発症後の日常生活自立度の改善に与える認知機能、性格の影響
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概要
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The Maudsley personality inventory (neurotic trait : N scale, extraversion and introversion traits : E scale), MMSE, and FIM (conducted at the start of rehabilitation and one month after, and the improvement rate was calculated) were conducted, and the effects of the character and cognitive function of the subjects onthe improvement of independence in ADL after the onset of diseases and prognoses of rehabilitation were examined. The subjects were 39 elderly people over 65 years old (25 with orthopedic, 11 with cerebrovascular, and 3 with other disorders), who showed indications for rehabilitation. Regression analysis identified a significant negative correlation between the E scale, MMSE, and FIM score one month after the start of rehabilitation. A possible correlation between the extraversion trait, cognitive function, and improvement of ADL was also suggested. Multi-regression analysis and the stepwise procedure showed that the explanatory variables of the FIM score one month after the start of rehabilitation were the FIM score at the start of rehabilitation and MMSE, and those improving the FIM were the MMSEand N scale. These results revealed that the neurotic trait was involved in ADL improvement, and the effect that characteristic traits have on improvement of ADLvaries depending on the disorder. However, the disorders of the subjects were variable, the number of subjects was small, and the detailed relationship between the character, cognitive function, and ADL improvement was not clarified.リハビリテーション対象となった６５歳以上の高齢者３９名（整形外科疾患２５名、脳血管疾患１１名、その他３名）を対象とし、モーズレイ性格検査（神経症的傾向：N尺度、外向－内向性傾向：E尺度）、MMSE、FIM（リハ開始時、リハ開始から１ヵ月後の２回実施し、改善率を算出）を実施し、リハビリテーション対象者の性格、認知機能が、発症後のADL自立度の改善、リハビリテーション予後に及ぼす影響について検討した。回帰分析の結果、E尺度とMMSE、リハ開始時・１ヵ月後のFIMの得点との間に有意な負の相関があり、性格の外向性傾向と認知機能、ADLの改善度の間には相互関係がある可能性があることが示唆された。重回帰分析、ステップワイズ法の結果、リハ開始から１ヵ月後のFIMの得点に有効であった説明変数は開始時のFIMの得点とMMSEであり、 FIMの改善率に有効であった説明変数はMMSEとN尺度であった。このことから、性格の神経症的傾向がADLの改善度に関与していること、性格特性がADLの改善度に及ぼす影響は疾患によって異なることが明らかになった。しかし、対象の疾患にばらつきが大きかった点、対象数が少なかったといった問題点があり、性格、認知機能とADLの改善度との詳細な関係は明確にできなかった。
- 2009-12-25
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