福祉ホーム入居高齢者の日常生活機能、うつとQOL-ミャンマーの宗教系ホームと日本の養護老人ホームにおける比較検討-(<特集>ミャンマー少数民族地域における生態資源利用と社会変容)

Abstract

Geriatric medicine has addressed not only the diseases but also the activities of daily living (ADL) and quality of life (QOL) of elderly people. Recent research into the QOL of the elderly has focused on the "spiritual" dimension in addition to the physical, mental, economic, and social aspects of QOL. We have been deeply impressed with the importance of the spiritual dimension in a recent international comparative study of QOL among elderly residents of nursing homes for the aged poor in Myanmar (Burma) and Japan. The study population consisted of 140 residents in a Buddhist nursing home (Buddhist Home) for the aged poor (M:F=58:82, mean age: 80.5 years) and 160 residents in a Catholic nursing home (Catholic Home) for the aged poor (M:F=63:97, mean age: 80.6 years) in Yangon (at the time the capital of Myanmar), compared with 283 residents in a nursing home for the aged poor in Osaka in Japan (M:F=152:131, mean age: 77.8 years). We interviewed and examined each elderly resident for depression and Quality of Life (QOL) as well as ADLs. The Geriatric Depression Scale-15 (GDS-15) was used for the depression screening. Five quantitative QOL indicators were assessed using a 100 mm visual analogue scale: subjective sense of health, relationship with family, relationship with friends, financial satisfaction, and subjective happiness. We compared the GDS-15 scores, prevalence of depression using a cutoff-point 5/6 or 9/10, and quantitative QOL scores (0-100) of the residents in the three homes. The GDS-15 scores and prevalence of depression were highest among residents in the nursing home in Japan and lowest among residents in the Buddhist Home. Each QOL score, with the exception of financial satisfaction, was highest among residents in the Buddhist Home, followed by those in the Catholic Home in Myanmar; they were lowest among residents in the home in Japan. Myanmar is one of the economically poorest countries in Southeast Asia, but is known to have many pious people, most of whom believe in Buddhism and some of whom believe in Christianity or Islam. In contrast, Japan is one of the economically richest countries in the world, but few Japanese believe deeply in any particular religion. Spiritual practices, such as meditation among Buddhists and prayer among Catholics in Myanmar, and religious solidarity between residents and care-givers might contribute to improving QOL of elderly poor residents, compared with less religious poor elderly residents in Japan.