Departmental Bulletin Paper わが国の地域在住統合失調症者における自己管理の概念構造に関する文献学的研究
Literature Review on General Idea Structure of Self-management for Community-dwelling People with Schizophrenia in Japan

山元, 恵子  ,  籔脇, 健司  ,  川野, 雅資

本研究の目的は,統合失調症者が地域で生活することを可能とする自己管理の概念構造を明確にすることであった。医学中央雑誌Web.5 を用いて統制語検索を行った。自己管理に関する原著論文50文献の結果から,目的に合致した文脈を抽出し,質的統合法で分析した結果,6つの要素が抽出された。それらの要素は,「病名告知を受け,症状悪化の兆候を自分で察知し,治療に参加する(要素1)」,「治療と疾病・服薬・心理教育を受け,主体的に服薬を継続する(要素2)」,「これからの生き方を明らかにするために自分らしさを保持する(要素3)」,「自分らしい生活をするために,自らを統制し,周囲の環境に適応する (要素4)」,「互恵的な関係を保つために,ストレス・悲観的な感情に対処する(要素5)」,「生活の枠組みを作り,自信をもって生活することで自分の価値を実感する(要素6)」であった。これらの要素の構造化を通して,医療を土台とする当事者主体の地域社会における自己管理の概念構造が明らかになった。
The purpose of this study is to make a general idea and clear structure of the self-care which can make it possible for a person with schizophrenia to live in an area. We conducted a control word search using Web.5, a medical central magazine. As a result, we extracted context in line with a purpose from results of 50 original literature reports about self-care, and having analyzed them by the qualitative unification method, six elements were extracted. Those elements were Element 1 was "In response to being informed of their disease, patients notice their symptoms and participate in treatment", Element 2 was "They receive education about treatment, disease, medication, psychology, becoming independent, which continues during medication", Element 3 was "which maintains a quality of oneself to determine your own way of life in the future", Element 4 was "We strive to live life in our own style and adapt to the surrounding environment", Element 5 was "to maintain good personal relations, deal with stress and pessimistic feelings", and Element 6 was "We make a framework of life knowledge which realizes one's value by living a life". A general idea structure of the self-care in the community of the person concerned, based on structured medical care of these elements was found.

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