èšæ¶åºŠ
4å
12å
0å
0å
0å
ã¢ã«ãŠã³ãç»é²ããŠãè§£ççµæãä¿åããã
åé¡äžèЧ
1
ADLè©äŸ¡ã§ã¯ãšãããããªã髿¬¡ç掻æ©èœãè©äŸ¡ããããã身äœçèªç«ããããäžäœã®ãææ®µçèªç«ïŒ1 ADLïŒã以äžã®æŽ»åèœåãæž¬å®ã§ããããææ®µçèªç«ããç¥çèœåæ§ãã瀟äŒç圹å²ãã®3ã€ã®äžäœé ç®ãããªãããã¯ããããããããã®äºè æäžã§åçãåŸç¹ç¯å²ã¯0ïœ13ç¹ã§ããã
èç åŒæŽ»åèœåææš
2
人éäœæ¥ã¢ãã«ïŒMOHOïŒãçè«çåºç€ãšããŠéçºãããã1æ¥ã®äœæ¥ã30åééã§èšé²ããããããã®äœæ¥ããä»äºããæ¥åžžçæŽ»æŽ»åããã¬ã¯ãªãšãŒã·ã§ã³ããäŒæ©ãã«åœãŠã¯ãããããã«äœæ¥ã«å¯Ÿããèªå·±èœã«ã䟡å€ã楜ãã¿ã«ã€ããŠèªå·±è©äŸ¡ã§ããã
äœæ¥è³ªåçŽ
3
é«éœ¢è ã®ç掻æ©èœãè©äŸ¡ããèŠä»è·ç¶æ ã®ãªã¹ã¯ãäºæž¬ããããšãç®çã«éçºããã25é ç®ïŒç·åççæŽ»æŽ»åãéåæ©èœãæ é€ç¶æ ãå£è æ©èœãéãããããèªç¥æ©èœããã€ïŒã®è³ªå祚ã§ãããä»è·èªå®ãä»è·äºé²äºæ¥ã®ã¹ã¯ãªãŒãã³ã°ã«ãå©çšãããã
åºæ¬ãã§ãã¯ãªã¹ã
4
æ§ã ãªçŸæ£ã®å¥åº·é¢é£ QOLãæž¬å®å¯èœã§æ¯èŒã§ãããäžäœå°ºåºŠã¯ã8é åã®å¥åº·ç¶æ ïŒ1ïŒèº«äœæ©èœ ïŒ2ïŒæ¥åžžåœ¹å²æ©èœïŒèº«äœïŒïŒ3ïŒäœã®çã¿ïŒ4ïŒå šäœçå¥åº·æïŒ5ïŒæŽ»åïŒ6ïŒç€ŸäŒç掻æ©èœïŒ7ïŒæ¥åžžåœ¹å²æ©èœïŒç²Ÿç¥ïŒïŒ8ïŒå¿ã®å¥åº·ã枬å®ãã質åé ç®ãå°ãªãççž®çãããã
SF-36
5
é«éœ¢è ã察象ãšãã身äœçãã€çç¶ãå«ãŸãªãè©äŸ¡å°ºåºŠã§ããããã¯ãããŸãã¯ãããããã®2ä»¶æ³ã§åçãããããåŸç¹ãé«ãã»ã©ãã€åŸåãé«ããšå€æã§ããã
GDS
6
ïŒæ¥åžžç掻ã«ãããå¿çšç掻åã®å®è·µç¶æ³ãè©äŸ¡ããã15ã®é ç®ïŒé£äºã®çšæãé£äºã®åŸçã¥ããæŽæ¿¯ãæé€ãæŽé ãåä»äºãè²·ç©ãå€åºãå±å€æ©è¡ãè¶£å³ãäº€éæ©é¢ã®å©çšãæ è¡ãåºä»äºãå®¶ãè»ã®æå ¥ããèªæžãå€åŽïŒã«ã€ããŠãå®è·µã®é »åºŠãåçããåŸç¹ç¯å²ã¯0ïœ45ç¹ã§ããã
FAI
7
äœæ¥æ©èœç¶æ ãç°å¢ã®åœ±é¿ã«é¢ããèªå·±èªèãè©äŸ¡ããã質åã®æ§æã¯ã第1éšïŒæ¯æ¥ã®ç©äºã第2éšïŒ ç°å¢ã§ãããâ äœæ¥æèœæ§ãâ¡äœæ¥åäžæ§ãè©å®ããäœæ¥æ©èœã®åé¡ãæ å ±åéã§ããã
OSAâ ¡
8
質åã®æ§æã¯ã第1éšïŒãåŠçããå€åŽè ããå®¶åºç¶æè ããªã©10ã®åœ¹å²ã«ã€ããŠãéå»ããçŸåšããå°æ¥ãã®ç¶æ³ã§ãã§ãã¯ãã圹å²ã®äŸ¡å€ããéåžžã«äŸ¡å€ãããããå°ãã¯äŸ¡å€ãããããå šã䟡å€ããªããã®3ä»¶æ³ã§ç¥ãããšãã§ããã
圹å²ãã§ãã¯ãªã¹ã
9
ã¯ã©ã€ãšã³ãã察人é¢ä¿ã®ãªãã§æŽ»åãéè¡ããŠããå Žé¢ã芳å¯ããŠè©äŸ¡ããã3é åãèº«äœæ§ããæ å ±ã®äº€æããé¢ä¿æ§ãã®20é ç®ã§æ§æãããŠãããå身çããèªçºçãŸã§ã®4ä»¶æ³ã§æ¡ç¹ããã
ã³ãã¥ãã±ãŒã·ã§ã³ãšäº€æµæèœè©äŸ¡
10
人éäœæ¥ã¢ãã«ïŒMOHOïŒã®æå¿ã®ãµãã·ã¹ãã ã«åºã¥ã 14é ç®ã®èгç¹ãã芳å¯ãããå身çããèªçºçãŸã§ã®4ä»¶æ³ã§æ¡ç¹ããã
æå¿è³ªåçŽ
11
ã«ããäœæ¥éè¡ã¢ãã«ãçè«çåºç€ãšããè©äŸ¡æ³ã«ã¯ãã«ããäœæ¥éè¡æž¬å®COPMãããããäœæ¥ã®ç®çã¯ãã»ã«ãã±ã¢ããçç£æŽ»åããâ ãã®3é åãšããŠãããâ ã¯äœã
ã¬ãžã£ãŒ
12
ã«ããäœæ¥éè¡ã¢ãã«ãçè«çåºç€ãšããè©äŸ¡æ¹æ³ã«ã¯ã«ããäœæ¥éè¡æž¬å®COPM ãããããäœæ¥ã®ç®çã¯ãã»ã«ãã±ã¢ããçç£æŽ»åããâ ãã® ïŒé åãšããŠããã 察象è (ã¯ã©ã€ãšã³ã)ã¯ã ç¹å®ããäœæ¥ã®éèŠæ§ãéè¡åºŠããâ¡ãã«ã€ããŠãïŒïœïŒïŒç¹ã§èªå·±è©äŸ¡ããã â¡ã¯äœãã
æºè¶³åºŠ
13
人éäœæ¥ã¢ãã«(MOHO)ã«ã¯ãã©ãã£ãã»ã¢ãããŒãã®é¢æ¥ã§æå¹ãªè³ªåçŽãšããŠãâ¢ããããããã®æ å ±ãããšã«ã察象è (ã¯ã©ã€ãšã³ã)ã¯ãâ£ããæããšã人çã«ãããäœæ¥ã®çµéšãâèŠããåâããããšãã§ããã â¢ã¯äœãã
OPHI-â ¡
14
人éäœæ¥ã¢ãã«(MOHO)ã«ã¯ãã©ãã£ãã»ã¢ãããŒãã®é¢æ¥ã§æå¹ãªè³ªåçŽãšããŠãâ¢ããããããã®æ å ±ãããšã«ã察象è (ã¯ã©ã€ãšã³ã)ã¯ãâ£ããæããšã人çã«ãããäœæ¥ã®çµéšãâèŠããåâããããšãã§ããã â£ã¯äœãã
ãã©ãã£ãã¹ããŒã
15
çæŽ»è¡çºåäžãããžã¡ã³ãã®ã€ã³ããŒã¯ã§ã¯ã 察象è ã«ãšã£ãŠéèŠãªç掻è¡çºãè ãåããããªããªãæãæµ®ãã°ãªãå Žåã«ã¯ãâ€ããå©çšããŠæããã(ãã³ã)ã«ããããšãã§ãããâ€ã¯äœãã
èå³ã»é¢å¿ãã§ãã¯ã·ãŒã
16
蚪åãªãããªããŒã·ã§ã³ã§ã¯ã 宿œååŸã«ãã€ã¿ã«ãµã€ã³ã枬å®ããŠã äœèª¿ã®å€åã蚺ãªããæ éã«å®æœããã ãã€ã¿ã«æž¬å®ã§ä»£è¡šçãªãã®ã«ã¯ã äœæž©ãèæããâ¥ããåŒåžæ°ãåèè¡é žçŽ é£œå床(SpOâ)ãªã©ãããã â¥ã¯äœãã
è¡å§
17
ãâŠããšã¯ã䜿ããªã(disuse)ãé床ãªå®éããçæŽ»äžæŽ»çºç ããªã©ãåå ãšãããçæŽ»æ©èœãåŸã ã«äœäžãããå šèº«ã®ããããåšå®ã»æ©èœã«çããå¿èº«æ©èœäœäžã§ããããã£ããçãããšå埩ãå°é£ãªããäºé²ãéèŠã§ããã âŠã¯äœãã
å»çšçå矀
18
é«éœ¢è ã®äœå枬å®ã§ããçšãããããã®ã¯ã æ¡å枬å®ãéçŒçè¶³ç«ã¡ã æ€ åç«ã¡äžãããã¹ã(CS-ïŒïŒ)ãªã©ããããä»ã«ããâ§ãã¯ãæ€ åããã®ç«ã¡äžããã»ç座ã®è€ååäœãå«ãç§»åèœåãæž¬å®ããã â§ã¯äœãã
TUG
19
ãã¬ã€ã«ã®æ¥æ¬çåºæº(J-CHS)ã®è©äŸ¡é ç®ã«ã¯äœéæžå°ãçåäœäžããâšããç²åŽæãèº«äœæŽ»åã®äœäžãããã âšã¯äœãã
æ©è¡é床ã®äœäž
20
æ é€ç¶æ ã®è©äŸ¡ã«ã¯ããâ©ããããã簡䟿ãªè³ªåé ç®ã§æ é€ç¶æ ã 12-14 ç¹ïŒæ é€ç¶æ è¯å¥œã 8-11 ç¹ïŒäœæ é€ã®ãããã 0-7 ç¹ïŒäœæ é€ã«å€å®ããããšãã§ããã
MNA-SF
21
äœæ¥ãéè¡ããŠããéã«ãèªåã®èº«äœã广çã«çšããèœåã®ããšãé éšãåè¢ãäœå¹¹ã®éåãã¿ãŒã³ãçã¿åºããŠå調ãããäœæ¥éè¡äžã«ãããç¶æããæ©èœãå«ãã
éåã³ã³ãããŒã«
22
äœæ¥çæ³ã®æŽå²ãéããŠãæ©æ¢°è«çãã©ãã€ã æã«æãæç¢ºã«ãªã£ãã¢ãã«ã§ãããæ¥åžžã®äœæ¥éè¡ã«ãããæ©èœçéåã®åºç€ãšãªãçéªšæ Œç³»ã®èœåã®åé¡ã«çç®ããã察象ã¯ãèªç±ãªéåãé©åãªçåãæçµ±æ§ã«å¶éã®ãã人ã«é©çšãããïŒçéªšæ Œç³»ãæªæ¢¢ç¥çµç³»ãå€ç®ç³»ãå¿èºç³»ã®çŸç ãå€å·ãäžæ¢ç¥çµç³»é害ã«ããå調éåã®é¢ç¯éåã®ç¶æãªã©ïŒã
çäœååŠã¢ãã«
23
ãã®ã¢ãã«ã®ååã¯ãã¡ã³ããŒã¯å ±éç®æšããã¡ããã€ãããã¯ãªäº€æµãå«ããèªå·±ç®¡çèœåããã€ãæå°è ããåŸã ã«èªç«ãä¿ããããå人ã®ããŒãºã«åãçµãããšãã§ããã倿§ãªãã£ãŒãããã¯ã𿝿Žãåããããã·ã§ãã®æé·ãšå€å®¹ãæ¯æã§ããããšãã£ãç¹åŸŽãããã
æ©èœçã°ã«ãŒãã¢ãã«
24
ãã®ã¢ãã«ã®è©äŸ¡ã¯ã颿¥ã§åŸéšããããšã«ãããã¯ã©ã€ã¢ã³ãã®äžé©å¿ãªèªç¥ãæããã«ãããè©äŸ¡ã®èŠç¹ã¯ãèªç¥ã®æªã¿ãšå å ¥èŠ³å¿µã®åºå¥ãèªåæèãç¹å®ãããæèãã¿ãŒã³ãçè§£ãããèŠçãªææ ãçè§£ãããã¹ãã¬ã¹èŠå ãæç¢ºã«ããããªã©ã§ãããä»å ¥æ¹æ³ã«ã¯ããè¡å掻æ§åããèªç¥åæŽçæ³ããªã©ãããã
èªç¥è¡åçæ³ã¢ãã«
25
ãèç åŒããåºç€ãšããçŸä»£ã»å°æ¥ã®é«éœ¢è ã«ããã髿¬¡ç掻æ©èœããäžäººæ®ããé«éœ¢è ãèªç«ããŠæŽ»åçã«æ®ããããã«å¿ èŠãªèœåããæž¬å®ããã
JST掻åèœåææš
26
äžäœå°ºåºŠã¯ã4é åã®å¥åº·ç¶æ ïŒ1ïŒèº«äœçé åïŒ2ïŒå¿ççé åïŒ3ïŒç€ŸäŒçé¢ä¿ïŒ4ïŒç°å¢çé å
WHOQOL26
27
ãã2é±éã®æãã€ææ ãæ°åã®20é ç®ã4段éã ã»åŸç¹ç¯å²0ïœ80ç¹
CES-D
28
5é ç®ãç§»åããã»ã«ãã±ã¢ããæ®æ®µã®æŽ»åããçã¿ã»äžå¿«æããäžå®ã»æãã€ãã®å¥åº·ç¶æ ãè²»çšå¯Ÿå¹æQALYïŒè³ªèª¿æŽçå幎ãç®åºã 5ä»¶æ³ïŒ1åé¡ãªãã2.å°ãåé¡ãããã3.äžçšåºŠã®åé¡ãããã 4.ããªãåé¡ãããã5.極床ã®åé¡ããã
EQ-5D-5L
29
ãæŠèŠïŒæŽ»åçè«ã®ç ç©¶ããçãŸããã ã尺床ã â èå³é¢å¿å¯Ÿç¡æ°å â¡æ±ºæãšäžå±ã â¢æãç®æšãšç®æšéæã®äžèŽåºŠ â£èªå·±æŠå¿µ â€æ°åã®ç¶æ ïŒæ¹æ³ïŒ ã»è³ªåã«ãããæããããããã¯æããªãããã©ã¡ããšãèšããªããããéžæããŠåç ã»å転質åã«ãããããæãããŸãã¯ãããã¯æããªããã«2ç¹ããã©ã¡ããšãæããªããã«1ç¹ ã»åŸç¹ç¯å² 0ïœ26ç¹
LSI-Z