金沢大学つるま保健学会 = the Tsuruma Health Science Society, Kanazawa University
Abstract
Purpose : The objectives of the present survey were set as follows : 1. To prepare a positivity scale for type-2 diabetic renal failure patients for the psychological construct of “Belated conviction of having worked hard to take care of oneself ” medical-care perception, which was a result reached inductively in the previous study. 2. To elucidate the relationships of the position on the positivity scale with QOL and duration of diabetic nephropathy treatment for type-2 diabetic renal failure patients. Methods : An interview- and questionnaire-based survey was carried out with 70 type-2 diabetes patients with renal failure. The answers to questions about 12 items relating to the psychological construct of the “I will overcome my regrets” medical-care perception were evaluated by factor analysis. The validity of the scale was tested using the GSES scale, and the correlation coefficient. With respect to the characteristics of the positivity scale, QOL is determined using the KDQOLSFTM1.3 scale, and its correlation with duration of diabetic nephropathy treatment is obtained using the correlation coefficient. Results : The outcome was that the three parameters that made up the scale in this research were factors, and were the same as the items in the previous qualitative research. Reliability was confirmed on the basis of the internal consistency of the three parameters. The concurrent validity was confirmed on the basis of significant correlation between the GSES scale and the positivity scale. Both the positivity scale and quality of life (QOL) showed significant positive correlations with the following parameters in the KDQOL-SFTM1.3 scale : social functioning, emotional wellbeing, general health perception, burden of kidney disease, and sleep. Discussion : The ability to hold the “Belated conviction of having worked hard to take care of oneself ” medical-care perception resulted in favorable QOL after introduction of dialysis. In addition, for high-level medical-care perception, it is necessary to recognize the condition as diabetic nephropathy, and to undergo treatment, for a significant period. 目的:帰納的に導き出した先行研究結果である、「遅ればせながらできるだけ頑張ったと納得する」療養認識の構成概念から糖尿病性腎不全患者の肯定感尺度を作成する。また、肯定感尺度とQOLおよび糖尿病性腎症療養期間との関係を明らかにする。方法:2型糖尿病性腎不全患者70名に面接式質問紙調査を行った。質問は、【後悔を収め る】療養認識の構成概念12項目であり、因子分析により、尺度とする3項目の構成を確認した。尺度の妥当性としてGSES尺度を用いて相関係数で検定した。療養認識の特徴は、QOLをKDQOL-SFTM13. 尺度を用い、糖尿病性腎症療養期間との関係を相関係数を用いて導いた。結果:肯定感尺度とする3項目は、質的研究結果と同様の項目で因子となった。3項目の内的一貫性による信頼性( =07. 0)が確認された。また、自己効力感尺度と正の相関により併存妥当性があった。QOLについては、KDQOL-SFTM13. 尺度において社会生活、心の健康、全体的健康感、腎疾患による負担、睡眠において有意な正の相関があった。糖尿病性腎症療養期間とも正の相関がみられた。考察:「遅ればせながらできるだけ頑張ったと納得する」という療養認識が低いよりも高いほうが透析導入後もQOLが良好である。また、その療養認識を高く持つには、糖尿病性腎症として認識して療養する期間が必要と言えた。Thesis of Matsui, Kiyoko / 松井 希代子 博士学位論文(金沢大学 / 大学院医薬保健学総合研究科