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富 山 医科 薬科大 学看護 学 会 誌 第1 号 1 9 9 8

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‑ fr o m th e R e s ults of a Su r v ey in R u r al So ciet y in Jap ^{a n ‑}

A i ko S A W A D A ^l_, N a oko T S U K A M O T O ²_, M in ak o N A K A B A Y A S H I^l,

M ichi_yo M A T S U D A ^l

l Scho ol of N u r s l n g, T oy ^{a m a} M ed ic al a nd P ha r m a c e utic al Univ e r s lt y 2 T ok_yo M et r op^olita n C olleg^{e o}f A llied M ed ic al Scie n c e s

要 約

T he be r e a v e m e nt of sp^{o u s e s} is the m o st s e rio u s trial in o n e

'

s lifetim e. W e c o n ^‑

du cted a s u r v ey ^{o n} the be r e a v e m e nt of _pe ople sixt y fiv e a nd o v e r in r u r al a r e a s in

J apa n fr o m O ct^obe r

'9 4 to Sep te m be r

'9 5^. F inding^s fr o m this s u r v ey ^{a r e a s} follo w s.

1^. E l de rl_y be r e a v ed _pe r s o n s in Jap^{a n}

'

s r u r al s o ciet y ^{e x}p ^{e r}ie n c e a mil d _g rief _pr o c e s s.

2 ^. H o w e v e r_, th e follo wing ^{c a s e s n e e}d s o cial s up p^{o r}ts; 1

)

)

the c a s e th at th ey had n o tim e fo r p ^{r e}p^{a r a}tio n p ^sy^ch olog^{l C a}ll_y bec a u s e their sp^{o u s e s}

'

de ath h ap p ^{e n e}d s ud de nl_y, 3

)

, 4

)

)

c a s e th at th ey ha v e a str o n g ^{a n}g ^{e r a n}d bla m e ph_ysicia n s fo r their sp ^{o u s e s}

'de ath, 6

)

in th e c a s e that e v e n tho ugh they liv e with th eir fa mil_y, their pe r s o n al r elatio n sh i_p s a r e n ot g^{o o}d ^. 3^. W e sh o ul d sta rt with the p ^{r e s e n}t sy^ste m of visitl ng n u r S l ng ^{a S a S O ‑}

cial s up p ^{o r}t fo r the el de rl_y be r e a v ed a nd ad d a c o u n s elling ^sy ^ste m to it . Still m o r e

,

s o m e k ind of v olu nte e r g^{r o u} p^s to c a r e fo r th e el de rl_y be r e a v ed a nd othe r s up p ^{o r}t g ^{r o u}p ^s fo r the m a r e n o w n e eded^.

K ey ^{w o r}d s

be r e a v e m e nt of sp o u s e s, the ^el de rl_y be r e a v ed, g ^rief _pr o c e s s,

r e e o v e ry fr o m b e r e a v e m e nt, a r u r al s o ciet y

Intr odu etio n

lt is s ai d th at n othing ^{l S S O} b itte r a trial in o u r liv e s a s to be b e r e a v ed of o u r

sp o u s e s.

1)

In m a ny c a s e s, the be r e a v ed e x ^‑

p^{e r}ie n c e m e ntal a nd _pb_ys I C al str e s s a nd

othe r r elated _pr oble m s afte r the lo s s . So m e

ha v e a n e xt_{r a o r}di^{n a r}il_y lo ng ^{a n}d ling ^{e r l n}g

‑ 9 ‑

g ^rief _p r o c e s s. H e r e, w e defin e g^rief _p r o c e s s a s th e p r o c e s s of cha ng^{e a n}d r e c o v e ry that the be r e a v ed _go thr o ugh ^.

N o w wh at kinds of _p r oble m s o c c u r whe n a n el de rl_{y p} e r s o n lo s e s a spo u s e? A s w e r e a ch a r lp^{e O}l d ag^e, the p ^{r o}b abili_{t y} of lo s^‑ 1 ng ^{O u r S}p^{o u s e} in c r e a s e s. U n e xp ^{e c}tedl_y,

h o w e v e r, the r e w a s v e ry lit tle data to be

高 齢者に おける配偶者死 別 後^の悲 嘆 過 程

fo u nd c o n c e r n l ng this s ub

j

e rl_y^. W e c o ndu cted a s u r v ey t^{o c}la rif_y what

c o n ditio n s the ag^ed e xp^{e r}ie n c e a nd w hat kind s of _pr ob le m s th ey fa c e afte r their be^‑ r e a v e m e nt, a nd to dis c u s s ho w they ^sh o ul d be s u p p^{o r}ted ^. In this a rticle

, th e s u r v ey r e ^‑ s ults will be pr e s e nted a nd dis c u s s ed fr o m s o m e i m p ^{o r}ta nt p ^{o l n}tS. T his s u r v ey ^{w a s}

c o ndu cted iⁿ T oy^{a m a}, w hich is a t y p^{l C a}l

ag^{r l C u}ltu r al a r e a in Jap ^{a n .} T h is a rticle will g^{l V e a C}le a r vie w of the el de rl_y be r e a v ed liv ^‑ 1 ng in a n ag ^{r l C u}ltu r al a r e a of J ap a n , a n ag^{l n}g ^{S O C}iet y^.

M etb od

T he data of the s u r v ey p ^{r e s e n}ted in this a rticle w e r e c olle cted fr o m O ctobe r of 1 9 9 4 to Sep t^{e m} be r of 1 9 9 5. T he s ub

j

p^{e o}ple of b oth s e x e s sixt y ^‑fiv e a nd o v e r wh o h ad be e n be r e a v ed of their sp^{o u s e s} fo r s e v e n o r ei_ght m o nth s, which is tho ught to

be the le ng th of tim e it take s fo r the be^‑ r e a v ed to r e c o v e r their c o m p^{o s u r e.}

T he m ethod is a s follo w s. F ir st , th e a uth o r s g ^ot the list of the be r e a v ed wh o w e r e r eg^{l S}te r ed at the c lt y ^Offic e of O_yabe_, which is a c lt y ^Of abo ut 3 0,0 0 0 _p e ople in

T oy^{a m a} P r efe ctu r e, a n ag^{r l C u}ltu r al a r e a.

P e ople wh o m et the abo v e m e ntio n ed c o nd i^‑ tio n s fr o m the list _{w e r e s e}le cted^. T he a utho r s telepho n ed the m a n d e xplain ed the

p ^{u r}po s e of the s u r v ey to the m , a nd the n

visited o nl_y tho s e who c o n s e nted to the s u r v ey^. O n e of the a utho r s visited a nd in ^‑

te r vie w ed th e m o n c e a w e ek ^. Inte r vie w s a v^‑ e r ag^ed o n e ho u r in le ng th ^. D u r l ng the

inte r vie w s

, th ey w e r e a sked to a n s w e r q ^{u e s‑} tio n s p ^{r e}p ^{a r e}d in adv a n c e, but th ey ^als o

tal ked fr e el_y abo ut th eir fe eling^{s a n}d tho ughts. T h einte r vie w e r to ok n ote s du r l ng the inte r vie w s with their c o n s e nt.

R e s 1 11ts a nd D is c u ssion

T he n u m be r of a p^op^ulatio n of the el d^‑

e rl_y be r e a v ed sixt y ^‑fiv e a nd o v e r in O y^abe w a s n ot g^{r a s}p^ed ^. H o w e v e r, thirt y ^‑fiv e b e^‑ r e a v ed _p e ople c o n s e nted to b e inte r vie w ed in th e c o u r s e of the ye a r . O ⁿl_y o n e w o m a n r efu s ed to be inte r vie w ed du r l ng the p ^{e r}iod

of the s u r v ey ^. N in e of the m w e r e m e n

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)

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ap plied o nl_{y t}o o n e p a rtici_p a nt of e a ch s e x.

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afte r the be r e a v e m e nt_, 4 4^.4 % of the m e n a nd 3 0 ^.8 % of the w o m e n liv ed alo n e. T h e el de rl_y wh o w e r e living ^with a s o n a nd h is

fa mil_y , with a da ug^･hte r a nd he r fa mil_y

w e r e 3 3^.3 % of the m e n a nd 5 3^.8 % of the w o m e n . F o r the q^{e s}tio n that if th ey had

c a r ed fo r their sp ^{o u s e s} du r l n g their illn e s s_,

7 7^.8 % of the m e n a nd 8 8^.5 % of the w o m e n s ai d,

"

Y e s

"

. In the c a s e of c a r l ng fo r their

Tablel T he c au s e of their sp^{o u s es}

'de ath

wido w e r s wido w s total

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de ath 丘o m a n i11n e s s 8 2 5 3 3

a cdde ntal d e atb 1 1 2

tot如 ^{9 2 6 3 5}

富 山 医科薬 科 大 学看護 学 会 誌 第¹ 号 1 9 9 8

sp ^{o u s e s} fo r thr e e o r m o r e m o nths, ho w ^‑ e v e r,7 8^.3 % of the w o m e n h ad ^this e xp^{e r}i^‑

e n c e wh ile o nl_y 1 4^.3 % of the m en d i d^. H e alth c o nditio n s w o r s e n ed in the c a s e s of 2 2 ^.2 % of the m e n a nd 1 9^.2 % of th e w o m e n afte r the be r e a v e m e nt. T he r e st felt the s a m e a s b efo r e the be r e a v e m e nt.

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w o r s e n ed had a te m p ^{o r a r}y lo s s of ap p^etite,

lo s s of w ei

g h

le m s s o o n afte r the be r e a v e m e nt . T hey h ad

r e c o v e r ed fr o m all of the s e sy ^m p t^{o m s e x ‑}

c ep t in s o m nia wh e n th e s u r v ey ^{w a s m a}de.

O n e of the m e n a nd tw o of the w o m e n still had in s o m nia wh e n th e s u r v ey ^{w a s c o n ‑} du cted^.

F o r the q^{e s}tio n,

"

W hat is m o st p^ainful fo r y ^{o u n o w}? ^" , m a ny p ^{e o}ple m e ntio n ed their p^{o o r} ph_y s I C al he alth ^. In m o st c a s e s,

ho w e v e r, they had e xp^{e r}ie n c ed chr o nic

he alth _pr oble m s b e c a u s e of their ag ^e befo r e

the be r e a v e m e nt, s o their ph_y s I C al c o ndi^‑

w

i do w e r s

(

)

wido w s

(

tio n s had n o sp ^{e c}ial r elatio n sh i_p to their

be r e a v e m e nt. A s fo r p ^sy^ch olog^{l C a}l a sp ^{e c}ts,

lo nlin e s s r a nked fir st_, ir r e sp ^{e c}tiv e of s e x .

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)

"

W he n l ha v e n oth ing t^o do , I c a n

't hel_p

th inking ^abo ut ^m y life^. I w a s v e ry lo n el_y d u r l ng N e w Y e a r

'

s H oliday this y^{e a r .}

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)

"

I fe el lo n el_y ^. N i_ghts s e e m v e ry lo ng ^.

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"

I fe el lo n el_y a s l fe a r ed ^. I tal k to hi m ,

b ut he do e s n ot r e sp ^{o n}d ^."

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ing ^with he r s on

)

A s fo r the m e n _, r eg ^{r e}ts_, w o r rie s abo ut in s o m nia a nd a n xiet y ^{o r} fe eling ^of hel_ple s s^‑

n e s s follo w ed a一te r

"

lo nlin e s s

"

. W o m e n had

simila r te nde n cie s. T he follo w l n g^{S a r e S O m e}

of their r e m a rk s of r eg^{r e}t .

"

At ni_ght_, whe n m y fa mil_y is fa st a sle ep ^, I s o m etim e s wish l had do n e v a rio u s thing^･s fo r he r.

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F i_g1 He alth c onditio n s after the be r e a v e m e nt

a : 2

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a : cha J lg^efo r the w o r s e

b: n o cha ng^e

Table2 T he m o st p^ainful thing^{s o r} fe eling^{s a}t this tim e

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wi^{do w e r s}

lo 且elin e s s

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fe eling ^of help^le s s n e s s

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"

the fe eling i^sinde s cri able

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wido w s

lo n elin e s s

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)

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w o rrie s atn utin s o mi a

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in c o n v e nie n c e'of d ai ly lif^e

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