Development and evaluation of QOL indexes of the femoral bone fracture patients from the viewpoint of the home care.

研究目的是阐明65岁或以上发生股骨骨折的老年人预防骨折的组件。在此基础上，建立骨折预防的生活质量指标，并对102例股骨骨折术后出院的老年患者进行研究。在排除死亡、痴呆症所致认知障碍等病例后，以38名老年人为研究对象，分析了询问否认、搬迁和地点不明确三个因素对老年人心理健康的影响。通过问卷邮寄方式通知受试者，要求回答。通过信函向受试者详细描述本研究的目的和效果等，并获得知情同意书，将受试者的主观健康感觉分为优和不优2类，以比较各自的评分。结果：优秀组IADL、PGC和自我效能感得分显著高于非优秀组（P<0.05）。并将自我效能分为优秀和不优秀两类，以比较各自的得分。结果显示，优秀者的IADL和PGC评分明显高于不优秀者（p<0.05）。最后，探讨日常生活因素、主观健康感和幸福感对骨折患者自我效能感的影响。结果表明，健康主观感觉和日常生活能力得分都倾向于显著提高自我效能感的方向（p<0.05）。提示ADL、IADL、自我效能感、主观健康感和公众参与度是老年股骨骨折患者生活质量评价指标。

The research purpose is clarifying the component for the fracture prevention among the elderly aged 65 years or more who experienced the femoral bone fracture. Based on the present findings, QOL indexes for the fracture prevention were developed and evaluated.Hundred two elderly patients who left the hospital with caring beds after the operation due to the femoral bone fracture were research subjects. After excluding the cases of death, cognition disorder due to dementias, etc., inquiry denial, relocation and location indistinctness, thirty eight elderly became the subjects for analysis. The subject was notified by the questionnaire mailing method, and the answer was required. The detailed description of purposes and effects of this research, etc. were carried out to the subjects by the letter, and the consent book was obtained.The subjective sensation on health was classified into 2 categories of the excellent and the not excellent as to compare respective scores. As the result, the excellent showed significantly (p<0.05) higher scores of IADL, PGC and self-efficacy compared with the not excellent. Furthermore, the self-efficacy was classified into 2 categories of the excellent and the not excellent as to compare respective scores. As the result, the excellent showed significantly (p<0.05) higher scores of IADL and PGC compared with the not excellent. In final, the combined effects of daily life factor, and subjective sensation on health and happiness on the self-efficacy among the fracture patients were investigated. As the result, it was shown that subjective sensation on health and IADL score were committed in the direction which significantly (p<0.05) increases the self-efficacy. From the above findings, it was indicated that ADL, IADL, self-efficacy, subjective sensation on health and the public participation were necessary to adopt as QOL indexes among the elderly patients with femoral bone fracture.