車椅子利用下における路面のバリアと移動時の声かけの影響に関する調査

【目的】車椅子利用者の安楽に及ぼす影響の１つとして「声かけ」に注目して，バリアが車椅子利用者の体感にどのような影響を及ぼすのかを知ることとを目的とした研究を行った．
【方法】対象者は，２０歳代女性の看護学生で，車椅子利用時の体感に体重が影響することを考慮し標準体重に近い者を選定した．路面の状態については，観察，自走介助兼用車椅子に装着した振動計，座席用振動ピックアップを用い客観的測定を行った．声かけによる路面の状態による主観的反応の相違は，対象者６０人を無作為にA群の「声かけあり群（n＝３０）」と，B群の「声かけなし群（n＝３０）」の２群に分けて把握した．
【倫理的配慮】対象者に本研究の目的及び方法を説明し，同意書に署名してもらった．
【分析方法】アンケート調査結果について２群を比較した．ゆれ・恐怖感・乗り心地の段階評価においてはウィルコクソンの符号順位和検定を行った．
【結果および考察】路面の見かけと振動値は概ね一致していたが，見かけは平らであっても振動値は高い場所もあった．路面に対する反応は以下の通りである．
１．振動が大きいところでは対象者の全身に振動を与え，不快をもたらしていた．
２．傾斜があるところでは対象者に恐怖感をもたらしていた．
３．声かけは対象者が振動を予測して，態勢を整えることに役立っていた．
４．声かけは安心感や気分転換等にもつながっていた．
以上のことから，車椅子利用者の介助に当たって声かけをすることは重要であることが明らかになった．また，多様な路面の性状下でも快適な車椅子利用ができるような介助の方法を探究していきたい．さらに，今回の結果は，車椅子以外にもシルバーカーや自走車椅子利用者の支援のあり方を示唆するものと考えられる．

Aim : A research was conducted to investigate the influence by barriers of road surface on the bodily sensation of wheelchair users, while paying attention to “calling” as a factor influencing the comfort of the users.
Method : The subjects were chosen from student nurses in their twenties. The objective measurement of the conditions of road surface was carried out through the use of observation, a vibrograph equipped on wheelchairs designed for both self-propelling and attendant-propelling, and a vibration pickup set on the seat of the wheelchairs. In order to grasp the differences emerged from calling in the subjective responses to road surface conditions, the 60 subjects were divided randomly into 2 groups of A and B, the former was “the group with calling（n=30）” whereas the latter was “the group without calling（n=30）”.
Ethical consideration : The subjects were explained about the aim and method of the research, and requested to sign the agreement of participation.
Analysis method : A comparison between the two groups on the results of the questionnaire was carried out. For the stage assessment of the vibration, fear and feeling of using a wheelchair, the Wilcoxon signedrank test was performed.
Results and Discussion : There was a general concordance between the appearance of the road surface and the vibration level, but there were some spots where the vibrational levels were high although the surface appeared to be flat. The followings were the responses to the road surface. 1. Where the vibration levels were high, shakes were caused to the subjects’ bodies and made them feel uncomfortable. 2. Besides vibration, slopes on the road also caused the feeling of fear to the subjects. 3. Calling helped the subjects to predict a vibration and to be ready for it. 4. Calling related to the feeling of relief and mood changes, as well.

From those findings, it has been clarified that calling is essential in assisting a wheelchair user. Also, it is a future theme to search for a way to assist in a comfortable use of wheelchairs under various conditions of the road surface.