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2005 2,720 2,178 2,171 383 1,788 79.8 57 9 6 4 51.0 23.9 2 WHO 2003 2005 2 2007 2 1 WHO 1988 5 31 2005 Tobacco control and health professionals 701-0193 TEL: 086-462-1111 FAX: 086-463-3508 e-mail: 2 3 health professionals 4 2007 11 65 2,722 451 16.5 5 10

2004 2005 6 6 7, 8 9 15 16 2005 7 41 20 53 114 2,720 2005 17 18 17, 18 57 17 9 29 6 11 4 4 2 Mann-Whitney U test 2 1 2 3 4 19 4 5 1.0 95 SPSS for Windows Ver. 17.0 028 11

日本禁煙学会雑誌 第 5 巻第 1 号 2010 年 平成 22 年 3 月 10 日 3 結果 が高くなるとともに低くなる傾向にあった p 1 対象者の属性 0.001 表 1 ② 職種別喫煙率 調査票は 114 施設 2,720 人中 109 施設 2,178 人から回 答を得た そのうち回答に不備のあった者を除く 職種別に喫煙率をみたところ男性は介護職が 2,171 人 男性 383 人 女性 1,788 人 について分析し 53.1 で相談職は 38.9 であった 女性は介護職 た 有効回答率 79.8 分析対象者の平均年齢は男 24.5 看護職 24.8 で相談職は 17.9 であった 表 2 性 31.9 SD 10.1 歳 女性 38.6 SD 12.5 歳であった ③ 施設別喫煙率 が 平均値の検定で有意な差はなかった 男性の施設別喫煙率は 特別養護老人ホーム 2 喫煙率 50.0 老人保健施設 27.4 グループホーム ① 年齢階級別喫煙率 51.5 であった 高齢者ケア施設のケア従事者の喫煙率は男性 各施設の喫煙率を比較すると 老人保健施設と特別 51.0 女性 23.9 であった 男性では年齢階級別 養護老人ホーム p 0.63 老人保健施設とグループ の喫煙率に差はなかった p 0.55 が 女性は年齢 ホーム P 0.85 特別養護老人ホームとグループホ 表1 表2 年齢階級別喫煙率 施設 職種別喫煙率 高齢者施設ケア従事者の喫煙率及び喫煙と職業性ストレスの関連 12

P 0.83 3 p 0.04 p 0.09 0.94 2 15.6 31.7 52.8 p 0.001 8.6 61.5 46.5 p 0.001 6.8 68.5 24.5 p 0.001 9 2 2.10 CI 1.26-3.49 3.75 CI 1.14-12.30 1.41 CI 1.03-1.93 1.66 CI 1.08-2.54 6 0.57 CI 13

日本禁煙学会雑誌 第 5 巻第 1 号 2010 年 平成 22 年 3 月 10 日 0.35-0.92 低い ない 者のオッズ比は 0.50 CI 4 つの他の因子では 上司のサポートが高いに対 0.26-0.96 と活気が低くなるほど有意に喫煙のリス し男性の普通でのオッズ比は 0.37 CI 0.17-0.79 と クが低く 活気がある者の喫煙リスクが高くなって 有意に低く 上司のサポートが高い者に喫煙のリス いた またイライラ感が低いと感じる者に対して クが高かった 男女とも同僚のサポート 家族 友 やや高い者のオッズ比は 1.79 CI 1.03-3.12 高いで 人のサポートおよび満足感では有意な差は見られな は 4.73 CI 1.96-11.45 とイライラ感が高くなるにつ かった れて喫煙のリスクが有意に高くなっていた 男女と 4 考察 も疲労感 不安感 抑うつ感および身体愁訴で有意 な関連はみられなかった 今回の調査対象施設は岡山県備前県民局内の特別養 ③ ストレス反応に影響を与える他の因子 表4 護老人ホーム 老人保健施設の全施設および岡山県グ 喫煙とストレスの関係 年齢調整オッズ比 高齢者施設ケア従事者の喫煙率及び喫煙と職業性ストレスの関連 14

95.6 79.8 2005 51.0 23.9 2005 1 39.3 11.3 11.9 12.6 2 2006 19 19.9 2005 30 39 30 20 20, 21 22 2 1 2 16 23 2 24 15

51.0 23.9 16 1 :. 2008; 91-93. 2 :. 2005; 79. 3 : 2.. 2002; 243. 4,, :.. 2005; 3-4. 5 : 2. 2002; 9. 6 ; 2008. 2008; 34. 7 :. 1994; 1; 20-26. 8,,, :. 1995; 17; 11-20. 9,, :. 1991; 31; 49-59. 10,, :. 1992; 14; 82-92. 11: 17.. 2005; 21-92. 12 :.. 1998; 143-151. 13,,, :. 2006; 53; 7-14. 14 :. 2004; 3; 21-29. 15 : 18. 2005; 26-88. 16 :. 2004; 237; 40-44. 17,, : 11. 2000; 117-164. 18 :. 14 16. 2005; 93-133. 19 :2006. 2007; 4. 20 Wills TA, Sandy JM, Yaeger AM:Stress and smoking in adolescence: A test of directional hypotheses.health Psychol 21: 2002; 122-130. 21 Byrne DG,Mazanov J: Adolescent stress and future smoking behavior: A prospective investigation.j Psychosom Res 2003; 54: 313-321. 22 Jonsson D,Rosengren A, Dotevall A, et al: Job control, job demands and social support at work in relation to cardiovascular risk factors in MONICA 1995, Goteborg. J Cardiovasc Risk 1999; 6 6 : 379-385. 23 Parrott AC: Stress modulation over the day in cigarette smokers. Addiction 1995; 90: 233-244. 24,,, : 0323001 0323001 0323001 0323001.. 21 3 23 16

Prevalence of smoking among workers at geriatric facilities and the relationship between smoking and their occupation-related stress Kazuko Mitoku Purpose The purpose of the current study is to find the prevalence of smoking among those who are directly involved in geriatric care in facilities for the aged and the relationship between smoking and occupational stress. Subjects and methods A survey was conducted in 2005 by distributing self-administered questionnaires on various attributes, smoking and occupational stress. The subjects were 2,720 employees who were directly involved in geriatric care at 114 facilities that included a special care home for the aged and Fgeriatric health care facilities under the jurisdiction of Okayama Prefecture Bizen General Service Bureau and Okayama Prefectural Group Home Association. Responses were received from 2,178, from which those with incomplete responses were excluded. Analyses were conducted on 2,171 383 males and 1,788 females, effective response rate, 79.8. To measure the level of stress, the Simple Survey Sheets for Occupational Stress was used. Through 57 questions, stress factors were described by 9 items, stress responses by 6 items and other factors affecting stress responses by 4 items. A logistic regression analysis was conducted by using each item of stress for the independent variable and the smoking/non-smoking status for the dependent variable. Results The prevalence of smoking was 51.0 for males and 23.9 for females. Smoking prevalence was associated with the levels of utilization of subjects' occupational skill, job satisfaction and supports from supervisors for males, and work environments, job satisfaction, vitality in life and irritability for females. Smoking prevalence was not associated with the levels of psychological burden quality and quantity, perceived physical burden, stress due to human relations, controllability of jobs, aptitude of jobs, support from colleagues and friends, and feeling of satisfaction. Conclusion Compared with the national statistics, the prevalence of smoking was higher among both men and women who were engaged in care giver at geriatric facilities. The prevalence among women employed at those facilities was more than twice the national figure for the corresponding gender. The correlation between smoking and stress was related to the work environment, utilization of their job skills, job satisfaction and vitality. There is an urgent need to implement countermeasures to improve in these problems areas. Key Words workers engaged in geriatric care, incidence of smoking, stress factors, stress responses Faculty of Health and Welfare Kawasaki University of Medical Welfare 17