自然流産を経験した夫婦のWHOQOL-26スコアの検討  [in Japanese] Study on WHOQOL-26 scores of couples who have experienced miscarriage  [in Japanese]

目的:自然流産後夫婦のQuality of Lifeの実態を明らかにする。方法:過去3ヵ月〜2年以内に妊娠22週未満で自然流産を経験した女性とその配偶者で募集に応じ,承諾が得られたカップル22組の対象に郵送法によりWHOQOL-26と,流産経験についての自由記述による調査を実施し,文献の一般健常人と比較した。結果:流産経験者のWHOQOL-26平均値は,男性3.15,女性3.10であった。中根ら,林田らの報告による一般健常人の平均値と比較し,男女ともに流産グループは低い値であった。中根らの報告との間では統計的に有意な差ではなかった(p<0.10)が,林田らの報告との比較では流産経験グループの男女ともに低い平均値であった(p<0.05)。下位尺度の身体的領域,心理的領域,社会関係,環境,全体的満足を林田らの一般健常人の値と比較したところ,身体的領域(男2.82,女2.79)(p<0.05),および心理的領域(男3.06,女3.05)が低い値(女性のみp<0.05)であった。社会,環境領域の得点はわずかに高い値であった。夫婦間のQOLで,夫婦間の平均値が最も低い事例,差が最も大きな事例,同程度の事例をあげ,自由記述内容とあわせて考察し,男性への精神的援助の必要性,精神的打撃の男女差が生じやすいため夫婦双方の状況を十分把握して援助する必要性があること,流産と悲哀のプロセスについて十分な説明が必要であることなど,援助についての示唆が得られた。

Purpose: The aim of this study was to investigate the actual quality of life of couples following spontaneous abortions. Method: Subjects of this survey included women who had experienced a miscarriage in less than 22 weeks of pregnancy from three months to two years previously and their relationships to their spouses. They were recruited by posting notices on bulletin boards at women's centers, on Internet web sites, and through acquaintances. WHOQOL-26 was employed. The data of 22 couples based on their miscarriages were analyzed. Result: The average WHOQOL-26 score of the miscarriage group was 3.15 (male) and 3.10 (female). These scores were compared with those of general healthy groups reported in the literature. The scores of both males and females of the miscarriage group were lower than those of the reported healthy groups and were statistically significant (p<0.05). Additionally, the scores on five domains of QOL-physical, mental, social relations, environmental, and overall satisfaction-were compared with those reported in the literature. The scores on the physical (male, 2.82; female, 2.79) (p<0.05) and mental domains (male, 3.06; female, 3.05) were low; the overall satisfaction of females was low and statistically significant (p<0.05). Scores on social and environmental domains were slightly high. The descriptions about couples' miscarriage experience where its average scores were the lowest, differences of the average scores between the couple were the biggest, and the average scores between couples were almost identical, were analyzed. This study highlighted the need to provide mental health assistance to men; sensitive care with appropriate attention to each spouse, including the coordination of their relationship; and a systematic consensual explanation to men and women on the incidence of miscarriage and the mourning process. Conclusion: The average WHOQOL-26 scores of men and women after miscarriage were lower than those of reported healthy groups. Although WHOQOL-26 is a useful assessment tool for couples who have experienced a miscarriage, it is necessary for healthcare providers to understand that the experience and feelings of each couple varies and adequate care should be provided based on their individual requirements.