高齢障害者の健康関連QOL(HRQOL)調査 : スモン患者におけるSF-8^<TM>の利用  [in Japanese] Use of the SF-8 to assess Health-Related Quality of Life (HRQOL) in Elderly Patients with SMON (Subacute Myelo-Optico-Neuropathy)  [in Japanese]

主観的視点に立脚する健康関連QOL(Health Related QOL; HRQOL)はリハ医療における重要なアウトカム指標の一つであるが,客観的に評価できるADL等とは異なり,地域で生活する高齢障害者のHRQOLを評価することは容易ではない.標準的な包括的HRQOL評価尺度であるSF-36^<TM>と高い互換性を有する短縮版として開発されたSF-8^<TM>を用い,近年,高齢化が著しいスモン患者7名(平均年齢78.0±5.8歳,平均罹病期間39.8±2.1年)を対象としてHRQOLの評価を試みた.スモン患者のHRQOLは同年代の高齢者と比べすべての下位項目で低下がみられ(p<0.05),ADLの自立が保たれている場合でも身体面での不満が大きい傾向が認められた.SF-8^<TM>はSMON患者への有効な適用の可能性が示され,今後の幅広い応用が期待される.

The aim of this study was to evaluate the health-related quality of life (HRQOL) in elderly persons with disabilities living in the community using the SF-8^<TM>. Their subjective HRQOL is one of the most important outcome measures for rehabilitation medicine. However, it is difficult to evaluate HRQOL in elderly people who have many chronic diseases and disorders. The SF-8^<TM> was developed as a short version of the SF-36^<TM> to lessen the burden on the respondents. The SF-8^<TM> was administered to seven patients with SMON (average age 78.0 years, range 69 to 84 years; 5 women) suffering from peripheral neuropathy. The average length of illness was 39.8 years. Functional limitations in ADL was also assessed with the Barthel Index (BI). Their SF-8^<TM> scores were significantly lower in all domains (p<0.05) in comparison with the age matched reference population, indicating their impaired HRQOL. Their physical satisfaction was low even if they had better ADL status (BI90). In addition, the questionnaire response had no defect value. Feasibility of the SF-8^<TM> measurement in SMON patients with disabilities was demonstrated. In conclusion, the SF-8^<TM> is a useful instrument in the management of SMON patients. In future studies, the measure should be tested on a larger scale, and its longitudinal responsiveness also needs to be examined.