The Research on the Construction of Community Care System Model from the Viewpoint of the Woman's Traditional Gender Role in Okinawa

平成13-15年度科学研究費補助金（基盤研究(C)(2)）研究成果報告書 / 成果概要:沖縄県西原町の80歳以上地域住民907名のうち回答の得られた536名(回収率74.2%)を対象に、抑うつ傾向および社会的健康度に焦点をあて検討した。 抑うつ傾向との関連でみると、経済状況ではゆとりがあるとする者で抑うつ傾向は有意に低く、身体的要因では聴力、視力、移動など身体的自立状況の全項目で有意な負の相関を示し、自立度が高くなるにともない抑うつ傾向は低かった。また、健康状況が良好で、過去に入院経験や転倒経験がなく、高血圧、泌尿器科疾患、関節系疾患、骨粗鬆症の罹患疾患のない者では抑うつ傾向は有意に高かった。心理社会的要因でみると、自尊感情と生活満足度いずれも有意な負の相関関係にあり、自尊感情および生活満足度が高くなるにともない、抑うつ傾向は低かった。社会的健康度との関連では領域得点が高くなるにともない抑うつ傾向は低かった。 社会的健康度についてみると、身体的健康状況では主観的健康度が高く、健康不安がない者、転倒経験や通院歴経験がない者、日常生活自立度が良好な者で社会的健康度は良好であった。まわりとの交流状況やソーシャルサポートとの関連では、子供、隣近所、友人・知人との交流頻度が多く、ソーシャルサポートの多い者ほど社会的健康度は良好であった。心理社会的状況との関連では、自尊感情や生活満足度が高く、抑うつ傾向が低い者では有意に社会的健康度は良好であった。沖縄の伝統的社会文化的要因との関連では、伝統行事へ参加し、その際役割を有する者、仏壇や位牌を毎日拝む者で社会的健康度は良好であった。有意な関連の認められた要因を独立変数、社会的健康度の「評価得点」を従属変数とする重回帰分析の結果、関連の認められた要因は伝統的行事への参加、日常生活自立度、隣近所との交流、ソーシャルサポート、自尊感情、生活満足度であった。This study examined the social health and its related factors of later stage elderly people and discussed with physical, psychological condition, and social states of welfare etc. The survey was carried out as a joint project by the author and Nishihara Town, with the help of regional social workers and Nishihara Town affiliated care managers. Surveys were collected through house visit interviews or collection box drop offs, with 536 people (176 male, 360 female) completing the surveys(return rate 74.2%).A relationship was found between a high level of physical health and the degree of subjective health, and social health was found to be good in those who had no health related anxiety, those who had no experience with falls, those who did not visit a hospital at frequent intervals, and those who were self sufficient. In addition, the existence of disease or illness was found to limit participation in social activities.In respect to social interaction and support, the more one interacted with children, neighbors, and friends/acquaintances, and the more one accepted and provided social support, the higher his/her level of social health.Concerning psychosocial conditions, social health was found to be significantly higher in those with higher levels of self esteem and life satisfaction, and less tendency towards depression.In relation to traditional events, views on life and death, the context of praying to an ancestor altar, and the utilization of an Okinawan Yuta, social health was found to be good in those who participated and were depended upon in traditional events, and those who worshipped to an ancestor alter daily.Multiple regression analysis showed a strong relationship between social health and participation in traditional events and self sufficiency in daily life activities, as well as a significant relationship between social health and interaction with neighbors, social support, self esteem, and life satisfaction.These results suggest the importance of an integrated physical, social, and mental approach to maintaining and improving the social health of later stage elderly people