「積極的に厳しい自己管理をする」，「折り合いをつけた自己管理をする」の2つの自己管理の様式を用いていた．自己管理を続ける気持ちは，「病気を前向きにとらえる」，「自己管理能力への満足感」，「糖尿病が生活のすべてではない」，「社会性維持への満足感」，「自己管理の成功達成感」，「負担感の少なさ」，「合併症に対する脅威」の7カテゴリーがあり，それを支えている背景として友人や家族による「周囲からの支援」と「療養法を実行しやすい生活環境」の2カテゴリーが見出された．本研究の結果から，自己効力感を高める看護への示唆として，患者が重視するQOL領域での満足感や成功達成感を保てるような援助が重要だと思われた．

　The purpose of this study was clarify its feeling and background of self-management experience of the diabetes mellitus regimen who is dietary self-efficacy maintaining over a long period of time. The subjects were 6 members higher self-efficacy in a self-administered questionnaire. The interview were revealed that patients with diabetes who is maintaining self-efficacy used the style of two self-managements, the severity self-management or a compatible with self-managements was carried out. As its feeling and background of self-management experience which there are seven categories of diabetes regimen catches positively, the satisfaction to self-management ability, diabetes not being all of lives, the satisfaction to social maintenance, the little of the feeling of a burden, the feeling of success achievement of self-management, the threat over complications, and supports it two categories of support from their families and friends and the living environment which is easy to perform regimen were found out. It was suggested that the assistance which can maintain the feeling of success achievement and the satisfaction in QOL from the result of this study suggestion to nursing which raises self-efficacy is important.