A study of development of quality indicator that evaluates the effect of home care service for the patients with neuro-intractable diseases

【目的】本研究旨在建立评价神经难治性疾病患者及其照护者家庭保健服务效果的质量指标。[方法]对资料进行定性分析，探讨影响家庭保健继续进行的因素，制作临时量表（30项）。这项研究的参与者是442名患者和他们的护理人员：男性；239名女性；203.[结果与讨论]采用因子分析方法，构建了一套包含25个项目的新量表，用于衡量心血管神经难治性疾病患者/照顾者继续进行家庭保健的难度。我们将Promax旋转法应用于因子分析中，并通过改变因子数量的方式进行多次重复。最后，从25个条目中提取出5个因子，每个因子的负荷量均大于0.3。各因素命名如下：1)对疾病和残疾的焦虑；2)照顾者压力；3)运动功能障碍；4)症状的表达。;5)社交网络利用的干扰。量表具有较高的信度，信度范围为0.784 ~ 0.908。

[Purpose] The purpose of the research is to develop the quality indicator that judges the effect of home health care service for the patients and their caregivers with neuro-intractable diseases.[Methods] Data was analyzed qualitatively in order to examine the factors that inhibit the continuation of home health care, and provisional scale item (30 items) were made. The participants of this research were 442 patients and their caregivers : male ; 239, female ; 203.[Results ＆ Discussion] We constructed a 25-item new scale which measures the difficulty of the continuation of home health care to the patients/caregivers with cardio-vascular and neuro-intractable diseases by means of use of factor analysis. We applied the Promax rotation method in factor analysis and repeated it several times by changing the number of factors. Finally, 5 factors were extracted from the 25 item, in each of which the all items having more than 0.3 factor loadings. Each of factors were named as following : 1) the anxiety for disease and disability ; 2)caregiver strain ; 3) the motor dysfunction ; 4) the expression of symptom. ; 5) the interference of the social-network utilization. The constructed scale demonstrated high reliabilities ranging from 0.784 to 0.908.