口唇口蓋裂患者の病名告知に関する研究 Clinical Study on Telling Patients with Cleft Lip and/or Palate the Name of their Disease

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著者

    • 石井 正俊 ISHII Masatoshi
    • 東京医科歯科大学大学院医歯学総合研究科口腔機能再構築学系口腔機能再建学講座口腔機能再建学分野 Oral Surgery, Oral Restitution, Oral Health Science, Graduate School, Tokyo Medical and Dental University
    • 石井 良昌 ISHII Yoshimasa
    • 東京医科歯科大学大学院医歯学総合研究科口腔機能再構築学系口腔機能再建学講座口腔機能再建学分野 Oral Surgery, Oral Restitution, Oral Health Science, Graduate School, Tokyo Medical and Dental University
    • 森山 孝 MORIYAMA Takashi
    • 東京医科歯科大学大学院医歯学総合研究科口腔機能再構築学系口腔機能再建学講座口腔機能再建学分野 Oral Surgery, Oral Restitution, Oral Health Science, Graduate School, Tokyo Medical and Dental University
    • 森田 圭一 MORITA Keiichi
    • 東京医科歯科大学大学院医歯学総合研究科口腔機能再構築学系口腔機能再建学講座口腔機能再建学分野 Oral Surgery, Oral Restitution, Oral Health Science, Graduate School, Tokyo Medical and Dental University
    • 郡司 明美 GUNJI Akemi
    • 東京医科歯科大学大学院医歯学総合研究科口腔機能再構築学系口腔機能再建学講座口腔機能再建学分野 Oral Surgery, Oral Restitution, Oral Health Science, Graduate School, Tokyo Medical and Dental University
    • 今泉 史子 IMAIZUMI Fumiko
    • 東京医科歯科大学大学院医歯学総合研究科口腔機能再構築学系口腔機能再建学講座口腔機能再建学分野 Oral Surgery, Oral Restitution, Oral Health Science, Graduate School, Tokyo Medical and Dental University
    • 村瀬 嘉代子 MURASE Kayoko
    • 東京医科歯科大学大学院医歯学総合研究科口腔機能再構築学系口腔機能再建学講座口腔機能再建学分野 Oral Surgery, Oral Restitution, Oral Health Science, Graduate School, Tokyo Medical and Dental University
    • 高橋 雄三 TAKAHASHI Yuzo
    • 東京医科歯科大学大学院医歯学総合研究科口腔機能再構築学系口腔機能再建学講座口腔機能再建学分野 Oral Surgery, Oral Restitution, Oral Health Science, Graduate School, Tokyo Medical and Dental University
    • 榎本 昭二 ENOMOTO Shoji
    • 東京医科歯科大学大学院医歯学総合研究科口腔機能再構築学系口腔機能再建学講座口腔機能再建学分野 Oral Surgery, Oral Restitution, Oral Health Science, Graduate School, Tokyo Medical and Dental University

抄録

本研究は,口唇裂口蓋裂(以下CL/CP)患者に対する病名告知の現状を知り,告知をいつ,どのような形で行うことが患者及び家族にとって適切であるかについて検討することを目的とした.1997年1月から2000年2月までに東京医科歯科大学歯学部付属病院口腔外科外来を受診したCL/CP患者のうち,13歳から27歳までの患者及びその親を対象とし,質問紙(患者26項目及びY・G,CMI,親44項目)による調査を行った.患者・親共133部の質問紙を配付し,患者64名(回収率48.1%),親73名(回収率54.9%),親子共に回答が得られたものは58組であった.<BR>結果は以下のとおりである.<BR>(1)告知に関して親は患者より肯定的な認識をしていることが多く,親子間での認識のズレがあった.<BR>(2)受診理由を知りたいと思ったことのある患者は全体の32.8%,受診i理由を知っている人は全体の78.0%であり,必ずしも受診理由を知りたいと思った人が知っている訳ではなかった.<BR>(3)病名を知りたいと思ったことのある患者ほど告知を受けたことを肯定的にとらえる傾向があった(P<.10).<BR>(4)Y・Gによる性格傾向は,CL/CP患者群では対照群と比べ,有意に情緒不安定なB類とE類が多く積極安定型のD類が少なかった(p<.01).<BR>(5)CMIによる精神的健康度はCL/CP患者群は,健康度の高いI/II領域に属する者が対照群より有意に多かった(p<.01).<BR>(6)告知時期の認識が親子間で不一致の群は,一致群より,家族関係に問題が生じやすいとされるFACESIIIのExtreme群の数が有意に多かった(p<.01).<BR>これらより,病名告知は患者の望む時期に,親や治療者が治療の見通しを伝え,患者の疑問に応えられるような配慮をしつつ行うことが重要であることが示唆された.

The purpose of this study was to learn the condition of telling patients with cleft lip and/or palate the name of disease, and to examine the best way to give such information. Questionnaire consisting 26 items, the Yatabe-Guilford personality test, and the Cornell Medical Index test for patients, and 44 items for parents was performed to 64 patients with CL/CP aged from 13 to 27 years old and 73 parents of the patients from Jan.1997 to Feb.2000.<BR>The results were as follows:<BR>(1)The parents recognized informing the name of the disease positively and there were discrepancies between the patients and their parents as to the recognition of informing the name of the disease.<BR>(2)32.8% of the patients wanted to know the reason for seeing a doctor, and 78.0% of them knew it actually, which meant that they did not always want to know the reason.<BR>(3)When the patients wanted to know the name of the disease, they seemed to accept being told the name of the disease more positively than the patients who did not want to know the name (p<.10).<BR>(4)According to the Yatabe-Guilford personality test, the group of the patients belonged to categories B and E, which represented emotional unstability, more than the control group (p<.01), and they also belonged to category D, which represented positive stability, less than the control group (p<.01).<BR>(5)According to the Cornell Medical Index test (CMI) the group of the patients belonged to areas I and II, which represented a high degree of mental health, significantly higher than the contlol group (p<.01).<BR>(6)According to the Family Adaptability and Cohesion Evaluation Scale (FACES III), the group that had disagreement on being told the name of the disease between the parents and the patients, belonged to the group of 'Extreme' significantly higher than the control group (p<.01).<BR>These findings indicated that patients who want to know the name of their disease should be told it, along with a careful explanation on the treatment planning by parents or medical staff, so that the patients can accept the disease without disturbance.

収録刊行物

  • 日本口蓋裂学会雑誌

    日本口蓋裂学会雑誌 26(1), 97-113, 2001-04-30

    Japanese Cleft Palate Association

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被引用文献:  2件中 1-2件 を表示

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