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論文名 |
看護の立場から（高齢者のターミナルケアをめぐって）
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| 著者名 |
鎌田ケイ子
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雑誌名
巻／号／頁／年 |
老年社会科学，
12
：
4-10，
1990
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| 抄録 |
Discussion by medical personnel about the death of patients has begun recently. Moreover most discussions are about terminal cancer patients；there are few discussions about the death of elderly patients. The death of elderly patients is more natural than the death of younger generations. But because ther are particlar problems about the death of the elderly, discussion should occur. The value of terminal care should be not only assessed by prologation of life, it should also be assessed by the quality of life. Therefore people should have their own individual ideas of how to meet death.
Terminal care shold be provided which satisfies the elderly, their families and medical personnel. Nurses should provide care to the dying elderly for relief of physical and psychological pain. Relief of stress of nurses who take care of dying elderly is a problem to selve in providing terminal care.
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論文名 |
ホスピス・ホームケアの実践から（高齢者のターミナルケアをめぐって）
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| 著者名 |
黒田輝政
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雑誌名
巻／号／頁／年 |
老年社会科学，
12
： 11-23，
1990
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| 抄録 |
In July 7th 1988, we started our practice at home of a bedridden man in Suita City, Osaka prefecture. By July 1989, we visited a total of 17 homes, 323 times, 905 hours. The diseases of the patients are lung cancer, stomach cancer, heart disease, and Parkinson's disease. Of these patients, six have already died.
We visit patients once, twice, three times a week or if necessary every day depending on the condition of their disease. We spend from one to six hours, sometimes alone, sometimes as a team of two or three.
When we are asked to care for a patient, the coordinator visits his home and decides content of care, number of times per weed and time to be spent each time. The current fee per an hour is 800 yen plus transportation. 34 people are registered as careworkers, but 24 have actually worked.
(The conternts of care)
1. We help with household chores such as cleaning rooms, washing and shopping.
2. We have time to talk and read the Bible with patients.
3. We share the grief of the bereaved family and clean the body after death.
Most careworkers are housewives. Some of them have the qualifications of nutritionist, cook, and tercher.
The span of our visits is from Osaka prefecture to Hyogo prefecture.
The way of our practice is that first we visit patients with nurses, who left Yodogawa Christian Hospice and we check points for caring. After this first visit, we have close contact with these nurses.
The feature of our association is that our practice is welfare work which is closely connected with Y.C.H. in the field of medical care, nursing, religion and welfare.
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論文名 |
在宅療養支援システムの現状と問題点について（高齢者のターミナルケアをめぐって）
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| 著者名 |
石黒順造
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雑誌名
巻／号／頁／年 |
老年社会科学，
12
：
24-37，
1990
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| 抄録 |
This is a report on the problems and present situation of a model project, which has been based on the "Home Care Support System", a proposal by the Nagoya City Medical Association.
The purpose of this proposal is to build a system which will free the elderly and their families from worry by making home medical treatment and care available. The system is based on three main concepts：a community care system, a home-care center, and a home-care-support-information system. This model project started in November of 1986 in parts of Higashi and Midori Wards and January, 1988 in all of Kita Ward in Nagoya.
The close cooperation of the three department of Health, Medicine, and Welfare, generally benefited those being cared for and their families. The problem and future tasks of the model project involve the need for more efficient organization between the home-care center, the support-information system and those receiving care. There is also a need for more financial support, trained, and a better understanding of home care for all those involved.
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論文名 |
ターミナルにおける仏教デス・エディケーション；満足した生と満足した死を得るために（高齢者のターミナルケアをめぐって）
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| 著者名 |
田代俊孝
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雑誌名
巻／号／頁／年 |
老年社会科学，
12
：
38-54，
1990
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| 抄録 |
How can we overcome the sadness and hardness of hardness of growing old and ending one's life? This theme is drawing new attention again in the age of aged-people densced society. However, this is not a new matter for us. Human beings have always suffered from this basic problem. We may say that all studies come from this basic point. However, almost all such studies have been in objective fields such as medical science and biology. Generally scientists have not tried best to clear away this hardness by subjectively studying themselves. They have not studied much in subjective fields such as philosophy and religion.
The longer people live, the stronger the question about their life itself comes to their mind. Usually people insist that the aged have to live a meaningful life and to live peacefully by enjoying hobbies and an improved health condition. To some extent these factors are important. Now is it possible to live an eased and well life with such endeavours? How is it possible to overcome the feeling of emptiness which we still feel before sleeping in bed? Without our intentional and subjective studies on the matter of life and death, we have to accept the inmatured end of our life. In other words such kind of life is almost the same as the life with no end stage.
Buddhism teaches us the importance of straightly looking at four aspects of our life：birth, aging, disease and death, and the experience of conversion in terms of the way of thinking about life. These teachings help us to achieve a fruitful and mature life. To gaze at and think about our coming stage of death means obtaining satisfactory life and death.
Wondering if completely burned-life or reached-life exist merely in the long life?
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論文名 |
システムタイナミクス法による老齢学のための人口予測モデル
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| 著者名 |
遠藤マツエ,大松繁
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雑誌名
巻／号／頁／年 |
老年社会科学，
12
：
55-70，
1990
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| 抄録 |
Rapid progress is Japanese industry has changed the social structure. The result has been that big urban cities such as Tokyo or Osaka have developed and prospered economically and financially. But the economic and political power of rural areas has gradually weakened. Thus, young people are concentrated in big urban areas, while, the ratio of the elderly in rural areas is larger than in big urban areas. In order to correct such an imbalance, we must propose alternatives based on future trends in social structure.
In this paper, we make a prediction model of population using the system dynamics method to obtain information on the growth rate of the population structure in rural areas and propose policies for future prosperity. We include six sectors in the social system model by using the system dynamics method. These sectors are the population sector, the industrial sector, the environmental sector, the land use sector, the energy resource sector, and the life quality sector. These sectors in the social model are combined with each other using the system dynamics method. Considering the past fundamental data in each sector, unknown parameters in the social model are identified. We can predict future trends in the population structure by using a model of the social system. We discuss the simulation results for four typical towns in Tokushima Prefecture which have different characteristics. Finally, we make some recommendations for making these towns active and attractive in the future based on the simulation results.
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論文名 |
地域における在宅痴呆老人のスクリーニング法に関する検討
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| 著者名 |
生地新,渡部由里,森岡由紀子,岩崎清,井原一成,安村誠司
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雑誌名
巻／号／頁／年 |
老年社会科学，
12
：
71-84，
1990
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| 抄録 |
For epidemiologic studies of dementia as well as for the public health service, it is important to develop an effective method to screen the aged with dementia residing at home. In the present study, the authors examined the validity of screening the aged with dementia by using a questionnaire.
This questionnaire developed by the authors consists of questions about physical and mental signs including ones related to dementia, ADL and health behavior. The questionnaire was tested on the inhabitants aged 70-74 in a rural town. This pilot study suggested that the questionnaire was quite effective in screening the aged with dementia.
Then this questionnaire was used is a more extended health survey of the elderly in Yamagata Prefecture. The subjects (n=1,884) of this survey were drawn at random from the inhabitants living at home aged 65 years and over in Yamagata Prefecture. In the first stage of this survey, the questionnaires were delivered and collected by welfare commissioners. 1,825 subjects responded to the questionnaire. In the second stage, a psychiatric examination was conducted for all subjects (n=215) who were suspected of dementia according to their answers to the questionnaire and the subjects (n=681) who were not suspected of dementia and who came to the health counseling meeting. As a result, 65 cares of dementia were found among the subjects suspected of dementia and 17 cases among those not suspected of dementia. The latter contained milder cases and fewer cases with vascular dementia as compared with the former.
The results suggested that the questionnaire was useful in screening those with moderate and severe dementia but not effective enough in screening those with mild dementia. The questionnaire may be helpful in finding families having problems with how to care for the demented.
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論文名 |
デイ・サービスセンターの利用に関する研究；老人のサ・メニュー利用評価と身体的・精神的状況の変容について
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| 著者名 |
竹嶋祥夫,足立啓,荒木兵一郎
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雑誌名
巻／号／頁／年 |
老年社会科学，
12
：
85-101，
1990
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| 抄録 |
The objectives of this study were to evaluate positive effects on the mental or physical conditions of elderly persons receiving various services at day-service centers for the aged, and to investigate reduced burdens on their family caregivers through the use of day-service centers for the aged. The study was conducted through questionnaires given to 335 subjects consisting of the elderly participants or their family members at ten centers in the Osaka area.
Major findings were summarized as follows：
(1) More than 80% of elderly participants enjoyed bathing and delivery services. More than 60% of elderly participants enjoyed lunch service and social activities. About 50% of elderly participants enjoyed rehabilitation services. These services were revealed to be effective.
(2) Physical and mental conditions in elderly participants were significantly improved through services being provided in day-service centers.
(3) Physical and mental burdens on family cares were reduced by utilizing these services.
(4) The study showed that day service centers functioned effectively, as far as required services by the local government were concerned. However, more extended services such as frequency of utilization, delivery-buses, and personal care were required to support elderly persons at home.
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論文名 |
生活満足度の構造；因子構造の不変性
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| 著者名 |
古谷野亘,柴田博,芳賀博,須山靖男
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雑誌名
巻／号／頁／年 |
老年社会科学，
12
：
102-116，
1990
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| 抄録 |
The invariability of factorial structure of a nine-item index of life satisfaction (Life Satisfaction Index K：LSIK) was tested with covariance structure model analysis (LISREL). The subjects were 723 elderly community residents in Koganei City, Tokyo, aged 66 years or older, and 465 elderly community residents in Yawata City, Kyoto, aged 65 years of older.
A second-order factor model fitted both the Koganei and Yawata samples well, and simultaneous factor analyses with various equality constraints did not show any significant difference in the factorial structure of LSIK between the samples. The model was composed of 9 observed indicators (items), 9 measurement errors of the observed indicators, 3 first-order factors,. 3 measurement errors of the first-order factors, 1 second-order factor, and 2 measurement error covariances. The first-order factors were named Satisfaction with Life as a Whole, Psychological Stability, and Evaluation of Own Aging, and the second-order factor was Subjective Well-Being.
The results confirmed the invariability of factorial structure of LSIK and its construct validity across the samples of elderly community residents.
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論文名 |
施設在園高齢者の生きがい意識に関連する身体・心理・社会的要因の研究；ストレス・コーピング様式との関連
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| 著者名 |
杉山善朗,中村浩,竹川忠男,佐藤豪,川本俊憲,大友芳恵
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雑誌名
巻／号／頁／年 |
老年社会科学，
12
：
117-126，
1990
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| 抄録 |
The purpose of this study was to identify and analyse several somato-psycho-social factors related to level of life satisfaction of elderly residents in nursing homes with a focus on stress coping styles.
The 72 subjects were elderly residents sampled from two nursing homes in Hokkaido. To measure the residents' level of life satisfaction and emotional support as well as adaptive stress coping and death anxiety, four kinds of questionnaires consisting of a total of 138 items were employed. In addition, medical diagnoses by medical doctors were used to establish the elderly's organic/stress associated diseases and ADL. In addition, one-hour semi-structured interviews were also conducted to categorize, based, on Lazarus' model, personal factors and style of coping with the subjects' daily hassles；their relationships with other residents, the staff members of the nursing home；and their own solitude. The study identified seven categories of coping styles, each of which could be divided into/either a positive or negative mode, for a total of 14 sub-categories. The relationship between level of life satisfaction and the binary data of the above mentioned somoto-psycho-social measures were analysed using Hayashi's quantification method II for discriminant analysis which was broken down into 28 items.
The results of discriminant analysis showed a rather high correlation value of 04440 with the level of life satisfaction according to each variable, especially such as death anxiety and the several coping styles；having positive activities, having moderate psychological distance with other person and so on.
The above results are discussed from somato-social points of view, focusing on the relationship between one's level of life satisfaction and somato-psycho-social variables, especially styles of coping with daily hassles in nursing home elderly.
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論文名 |
情景画の叙述能力における年齢差の検討
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| 著者名 |
佐久間尚子,笹沼澄子
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雑誌名
巻／号／頁／年 |
老年社会科学，
12
：
127-146，
1990
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| 抄録 |
To investigate the effects of aging on narrative production ability, 101 healthy adults in 4 age groups (50's through 80's) and 19 college students were asked to describe a situational picture. Four variables were analysed：1) the number of items in the picture correctly described (amount of information conveyed), 2) the number of major constituents of the picture described, 3) the number of descriptions repeated for each major constituent of the picture (efficiency of narration), 4) ability to infer the theme of the picture and where in the temporal course of the narrative it was given.
Risults：Age differences were observed land 4. a) College students described a significantly greater number of items in the picture than three of the elderly age groups (60's through 80's). On the other hand, no significant difference was observed across the four elderly age groups in terms of describing essential items in the picture. b) The theme of the picture was given in the beginning of the narrative by all but one subject in his 50s. Some students and elderly subjects in other age groups field to give a theme at all, or gave it in the meddle of the narrative. These results suggest that the subjects in their 50s produced more easy-understand narration than the other subjects.
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論文名 |
日本の高齢者の自尊感情とその要因分析
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| 著者名 |
大和三重,前田大作,野口裕二,中谷陽明,直井道子,坂田周一,玉野和志
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雑誌名
巻／号／頁／年 |
老年社会科学，
12
：
147-167，
1990
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| 抄録 |
The purpose of this paper was to study various scales of self-esteem, and to analyze what factors influence the self-esteem of the Japanese elderly. The present study also investigated the possible existence of a high correlation between self-esteem and health, and/or self-esteem and social integration as previous studies in western countries have reported. In addition, the future direction of research was discussed at the end of the paper.
A nationwide survey was conducted of older people who were sixty years old or over. 3,067 subjects were randomly chosen, of which 2,200 were valid cases (male 995, female 1,205；71.7% of those interviewed). A questionnaire was developed to investigate present conditions of the elderly. To measure self-esteem, Rosenberg's Self-Esteem Scale was cut in half and used in order to reduce the number of questions in the total questionnaire. Pearson Correlation and ANOVA were used to look at the relationships between various factors and self-esteem.
The findings showed that "subjective health" and "social integration" have significant effects on self-esteem. This result supported the previous studies of self-esteem in western countries. Also, there was a sex difference is self-esteem. Men tended to have higher self-esteem than women. Factors such as having a job, or whether a person was satisfied with what he-she was doing for other people close to him/her satisfied with his/her health, or felt isolated, influenced both men's and women's level of self-esteem. However, in addition to the previous four factors, the degree of satisfaction with financial status greatly influenced men's self-esteem. On the other hand, woman's self-esteem had a significant relationship with the level of her satisfaction toward support from other people close to her and the level or her daily physical activities.
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論文名 |
パーキンソン病患者における機能低下予防のための運動の実施と重症度の関連
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| 著者名 |
黒田研二,西垣千春,高鳥毛敏雄,中西範幸,新庄文明,多田羅浩三
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雑誌名
巻／号／頁／年 |
老年社会科学，
12
：
168-181，
1990
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| 抄録 |
A mail questionnaire survey was conducted on 2,446 patients with Parkinson's disease who were members of the national patient's association. Valid answers were returned from 1,262 patients with a response fate of 51.6%.
The average age of the subjects was 64.9, and the mean age at onset was 55.2. The distribution of the degree of severity of the disease was as follows；mild 30.9%, moderate 43.0% severe 26.0%. The severity of the disease showed a statistically significant relationship with such variables as the duration of the disease, present age, physical exercise, and compliance with medicine. The more severe disease, the greater the proportion of those who had received physical therapy.
The subjects were divide into four groups according to the duration of the disease. In each group, the patients who were doing exercises by themselves showed a significantly lower proportion of patients with severe cases of the disease regardless of its duration. A stepwise regression analysis, with the degree of disease severity held as the dependent variable, yielded the result that the predictive variables for the degree of the disease were the duration of the disease, physical exercise, and present age in order of standardized coefficients.
These results indicate the possibility that exercise prevents the progression of disability due to Parkinson's disease. It was also found that whether or not the patients exercised was influenced by the explanation about the disease by the physician and the family situation of the patient.
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論文名 |
地域老人の活動能力とその関連要因
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| 著者名 |
芳賀博,柴田博,上野満雄,永井晴美,須山靖男,安村誠司,平良一彦,岩崎清
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雑誌名
巻／号／頁／年 |
老年社会科学，
12
：
182-198，
1990
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| 抄録 |
The present study aims at investigating the level of competence and factors associated with competence in the elderly living at home in rural area.
Subjects consisted of 707 elderly persons living in Ohgimi Village in Okinawa Prefecture and 678 living Nangai Village in Akita Prefecture. The Index it Competence developed by the Tokyo Metropolitan Institute of Gerontology was used for measurement of competence.
The results obtained were as follows：
1) The level of competence decreased with advancing age in both Ohgimi and Nangai. The decline was marked in females than in males for both villages.
2) The difference in competence between Ohgimi and Nangai was not found in males, but females in Nangai showed a significantly level of competence than those Ohgimi did.
3) Controlled for age, self-rated health (in both sexes for both villages), the levels of memory and morale (except females in Ohgimi Village), and the presence of work (except females in Nangai Village) were positively and significantly associated with the level competence.
4) Among physical variables, grip strength (in both sexes for both villages) and time of standing on one except for females in Ohgimi Village, had significant positive relationships with the level of competence. Only in females, was the level of competence significantly associated with skinfold thickness, positively, and with systolic blood pressure, negatively.
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論文名 |
特別養護老人ホームにおける痴呆性老人への建築的対応
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| 著者名 |
足立啓,荒木兵一郎
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雑誌名
巻／号／頁／年 |
老年社会科学，
12
：
199-213，
1990
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| 抄録 |
Integration versus segregation for elderly residents in nursing homes is a perennial issue, often argues in terms of whether or not senile elderly persons should share living areas with the non-senile elderly.
Surveys of 15 nursing homes in Japan were conducted to evaluate the current care management, programs and the physical environment employed in coping with senile elderly persons. Surveys were conducted through interviews and by using an architectural check-list. Nursing homes are conceptually categorized into five types in terms of degrees of integration. A check-list was prepared to evaluate architectural provisions used to cope with confused and disturbing behavior such as night wandering, interference with other residents' possessions, loud talk, acting-out, and undesirable toilet habits.
The higher the ratio of senile elderly persons among the residents and the severer the degree of senile dementia, the greater than need for architectural provisions such as a lock unit, a specially designed corridor for free wandering, a TV-camera monitoring system and sound proofing and so on in facilities.
However, the use of some architectural provisions are controversial in terms of care management and human rights, and need to be re-evaluated.
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論文名 |
在宅痴呆性老人の行動類型別居住環境構成
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| 著者名 |
荒木兵一郎,足立啓
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雑誌名
巻／号／頁／年 |
老年社会科学，
12
：
214-227，
1990
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| 抄録 |
This study discusses suitable organization of dwelling environments for coping with the demented elderly. For this purpose, "wandering" and "urinary incontinence" are chosen significant indicies through correlation analysis of various confused behavior. A cross analysis was then conducted among ４groups of elderly persons, classified by presence or absence of each of the above two confused types of behavior.
On the other hand, home surveys show that most family members segregate the elderly and put them in a limited space in order to maintain their safety and cleanliness.
The following recommendations are presented considering the desirability of minimizing segregation and limitations, of easing the burden on the family and of even assisting the elderly to help themselves at any level. 1. Clear landmarks and signs are required to improve ligibility. 2. A bathroom should be located at the nearest convenience to minimize urinary incontinence. 3. A private bedroom is required to maintain privacy not only for the elderly but also for his or her family members. 4. The bedroom should be located close enough to the family living room and dining room to enhance family care and interaction.
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論文名 |
痴呆性老人のデイ・サービスに関する調査研究；デイ・サービスの評価とその位置づけについての一考察
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| 著者名 |
廖哲慧
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雑誌名
巻／号／頁／年 |
老年社会科学，
12
：
228-244，
1990
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| 抄録 |
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