並列タイトル等Qualitative study of patients' difficulties and coping after total hip arthroplasty in northern Japan
一般注記出版タイプ： VoR
積雪寒冷地在住の人工股関節全置換術(THA：Total Hip Arthroplasty) 後患者が体験する冬期間の雪と寒さに関する問題と対処方法を明らかにするため, 半構造化面接法による調査を行った. Ａ県のＢ総合病院にて, THA 術後1年以上の患者を対象とし個別に45分程度の面接を行った. 面接内容は｢冬期間に問題となること｣｢冬期間に対処していたこと｣であった. 面接内容を逐語録化した後に, 3名の看護研究者にて内容を分析した. 11名のTHA 術後患者の協力を得た. 女性10名, 平均年齢69.3歳, 術後は1年から6年であった. 1名のみが一人暮らしであり, 2名のみが仕事をしていた. THA 患者の寒冷地における冬期間の問題は,【転倒の経験】,【転倒への恐れにより生じる困難】,【寒さによる痛みと冷え】であった. 対処方法は,【転倒予防】,【屋内でのリハビリテーション】,【人との交流】,【寒さへの対処】であった. 今後, この結果を用いて, 質問紙調査を行い, THA 患者の生活を困難にしている要因を明らかにする研究が必要だと考える.
In northern Japan, snowfall accumulates to 2-3 meters on average, and the road can become very icy in winter. It is a difficult environment for patients with total hip arthroplasty (THA). Quantitative and qualitative studies on the quality of life of THA patients have focused on functional improvement and pain reduction in general, and patients’ experience in cold climate has not been examined in detail. The aim of our study was to explore and describe patients’ difficulties and coping after THA in northern Japan by a qualitative research method. Patients who had undergone primary THA were recruited for this study. Verbatim data were analyzed using content analysis. Eleven patients volunteered for this research. Their average age was 69.3 years. In winter, patients had various problems related to icy roads. Patients experienced falls. They expressed a fear of falling and a difficulty in shopping, meeting friends, going for a walk or clearing away snow around their house. Patients also described pain around their operated hip due to the cold. Patients coped with these difficulties in several ways. When patients had to walk outside in winter, they tried to avoid falling by walking slowly or by holding on to somebody while walking. Some patients avoided going out. Patients also asked their family members or social support for help with shopping and clearing away the snow from the roof and the front of the house. For pain in around their operated hip due to the cold, they tried raising the room temperature, wearing several layers, or applying hot compresses around the operated hip. Patients asked their friends to visit them instead of patients visiting their friends. In place of going for a walk outside, patients walked up and down the corridor at home. Patients following THA experienced substantial difficulties in winter in northern Japan. They managed these difficulties with various strategies. Further research is necessary to find out factors of THA patients’ difficulties in cold regions.
連携機関・データベース国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）