在宅療養中の気管支喘息学童のQOL調査—低得点群の状況を中心に

A QOL Investigation of Children with Bronchial Asthma Receiving Home Care: Results of the Low Scoring Group

和文抄録

　気管支喘息児のQOL（Quality of life）の現状と低下させる要因を明らかにするために、40項目、5段階のリカードスケールからなるQOL調査票（Cronbach's α＝0.85）を用いて調査を行った。対象は在宅療養中の気管支喘息児245名（10〜18歳、平均12.3歳）である。その結果、女子のQOL得点（200点満点中166.2±13.7）は男子（171.8±12.5）よりも低かった（p＜0.01）。1秒率（FEV_1.0％）70％未満の児のQOL得点（160.7±13.3）は70％以上の児（171.2±12.6）よりも低かった（p＜0.05）。喘息重症度が「重症」の児のQOL得点が低いとはいえなかった。低得点群（平均−SD）で特に低かった項目は「感情との関連」に属する6項目、「社会」の3項目｡「身体」の2項目であった｡しかし、カテゴリー別平均値を平均群と比較すると、「家族」の項目が特に低い傾向にあった。生活の満足度、健康に対する自己評価、充実した学校生活、身体鍛錬の決心、薬の飲み忘れ、家族の協力や性差についてのアセスメントと指導が重要である。

Abstract

　The purpose of this study was to investigate QOL(quality of life)of children with bronchial asthma and the factors contributing to a decline in QOL. We utilized a survey instrument(Cronbach's α = 0.85)which consisted of 40 items, which was scored using a five-point Likert scale. The subjects were 245 children, aged 10 to 18(average age: 12.3 years), with bronchial asthma and receiving home care.

　The results were as follows:

　The average score for girls, 166.2 ± 13.7(maximum 200)was lower than that for boys, 171.8±12.5(p＜0.01). The average score was 160.7+13.3 for children with FEV_1.0％ rate under 70％, and 171.2+12.6 for those with a rate greater than or equal to 70％(p＜0.05). Children with severe asthma did not necessarily have low QOL scores. Six items in the emotional domain, three in the social domain and two in the physical domain were found to be low in the low score group. However, items in the family domain showed a tendency to be especially low. Overall, this showed the importance of assessing satisfaction of life, healthy life, leading of full school life, motivation of physical training, poor compliance in medication, family support and sexual distinction in children with asthma.