胃切除術後患者の食の変化と生活満足感への影響

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  • イ セツジョ ジュツゴ カンジャ ノ ショク ノ ヘンカ ト セイカツ マンゾクカン エノ エイキョウ
  • Changes in Patients’ Diet after Gastrectomy and the Eff ect of these Changes on Life Satisfaction

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本研究は,胃切除術後患者の食の変化の影響について主観的な生活満足感の視点から明らかにすることを目的とした.大学病院と一般総合病院の2 施設で胃がんの手術を受け術後1ケ月以内の患者25名を対象に,退院後初回の外来受診日に自記式の質問紙による調査を行った.調査には,古谷野らが作成した生活満足度尺度Kを使用した.分析では,対象者を生活満足度尺度のスケール中央値で2群に分け5.0点以上を高群,5.0 点未満を低群とし群間比較を行った.統計解析ソフトPASW Ver.18 for Win. を用いて,χ2 検定,Mann‐Whitney U検定を行った.その結果,対象者の性別は男性21名(84.0%),女性4名(16.0%),平均年齢は62.2 ± 10.3歳(SD)で対象者全員に同居者があり,16名が職業をもっていた.術式は,13名が胃全摘出術であった.生活満足度尺度は9項目で構成され「人生全体についての満足感」4項目,「心理的安定」3項目,「老いについての評価」2項目の3因子構造である.対象の「人生全体についての満足感」は平均1.9 ± 0.9点,「心理的安定」は平均1.8± 0.9点,「老いについての評価」は平均0.8 ± 0.7点で,生活満足度総得点は平均4.4 ± 1.6点であった.生活満足度得点の高群は14名で生活満足度総得点平均5.8 ± 0.8点,低群は11 名で3.0 ± 1.0点であった.高群・低群の2群間比較では,因子「人生全体についての満足感」,「心理的安定」は高群の方が低群に比べ有意に得点が高く,「老いについての評価」では有意差は認められなかった.生活満足度総得点では,高群の方が低群に比べ有意に高かった.以上のことから,胃切除術後患者の生活満足度は,健康に生活している人々と比較しても得点に大きな違いはなく,術後1ヶ月の人々では食の変化のおよぼす主観的な生活満足度への影響は少ないことが明らかになった.

The aim of the present study was to clarify subjective life satisfaction in patients aftergastrectomy with respect to the effects of changes in patients’ diets. The subjects were 25 patients who had undergone operation for stomach cancer within the preceding month at 2 hospitals, a university hospital and a general hospital. A survey was conducted by self-administered questionnaire on patients’ first outpatient visit since leaving the hospital following the operation. The Life Satisfaction Index K developed by Koyano et al. was used in the investigation. The subjects were divided into 2 groups using the median value for life satisfaction as the cutoff point. The groups were a high group with a score of ≥ 5 and a low group with a score of <5. The groups were then compared using the χ 2 test and Mann-Whitney U test with statistical analysis software PASW Ver. 18 for Windows. The subjects were 21 men (84.0%) and 4 woman (16.0%), with a mean age of 62.2 ± 10.3 years(SD). All subjects lived with family members. There were none who lived alone. Sixteen were employed and 9 were not. The surgical procedure was distal gastrectomy in 12 patients and total gastric resection in 13 patients. There were 3 factors for life satisfaction,“ satisfaction with entire life,”“ psychological stability,” and “assessment on aging,” for which the mean scores were 1.9 ± 0.9, 1.8 ± 0.9, and 0.8 ± 0.7, respectively. The mean total score for life satisfaction was 4.4 ± 1.6. The 14 patients of the high life satisfaction score group had a mean total score for life satisfaction of 5.8±0.8. The mean total score for the 11 patients of the low group was 3.0 ± 1.0. A comparison of the 2 groups revealed that the life satisfaction score was significantly higher in the high group than in the low group. There was not a large difference in a comparison between the life satisfaction of patients following gastrectomy and that of healthy people. This demonstrates that changes in diet do not have a large effect on subjective life satisfaction of patients 1 month after gastrectomy.

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