在宅医療を受ける高齢者のQOL(quality of life)評価票における本人と介護者による代理評価の回答の一致性の検討  [in Japanese] Agreement in the responses to self-reported and proxy-reported versions of QOL-HC: a new quality-of-life scale for patients receiving home-based medical care  [in Japanese]

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Abstract

<p><b>目的:</b>認知症患者のQOL(quality of life)について,本人による評価と介護者による代理評価との一致に関する研究はあるが,在宅療養患者のためのQOL評価票をもちいて検討したものはない.本研究の目的は,主介護者などの代理人に回答を求めるQOL評価票の作成と,本人の回答との一致性について検討することとした.<b>方法:</b>この研究は在宅患者の観察研究である.我々が開発した,4つの質問からなるQOL評価票であるQOL-HC(QOL for patients receiving home-based medical care)(本人用)に基づいて,QOL-HC(介護者用)を作成した.また,QOL-HC(本人用)とQOL-HC(介護者用)を用いて,患者本人と主介護者から回答を求め,それぞれの質問への回答の一致率についてクロス集計表を用いて考察した.また,合計得点についてはSpearmanの順位相関係数を求めた.<b>結果:</b>質問1「おだやかな気持ちで過ごしていますか.」,質問2「現在まで充実した人生だった,と感じていますか.」,質問3「話し相手になる人がいますか.」,質問4「介護に関するサービスに満足していますか.」について,本人と介護者の回答の一致率は,それぞれ52.3%,52.3%,79.5%,81.8%であった.また,QOL-HC(本人用)合計点とQOL-HC(介護者用)合計点について有意な弱い相関を認めた(Spearmanのρ=0.364*,p=0.015).<b>結論:</b>本人と介護者による評価とに50%以上の一致率をみとめ,合計点について有意な相関をみとめた.介護者による評価を参考にできる可能性はあるが,評価のかい離の要因およびQOL-HC(介護者用)の信頼性の検討が必要である.</p>

<p><b>Aim: </b>We developed quality-of-life (QOL) scales for patients receiving home medical care. The objective of this study was to examine the agreement between the scores of the scales answered by patients and those answered by their proxy, as cognitive decline may interfere with one's ability to understand complex topics, such as the QOL.</p><p><b>Methods: </b>Participants were pairs of patients receiving home medical care and their proxy. The patients were asked to complete self-reported QOL scales (QOL-HC), and their proxies were asked to complete proxy-reported versions of the QOL scales (QOL-HC for caregivers). We then statistically examined the extent of agreement between the self- and proxy-reported QOL-HC scores using contingency tables and Spearman's rank correlation coefficient. The SPSS software program, version 24, was used for all statistical analyses.</p><p><b>Results: </b>The concordance rate between patients and caregivers for questions 1 ( "Do you have peace of mind?" ), 2 ( "Do you feel satisfied with your life when you reflect on it?" ), 3 ( "Do you have someone that you spend time talking with?" ), and 4 ( "Are you satisfied with the home care service system?" ) were 52.3%, 52.3%, 79.5%, and 81.8%, respectively. The total scores for the patients and caregivers were significantly correlated (Spearman's ρ=0.364*).</p><p><b>Conclusions: </b>We created the first QOL scale for patients receiving home-based medical care and for caregivers. The findings of this study suggest that the QOL-HC can be used in clinical practice for the assessment of patients receiving professional home care.</p>

Journal

  • Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics

    Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 55(1), 98-105, 2018

    The Japan Geriatrics Society

Codes

  • NII Article ID (NAID)
    130006434168
  • NII NACSIS-CAT ID (NCID)
    AN00199010
  • Text Lang
    JPN
  • ISSN
    0300-9173
  • NDL Article ID
    028852813
  • NDL Call No.
    Z19-25
  • Data Source
    NDL  J-STAGE 
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