脳血管障害患者における機能的自立度評価法(FIM)の社会的認知項目と看護師の心理的負担度との関係 Relationship between Social Cognition Items of FIM among Cerebrovascular Disorder Patients and the Psychological Burden on Nurses

日常生活活動(ADL)を測定する機能的自立度評価法FIM(Functional Independence Measure)は介護負担度を測定することを特徴としている.今回,脳血管障害患者を対象に患者への看護師の心理的負担度が介護負担度に反映されているかをFIM社会的認知項目との関係から検討した結果,FIM社会的認知項目と看護師の心理的負担度には相関がみられ,看護師の心理的負担度は介護負担度に反映されていることが示された.看護師の心理的負担度とFIM社会的認知項目合計との関係において,全体と異なった傾向を示した患者の特徴を検討すると,脳血管障害患者の中には,注意障害,遂行機能障害,社会的行動障害などの高次脳機能障害を呈する者がおり,数字上では少ないが看護師が対応に苦慮するケースがあり,介護負担度には反映されない場合があることがわかった.

The Functional Independence Measure (FIM) which measures independence in activities of daily living (ADL) features in assessing the degree of burden associated with caregiving. In this study, among patients with cerebrovascular disorders, we examined whether the degree of nurse's psychological burden was reflected in the degree of caring burden focusing on the social cognition of FIM. The results revealed a correlation between FIM social cognition items and the degree of nurse's psychological burden which showed that the nurse's psychological burden was reflected in the degree of caring burden. However, in further studying the characteristics of patients whose scores showed different traits in the relationship between the nurse's psychological burden and total FIM social points, some of those patients with cerebrovascular disorders were found to manifest higher brain dysfunction such as attention disorder, executive disorder and social behavioral disorder. Although the percentage of such patients remained low, we found that in some cases the difficulty in coping with such patients experienced by nurses, was not reflected in the degree of caring burden.