ファロー四徴症修復術後患者の社会的自立状況と生活習慣の検討

Ryoji Shinbara; 新原亮史; Hiroyuki Sawatari; 澤渡浩之; Keiko Yamasaki; 山﨑啓子; Minjeong Kang; 姜旻廷; Ichiro Sakamoto; 坂本一郎; Kenichiro Yamamura; 山村健一郎; Hazumu Nagata; 永田弾; Hiroyuki Tsutsui; 筒井裕之; Hiroaki Chishaki; 樗木浩朗; Tomotake Tokunou; 得能智武; Akiko Chishaki; 樗木晶子

doi:10.9794/jspccs.38.128

ファロー四徴症修復術後患者の社会的自立状況と生活習慣の検討Social Independence and Lifestyles in Patients with Repaired Tetralogy of Fallot

新原亮史¹，澤渡浩之²，山﨑啓子³，姜旻廷⁴，坂本一郎⁵，山村健一郎⁶，永田弾⁶，筒井裕之⁵，樗木浩朗⁷，得能智武⁸，樗木晶子^3,9Ryoji Shinbara¹, Hiroyuki Sawatari², Keiko Yamasaki³, Minjeong Kang⁴, Ichiro Sakamoto⁵, Kenichiro Yamamura⁶, Hazumu Nagata⁶, Hiroyuki Tsutsui⁵, Hiroaki Chishaki⁷, Tomotake Tokunou⁸, Akiko Chishaki^3,9

¹ 九州大学病院看護部Department of Nursing, Kyushu University Hospital ◇ Fukuoka, Japan

² 広島大学大学院医系科学研究科周手術期・クリティカルケア開発学Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University ◇ Hiroshima, Japan

³ 福岡看護大学看護学部看護学科Faculty of Nursing, Department of Nursing, Fukuoka Nursing College ◇ Fukuoka, Japan

⁴ 第一薬科大学看護学部Faculty of Nursing, Daiichi University of Pharmacy ◇ Fukuoka, Japan

⁵ 九州大学大学院医学研究院循環器内科学Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences ◇ Fukuoka, Japan

⁶ 九州大学大学院医学研究院小児科学Department of Pediatrics, Kyushu University Graduate School of Medical Sciences ◇ Fukuoka, Japan

⁷ 保健医療経営大学保健医療経営学部Department of Healthcare Management, College of Healthcare Management ◇ Fukuoka, Japan

⁸ 九州大学病院別府病院Department of Internal Medicine, Kyushu University Beppu Hospital ◇ Oita, Japan

⁹ 福岡歯科大学医科歯科総合病院健診センターHealth Care Center, Fukuoka Dental College Hospital ◇ Fukuoka, Japan

受付日：2021年3月15日Received: March 15, 2021

受理日：2022年4月9日Accepted: April 9, 2022

発行日：2022年5月1日Published: May 1, 2022

背景：チアノーゼ性成人先天性心疾患の中で頻度の高いファロー四徴症において社会的自立や生活習慣を調査し保健指導の基盤を得ることを目的とした．

方法：186名に質問紙調査（病気や治療に関する理解や不安，社会的自立，生活習慣等）を行い，身体障害者手帳認定の有無で比較した．臨床情報は診療録より抽出した．

結果：有効回答者112名（男41名，平均28歳）の半数が親と同居し，学生を除いた93名の83％が就労していた．71％が病気に対する不安をもち，28％は睡眠満足度が低かった．職種では非認定群は専門職が多いが，認定群では事務職が多かった．認定群の医療へのアクセスは高かったが，就労内容や周囲の理解などに不安を持っており習慣飲酒，睡眠導入剤の使用も多い傾向がみられた．

結論：本対象者は比較的高い就労率で社会的自立度も高かったが，様々な不安を抱えており特に心疾患重症度の高い認定群は不安や睡眠障害に対する支援の必要性が示唆された．

Background: The purpose of this study was to look at the current state of the adult patients with tetralogy of Fallot, the most common cyanotic congenital heart disease, to encourage social independence and healthy lifestyles.

Methods: On 186 patients, a questionnaire survey (understanding and anxiety about their heart diseases, treatments, social independence, and lifestyles) was administered. These data were also compared between patients with and without physical disability certification (a certified group and a noncertified group). Clinical data were extracted from the medical records.

Results: After excluding the cases without meeting the inclusion criteria, 112 patients (41 males, mean age 28 years) were studied. Eighty-three percent of 93 patients after excluding 19 students, were employed (66％ full-time employee), half of them lived with their parents, and 71％ were concerned about their heart diseases. In terms of lifestyle, 28％ were dissatisfied with the quality of their sleep. The noncertified group (n=59) was assigned more professional tasks, whereas the certified group (n=53) was assigned more office duties. The certified group had more regular outpatient clinic visits and dental consultations, but also had a greater experience to drink alcohol and take a sleeping pill.

Conclusion: The study patients had a relatively good job rate and a high level of social independence, despite having a variety of anxiety disorders. It was suggested that some supports for anxiety and sleep disorder issues be implemented especially in the certified group.

Key words: tetralogy of Fallot; social independence; lifestyles

日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

原著Original

ファロー四徴症修復術後患者の社会的自立状況と生活習慣の検討Social Independence and Lifestyles in Patients with Repaired Tetralogy of Fallot