˨˻̎˴̉̍ˇʸለኴɉዿ²´ऍɉዿᶱ‫׳‬³±²³शᶶಏɉ²-¸᮱Journal of Human Care Studies Vol. ²´ No. ²
June ³±²³, pp ²-¸ఖಢ˨˻̎˴̉̍ˇʸ৔Ⴞࠜϥዿ ²´ ‫ށۋ‬ϥၔԠ᠘ཱ࿔࠿ɪʨʍ৊ᕁʱோ୸ɸʪ˨˻̎˴̉ˇʸ᷾ᤡ̍‫̍ح‬ዶʍɲɲʬʆ᷾
‫ށ‬᫻κ᫙ቿࠜ‫ࠜށ‬ɉࢡᄑӦᑬᭀʎɷʠʊʊʃɣʅʍᄉႾ৔ႾࠜለኴʍીೖɪʨɊ˨˻̎˴̉ˇʸʊዶɣɫ‫ށ‬ԕʆɸʧʇɣɥɩ់ʱɶʧɥʇ

³±²² शᶳಏ ²² ఖʎ৚ʫʨʫʉɣఖʇʉʬɥɋ

ᒑɧʅɣɾɿɰɿʂɾɫɊɲʫʚʈᄆ‫ށ‬ʉ᜴࠿ʱϋ‫׮‬ຒʆᆌᄉɶɾ˴ˆˡ˗˻̎˟ º.± ʍۨ᭝ʎɊ

ͮɧɾ࿔࠿ʍशʊɼʫʆʎɸʝʉɣʇɣɥ๨ʊ

ʇʅʃʡʉɣ୻ʫʍা௦֝ԔʱɩɣʅɊᱝɴ ²¶mʉʂɾɋʱᢲɧʪ‫ށ‬ໄາʱᄉʞԎɶɾɋᶱशᶲ̌ಏাʍ

ɼɲʆ᠘ཱʆʎɊ೅ఖಢ‫ށ‬᭝࿔ʊɩɰʪ˨˻̎

³±²³ शᶵಏ ²± ఖႻ‫ۦ‬Ɋึᒓ ²¶,¹¶¹ κɊᜓఄͭన˴̉ˇʸʍខ࿢ʊ࿶࿢ʱঞʅʪɲʇʊɶɾɋɼʫᒓ ´,±³² κɊ᭝࿔᫟᥸ึ ²,·´³ ‫׾‬ʊʍʛʪ‫ށ‬࿔࠿ʇʎɊಢ‫ށ‬ϥʍ˜̎˴ʆʡɡʪɊ
ɔᤡ̍‫̍ح‬ዶɕʍʉʂɾɋɲɲʬʆɡʪɋ

ۨ᭝ʇɼʍাʍໄາ࿔࠿Ɋᦪ᭐ᄉໍʉʈʍපࠍʎɊ˜̂˩ʱᥱɷʅ̀ʸ́˕ʺ˶ʆӂ‫۔‬ʊि्ʡɔᤡ̍‫̍ح‬ዶɕ௓రɴʫʪʇʇʡʊɊʺ̉˕̎ˣ˙˞ʍթᄘˋʺ
˞ʆӂͳᄟʊʚʛ‫ీ׽‬Ԭʊ‫ܫ‬ɷʨʫɾɋ

ಢࠜϥཇѹ߆‫ى‬ϥʆʎɊ‫ށ‬ϥ˜̎˴ʱʈɥɶʧ

࿔࠿ʊʧʪ৔ʍҁɊɣʮʥʪ˞˿ʼ˴Ϲ᰺ʎɊɥɪʇɊि्ʡᠳ៵ɶɾɋ‫ށ‬᫻ʆ᫕ѻɸʪʍɿɪ

᭝࿔ʍᇀଢ଼᜴࠿ᒓʏɪʩɪɊ˜̂˩ʱᥱɷʅ᫙ଢ଼

ʨɊǋዶɣʱ഑ʇɶʅɊǌκɍʍᤡɊɼɶʅǍ‫ح‬ᆔʊϹ᰺ɶɾខᒴᒓʊʡͮɧʪɲʇʇʉʂɾɋ

ʞʍᎃቛʍᶳʃʍɔʮɕɫͪʃऊʇʉʪ˴̎˅ʡ

˨˻̎˴̉ˇʸ৔Ⴞࠜϥʍ᠘ཱʱКᯈɴʫɾ³±²± शʊʎɊጅᒓʍଙɣዶɣᶨlaughterɊsmileᶩឮ࠳ɶɾɋʝɿ೅ఖಢ‫ށ‬᭝࿔ʍұыɸʨʞɧʉɣ
ʇɬʍɲʇʆɡʪɋ
ɔᤡ̍‫̍ح‬ዶɕʎɊ˨˻̎˴̉ˇʸ৔Ⴞࠜϥशต‫ށ‬ϥʍ CG ʊᦋɭʉɪʂɾʍɿɫɊ
ɔ´.²²ɕϒಿɊቼʍᜓթׄႾʍͥធʇɶʅตዿʊওɮʉʂʅɬ
ɾɋɣʝʆʎɊǋʍɔᤡɕʎɊͥκʆ֫ၵᜓթʱ
ʇʪʍʆʎʉɮ˗̎˶ʆໍթɸʪ‫ށ‬ԕɴʱᜟɸʡ
ʍʇʉʂʅɣʪɋǌʍɔ‫ح‬ɕʎɊۨ‫ܕ‬᫙ʣᒑɧఄ
ʇɣʂɾࡷɴʉआʱও៬ɸʪʧʩɊ‫ࢋށ‬ʊዒʂʅӉᥱʍᆾ෋ʊ‫؂‬ɪɥ‫ح‬ʍ๨ପʀʱᜟɸʡʍʇʉʂ
ʅɣʪɋɼɶʅǍʍዶʎɊ‫ݩށ‬ʱԎɶʅዶɥɲʇ
ɫѪ॓ʊʧɣʇɣɥ‫ܛ‬ಢׄႾʱᇽʂʅோ୸ʊᄍɣ

‫ۑ‬ᶱɉ᠘ཱɸʪጅᒓ

ɾɣʇɣɥૌᄬʱᜟɸʡʍʗʇʉʂʅɣʪɋŻ¡²¡Ż˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬ɉ᠘ཱɪʨᶱश᥎ɮɾʂɾρɊʧɥʣɮɩϧɧʍψᒓʊࡩɸʪ୸Օᜓթᶨhelping behaviorᶩʇ‫׽‬ɶɾɪʂɾͼ᣸ɫɊɼɶʅɼʍಢᢑʍੜ‫ء‬ɫʮᑵʆɡʩɊᔵԔɫᏀ༔ᆔɊ᣸ϹᆔɊ৔Ⴞᆔʉˉˏ

ɪʂʅɬɾʇɣɧʧɥɋಢ᠘ʆʎɊঞఖɩ់ɶɾ

˞ᶨᡥଉᶩʱᡥʂʅʆʡɊψᒓʊՏʱᡷɸᜓ࿣ʇ

˧̅˳ʺ̉˞ᢁ௶ʱͥᧅԢᄍɶʃʃɊ೅ఖಢ‫ށ‬᭝ʞʉɸɋᜓթʱோ᧖ɸʪфκᆔ᝿ጳʧʩʡɊ቎ϥ࿔াʍቼʍᶱशʱଶʩ᥏ʂʅɊɔ੠ψʍ৔ɕʱᓑ

ᆔ᝿ጳʱҥҳɸʪɲʇʊʧʂʅɲʍ੠ψᜓթʱ៥ʟ˨˻̎˴̉ˇʸʊʃɣʅɩ់ɶɶɾɣɋ

నɸʪɲʇɫʆɬʪᶨSchwartzᶬ²º¸¸ᶩɋ੠ψ৷ʍ࠳ᑵ

᭝࿔ʆᇽʪ੠ψ৷ɉɔᤡ̍‫̍ح‬ዶɕʍɲɲʬʎɊ᜴࿔ᒓʱ৲ɥ᜴

ጅᒓɫ੠ψ৷ʉʪ඘৤ʱᇽʪʊɣɾʂɾɬʂɪ

࿔ۨϒ‫ݹ‬ʍఖಢκʍ੡ɷɾ੠ψʍ৔ɊԢψᎃቛʇɰʎɊ᫻ቛༀᣈ‫ށ‬᭝࿔ʆʍɪɪʮʩʊɡʪɋ²ºº¶ʡᥱɷʪɋ᜴࿔ᒓɫψʍ᜴࿔ᒓʱ৲ɣɊՕɰ‫׹‬ɩ

शᶱಏ ²¸ ఖʊᆌᄉɶɾӑᬛ‫ۨۿ‬᭝ʎ ·,µ±± ‫׾‬ʱᢲɥʇɸʪ๨ପʀʆɡʩɊɴʨʊʝɾ᜴࿔ᒓɫψۨɧʪၝၒᒓʇ ´± ͨκϒͫʍ᜴࿔ᒓʱᄉʲɿɋঞ‫ܕ‬ʍᖐɶʲʆɣʪκɍɊᅕ๨ʊᖐɶʟκɍʱ৲ɣీቼʎ‫ށ‬᫻ोዒᇉᠷ‫ࠜށ‬ʊմʠʪɪɾʮʨɊ‫ށ‬᫻ʣʪ๨ପʀɊɸʉʮʀɔᎽɕʍɲɲʬʆɡʪɋ

ोዒɲɲʬʍѪ॓Ᏼ‫׹‬ˑ̉˕̎ˏ˞̂ˏࡩጐ៨ʍ

੠ψ৷ᶨaltruismᶩʎԢψ৷ʇʡឰɴʫʪ඘৤

৔Ⴞ૮जᶨӎϙᶩʇɶʅɊˏ˞̂ˏ˴ˣˎ˷̉˞ʆɊψᒓʱੱɶʞɊψᒓʱႾពɶɊψᒓʍɾʠʊ

ʱ࡬᫏ʇɸʪ˨˻̎˴̉ˇʸʍχΟʊஉʮʂʅɣ

ʉʪᜓթʱʇʬɥʇɸʪੳ्ʆɡʩɊᔵԔʍԢᆯ

ɾɋ፥‫۔‬ʍᇽʩ‫׹‬ɣʉʈɪʨᥡʨʫʅɮʪ‫ށ‬ᨃʧʩψᒓʍԢᆯʱҥҳɸʪੳ्ʱବɸɲʇʡɡʪɋ

ʍ˫ʷ˙˅ˏʉʈɪʨʍʊʮɪզওʆɊ‫ށ‬᝿ාᄉၑᄟʆʎ᝖௦ʍᄉၑኚɫᇁΣʊ᫟Фʱвʀʃ᭝࿔ʍাʊʎɊ৔ᆔ‫ݹ‬ҁাˏ˞̂ˏᬬᶨPTSDᶺʃ‫׽‬ɷ‫ܬ‬૗ʆᄉໍɸʪӉᄉʇɣɥႻᡑɫɡʪɋɲ

posttraumatic stress disorderᶩɫ৕ɹᆌᄉɸʪɲʇɊ

ʫʱ˨˞ʍ቎ϥʊᑝɬ୳ɧʅʞʪʇɬɊᦐৎ৔ʣ

ᇀাɪʨᦞԕʉˏ˞̂ˏ˴ˣˎ˷̉˞ʱ࠷ఆɸʪ

јႾឍʉʈʍᱝตʍ඘৤ɫ৕᝸ʇʉʪɫɊቿࠜʇ

ɲʇɫಐ՞ʆɡʪɲʇʱᇽʂɾɋ‫ށ‬᫻ोɪʨʍӊɶʅʍ৔Ⴞࠜɫ૨ɣʣɸɣ඘৤ʇɶʅЀʂɾϔ៥ॏϗʗʍோ୸ᧅᬡʍাఄோ୸ʉʈɶʃʃɊ᭝࿔া

ථી඘৤ʆɡʪɋ੠ψ৷̍Ԣψ৷ʱфκʍ቎ϥᆔ֤ಏɫᦋɭɾᶲಏԞᯃɪʨɊӊॏᇊ᝷࠽ऐ௟ᓑ߆

ᜓթʇɶʅʞʪʇɊψᒓʍ੡਺ʱႾព̍Ӊ੡ɶɊ‫ى‬ϥɪʨಒᧅ቟ࠍ௟୏ʍʡʇʊ࢐ɣɾோ୸Кᯈʱ๨ᦚɣ᧖઄ɸʪᜓթʉʈʆථીɴʫʪɋʝɾɊψ‫ל‬ɰɊ֚जɊ৔Ⴞ‫ݥ‬Ɋᇉᠷजʉʈɪʨʉʪɔࠍʈ

ᒓʊ᧖઄ʆɬʪκʎɊψᒓɫ৔ʱʡʂʅɣʪɲʇ

ʡʍˏ˞̂ˏለኴϥɕʱᎻᐨ֊ɶɊ᜴࿔ۨࡷࠜഊ

ʱ៖ᠪɶɊɣʮʥʪɔ৔ʍႾ៵ɕʱʡʃɲʇɫԳ

ᶲഊʇͼࠜഊᶱഊʗʍςӁʱ᫕߂ɸʪɲʇʊʉʂ

୯ʇʉʩɊ৔ʍႾ៵ʊ‫ܛ‬ʄɣʅᜓթɶʅɣʪʇʞ

ɾʍʆɡʪᶨಒᧅ̍ࢡᄑᶬ²ºººᶩɋʉɴʫʪᶨͼಳᶬ³±²²ᶩɋʝɾ੠ψ৷̍Ԣψ৷ʍ᝿ࠍʈʡɾʀʍ᭝࿔ʊʧʪˏ˞̂ˏʱ೿࠳ɸ

࠳‫ی‬ʊʎӑᆔ᝸‫ی‬ʇ‫ݹ‬ᆔ᝸‫ی‬ʇɫɡʩɊӑᆔ᝸‫ی‬ʪ ɾɊ ࠍ ʈ ʡ ၅ PTSD ‫ ט‬ড় ବ ෋ᶨCPTSD ᶭ RIᶺ

ʊʎӉ੡৷Ɋ঱Ձ‫ৃכ‬ᓧՏɊԟఀՏɊᔵइԧৈՏɊ

Pynoos ʨᶬ²ºº¹ᶩʱఖಢៜឰɶɾ ³² ᮴ᆾʊɊଉঞ

๨ԔʉʈɫɊ‫ݹ‬ᆔ᝸‫ی‬ʊʎᏲ৵৷ʍ኏्Ɋψᒓʍഊʍ᯷ᠷ௟᠂ɪʨʍᒫɬ‫כ‬ʩʆৃɾ੠ψ৷ᶲ᮴ᆾࠓ‫ۦ‬ʍಐ࿵Ɋញࡋ्Ɋˉˏ˞Ɋࡩᡑᒓʍ৷Ԡʣश

ʱᥟՒɶɊ³´ ᮴ᆾɪʨʉʪ˗ʽ˅̀ˏ˞ʱᶱ᥻

ᵱʉʈɫɡɱʨʫʪᶨ໒ࣽʨᶬ³±±¹ᶩɋ቎ϥ৔Ⴞࠜ᫙ʆЀʩɡɱɾɋࡷࠜഊᶱशᄉɪʨͼࠜᶳशᄉʝ

ʆʎɊ੠ψᜓթʎ቎ϥʣ቎ϥʱථીɸʪᔵԔϒ‫ݹ‬ʆʊᦞᄍʆɬʪʧɥʊʇɊញ‫ז‬ʍʺ˿ˏ˞̂̎

Ż¡³¡Żࢡɉᄑᶺ࿔࠿ɪʨʍ৊ᕁʱோ୸ɸʪ˨˻̎˴̉ˇʸ᷾ᤡ̍‫̍ح‬ዶʍɲɲʬʆ᷾

˕̎ࡷ໕གू๤ʊ˴̉˂ᯞʍʺ˿ˏ˞ʱ୮ɣʅʡ

ʇʉʪɔ੠ψɕৃ࿢ʱጣԎɶɊࠍʈʡӂ‫ى‬ʗʍфʨɣɊ‫ۑ‬ᶲʍʧɥʉɔᔵԔʱᇽʬɥ˗ʽ˙˅̀ˏԠᮅଢ଼ɊͭࠪɊɥʃɊ༌Εৃ࿢ɫ‫ܛ‬ཇʱᢲɧʅᱝ

˞ɕʊχዒʅʉɩɶɾɋɲʫʱ֧උ᫙ᬫʍͼࠜᶳɣࠍʈʡʗʍᦦ૾ᮅଢ଼ʱ࠷ఆɶɊ৕᝸ʊড়ɷʅ֚

शᄉ ·¹ ‫׾‬ʊᦞᄍɶɊᶴ‫ࠍی‬ᶨͭࠪɊɥʃɊ༌ΕɊᅸ෤᫟ʊᎶςɸʪʇɣɥ์‫כ‬ʩʡʆɬɡɫʂɾɋ

੠ψᶩʱၔ࠳ɶɾɋɴʨʊ CMI ৃ࿢ʇʍᇁ᫟ɪ

ɲɥɶɾࠜഊʗʍςӁʍᏃೖɊࠍʈʡɾʀʍˏ

ʨɊͭࠪʣɥʃʉʈʍˏ˞̂ˏ‫ט‬ড়᮴ᆾʍ޸ঞ৷

˞̂ˏᅖၤᶨͭࠪɊɥʃɊ༌ΕᶩʎɊ֤शɊᶱशɊ

ʱሯ៖ɶɾাɊࡩᡑʇʉʪࡷͼࠜᄉ ²¶±± ‫׾‬ʇɊᶲशɊᶳशʇీɫɾʃʊʃʫʅϵͬɶɊ᭝࿔াచ

ࡩဆᑳʇɶʅ᭝्ᶴʍࡷͼࠜᄉ᎜ ²³±± ‫׾‬ʱࡩᡑಜʍˏ˞̂ˏ˴ˣˎ˷̉˞௟ᓑςӁɫ PTSD ʗʍʊᦞᄍɶɊˏ˞̂ˏᅖၤʍ࠸ឍᆔ૳୴ʱᜓɥʇ‫׽‬ኌᜓʱ૴ɧʪ҇ɬɫɡʪɲʇʱ࠷ាɶɾᶨಒᧅ̍

ీʊɊ˗ʽ˙˅̀ˏ˞࠷ఆీʊ᭝࿔ˏ˞̂ˏ˴ˣࢡᄑᶬ²ºººᶩɋɴʨʊɊ੠ψৃ࿢ʎɊͭࠪ‫ט‬ড়ʍ‫ݳ‬ˎ˷̉˞௟ᓑʱᜓʂɾʍʆɡʂɾɋ

թʇ᥸թɸʪ҂‫؂‬ʱቌɸɲʇɫሯɪʠʨʫɾᶨࢡ

֤शাɊɼɶʅᶱशাʍᶳ्ɲɥɶɾໍթʱᏙ

ᄑʨᶬ²ºººᶩɋɰɾাɊࠜഊʍвѪ߆‫ى‬ϥɪʨʍ᝸ಙʊড়ɧʅɊ

ɉ᭝࿔ɪʨʍ৊ᕁɫ᥼ʟʊʃʫʅɊࠜഊʗʍֵ

ᶱࡷࠜഊʆᶲशা̍ᶳशাʝʆɪɪʮʩᏙɰɾɋ

෤ςӁʍᏀ᰺ʱҮʊɊ‫ۑ‬ᶳʊቌɸɔ᭝࿔ˏ˞̂ˏ

ঞీɊӆዒʍࡷͼࠜഊʊ‫ࠜށ‬ʍ৔Ⴞʍ࡬᫏ࡂɫᫎ

ˇʸ˴ˡ˻ʸ́ɕʱԧЀɶɊӂ‫۔‬ʍࠜഊʊ࿵௶᧖

ಜ᫙ςӁɸʪɲʇɫʉɪʂɾʍʆɊ૜୛ʩʆʍ

ऑɶɾɋɼʍা௑វɴʫɊρ‫ۋ‬ʍ೅ఖಢ‫ށ‬᭝࿔ʆ˨˻̎˴̉ˇʸʇʉʂɾɋ

ʡ᫟Фᒓʊ᧖ऑɶʅໍᄍɴʫɾɋᔵԔʱᇽʬɥ

ɲɥɶɾςӁʍͼɪʨɊଉϙʱࡩᡑʇɶɾˏ˞˗ʽ˙˅̀ˏ˞ʎɊɼʍাᆌᄉɶɾ๽ᄑࡷࠜഊΟ̂ˏ˴ˣˎ˷̉˞௟ᓑለиɊᔵԔʱᇽʬɥ˗ʽ˙ϗɊ‫׮‬ཀ᭝࿔ʆʡጅᒓʍᡭϙʍʡʇʊ௑ᐁԢᄍʊ

˅̀ˏ˞࠷ఆ˴ˡ˻ʸ́ʱʃɪʂɾଉϙʊʧʪѪЙɸʪʇʇʡʊɊдᯈʆɬʪϖ᫙ʍ૜ʊʧʪ௑ᐁ

॓௟ᓑʇɶʅʍˏ˞̂ˏ˴ˣˎ˷̉˞௟ᓑ࠷ᣊʇ

ʍɥɧ‫۔‬ӑ‫ݹ‬ʍۨ᭝̍࿔࠿াʍˏ˞̂ˏ˴ˣˎ˷ɣɥ‫ܛ‬ಢ˭̃ˆ˿˶ɫʆɬɡɫʂɾɋʡʀʬʲ‫ۋ‬̉˞௟ᓑʊԢᄍɴʫʅɣʪɋ

‫י‬ɶɾ˗ʽ˙˅̀ˏ˞ʎɊࠍʈʡʍˏ˞̂ˏለኴ
ϥ˷̉˦̎ʊʧʂʅַఖˉ̉˪˻̎˕ʊӁՏɶɊ
ɔͭࠪɕ
Ɋɔɥʃɕ
Ɋɔ༌ΕɕɊɼɶʅಢ៵ᒑʍ΂Ϲ‫ۑ‬ᶲɉᔵԔʱᇽʬɥ˗ʽ˙˅̀ˏ˞ʍɥʀ
ɔ੠ψ৷ɕ᮴ᆾʍʺ˿ˏ˞ɋɉɉ

‫ۑ‬ᶳɉ᭝࿔ˏ˞̂ˏˇʸ˴ˡ˻ʸ́ᶨࡷࠜᄉ၅ᶩɉɉɉɉɉɉɉŻ¡´¡Ż˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬ËÓ ࢇࣉԝᤁᤉ᝺Οϗᒓʨʇʍί໐ɫʎɷʝʂɾɋJR ᝷ఖಢʍᦧఎଉ
ঞʍఄʎɊɩ࠳ʝʩʍᦧఎФʇɶʅʆʎʉɮɊκ³±±¶ शᶴಏ ³¶ ఖɊJR ᝷ఖಢࢇࣉᰢᇀԳʍˁ̎
ˬʆԝᤁɫ౭᢫ᤉ᝺ɸʪΟ௕ɫᆌᄉɶɾɋΎ࠸᫙ʇɶʅ‫ݳށ‬༦ɪʞʍɡʪ৔ഒʍʧɣκɾʀʆɡʂɾɋ

²±· ‫׾‬ɫၝၒʇʉʂɾɫɊɼʍͥκʎጅᒓʍᑵ߁Ɋ

үʎɲʍ᮳ɪʨ‫ీࠜށ‬ϐʍᗹៜለኴϥϖ᫙ʇӖ֬ࠍʆɡʂɾɋᑵ߁ʎɊɣʃʡʍʧɥʊࡂఎʱ᝾

᫕ʱೖɾɶɊ࠳शাʊ‫؂‬ɰɾᗹៜͪళʍఖɍʱៜ

ᥡʂɾাɊ๖ញʍςᠷʍɾʠɲʍ᭙ᤁʊΎʩ‫׹‬ʮʩ߂ʠɾɋɼɶʅΟ௕ɪʨᶲशᆾʍలɊ
ɔˆ́̎ɺɊΟ௕ʊɡʂɾɋүʇɼʍࡂఎʎɊɼʍఖʱ݄

˭ɣʂɺɬɕʇɣɥᎫκᗹៜࡂᭂ‫ۍ‬ʱᏃીɶɊᱝ

ʊਲՈʍ΂κӆʇ֊ɶɾɋਲ੉ʉϹ᰺ʎጅᕄɶ᭐

ॎʱϜᄘɶɊκɍʱዶʮɺ߂ʠɾɋͭहʉԎಿΟɣɋቼʎɊ᣸᥎ɪʨ PTSD ɫʈʍʧɥʊᆌႻɸʪ

ʱΎʩᢳɧʪՏʎɊዶɣʇɣɥ˳ˎ˜ʹˬ੡਺ʱ

ɪʱᇽʂɾɋᦧఎʍᖐɶʞʎɊψκʊʎԔɪʨʉ

ᔵʨପʀᏙɰɊψᒓʊϧɧɊψᒓʱඕɶɮɴɺʪ

ɣɋ˴ˏ˷˝ʹʸʍ‫כ‬ಲ௒ղʍӵɴʊʎ੍҈ʱᏒʺ˯̉˞ʆಂʊሼɬɫɪɰʨʫɾʧɥʆɡʂɾɋ

ɶɾɋүʊʇʂʅʎঈʆɡʩɊᄋʣߍʊʇʂʅʎ

үʎɲɥɶʅᶲशʱহɾɹʊዒʀᇀʩɊࡂఎʡɼ

ញɶɣ‫ך‬ျʆɡʩʃʄɰʎɶɾɫɊ˨˻̎˴̉ˇ

ʫʊʑʂʐʨʫʪʧɥʊҮ๨ʱ‫כ‬ʩ૕ɶɾɋ
³±²² शɊͧ‫ۋ‬৖ʱ᥍ɧɾɼʍఖɊၵዒɶɾࠍʸʍ࡬᫏ࡂʇɶʅʎӂɮ࿵Տʆɡʂɾɋ
ᦧఎʣᡥҁᒓˆ́̎˭᫙ʆʍੜ᝾ʍᦒɣʊ໤ᒚ

ʈʡɾʀʍᯐʎᄉɬᄉɬɶʅɣɾɋ

ɶɊ‫כ‬ಲʱ‫ל‬ɰʅʡϧɧɾɣӑࡄʍͥᧅɶɪ‫כ‬ʩዶɣʍᥡʩ૜ʊʉʪ՞ᄍʊʃɣʅɊঞఖʍ᠘ཱ

ͫɱʨʫʉɣ˴ˏ˷˝ʹʸʊᖉዒʃүʇɊɼʍࡂ

ʆʎ ²¶ Ԕʚʈᇀଢ଼үʊ់ɶʅʡʨʂɾᶨ‫ۑ‬ᶴᶩɋఎʱ᣸᥎ʆ᝾ʪ᣸ʎᤸɪʂɾɋɼʲʉͼɊቼʍੜɼʍీʍ់ʍӑࡄʱ‫ۑ‬ᶵʊቌɸɋ

᝾ʱɼʍʝʝ୤ᤓɶʫɮʫʪ৔ɡʪឧᒓʊԎϥɧϥ‫ܬ‬ɪʨɊዶɣ‫ݩ‬ʇʇʡʊɊɸɸʩຳɮ‫ݩ‬ɫᒫɾɋቼʎԳ‫؂‬ɬʊκᄉʱ଻ɧʪɲʇɫ‫ށ‬ԕɿʇ៵ɲɧɾʍʎቼʍ኶ᒠʆɡʂɾʍɿʬɥɪɋʝɾɲ

ɷɾᶨࢡᄑᶬ³±±·ᶩɋʍఖʍથញϥԳʊʎɊˆ́̎˭ɣʂɺɬ᫟‫ށ‬εዶᶱशাʍ ³±±· शᶴಏ ³¶ ఖʍઆ᭟ॾʆɊүɫέ‫ᦿރ‬ɴʲʊʧʪɔࠍʎ᪚ᶨɪɸɫɣᶩɕʆɊ‫ב‬Ւɬᑵ߁ʊៜʩɪɰɾӑࡄɫɊಚఖంᒫʍˉ˿˶

ᒓʍʞʉɴʲʊʎຳɬዶɣʱϹ᰺ɶʅʡʨʂɾɋ

ɔ‫ݩނ‬κៜɕʊ࠷‫׾‬ӁʩʆᎶςɴʫɾɋϒಿɊүʍᆌលʊ৔ɫᥱɷɾឧᒓʣɊϜඋκΟଉঞᒓɊࠜ

‫ۑ‬ᶴɉ᠘ཱͼʆүᶨࢡᄑӦ‫ݥ‬ᭀᶩʡ់ɸ

‫ۑ‬ᶵɉүʍ៯់ʧʩᶳʃʍɰɷʠ

Ż¡µ¡Żࢡɉᄑᶺ࿔࠿ɪʨʍ৊ᕁʱோ୸ɸʪ˨˻̎˴̉ˇʸ᷾ᤡ̍‫̍ح‬ዶʍɲɲʬʆ᷾

೅ఖಢ‫ށ‬᭝࿔ʇ੠ψ৷ࠜϥ᠘ཱɪʨᶱ̌ಏাʍᶸಏ ³µ ఖɊӖʒሃऍʱឭʫɾɫɊჱ቉ʍපࠍʊ‫ݳ‬ʮʩʎʉɪʂɾɋA

᠘ཱʍఖʍᶱ᥻᫙ԳɊቼʎ࠽܏ᇊሃऍऐʍ A ࡷࡷࠜഊʍᬯɊB ࡷࠜഊʆɔᔵԔʱᇽʬɥ˗ʽ˙˅ࠜഊʱឭ٨ɶʅɣɾɋᬎᄉʇΠκʆɊॗ݊ʇ֊ɶ

̀ˏ˞ɕʍ˝̎˕ӁՏЀඋʱᬎᄉɾʀʇᜓʂɾᒁ

ɾ A ࡷࠜഊʱឭʫɾీɊ᫻ቛༀᣈ‫ށ‬᭝࿔ɪʨᶲ᥻

ఖɊག྇ʇ᭑ʆഊॐɫ๬໠ɶʍ A ࡷࠜഊʱӖʒឭ᫙াʍ᝷࠽ऐӑʱฯɬ‫ۋ‬ʂɾీʍɲʇʱ৲ɣԎɶʫɾɋౡɴʇᄴᔶཫɥᦪ᭐૗ʊ϶ʟκɍʎᅋॺʅɣɾɋჱ቉ɫࢡከʞʊʉʩɊࣖʫᗹʀɾᱝᥴᦐ

ɶɊលᗼ௦ʡࡸʉɪʂɾɋɶɪɶɊᬈʩɡʪᯨ௶

ᣈʍᓫʱࠍʈʡɾʀɫ᥸ʫዒʂʅฯɮᯞ౔ʇɼʂ

ʣ᧖Ꮛၑᢁʱ˲˿̉˜ʹʸʍᖏᒓɪʨ‫ל‬ɰ‫כ‬ʩɊɮʩʍҴ౔ɫɡʀɲʀʊʞʨʫɾɋд‫׳‬ʎ‫ݘ‬ʫɊᆕʆԔɰ‫׹‬ɣɊ҄ɪʉԎಿΟʱඕɶɮៜʩɡʂʅ

ఖಢӂ‫۔‬ɪʨʣʂʅɬɾɩࣿʩɴʲɫίᥱ௨Ⴞʱఖɍʱ‫ډ‬ʲʆɣɾɋɸʪߑʡ·ɍʊ᝾ɾɋɼʍఖʍሃऍʎɊ᭝࿔ɪʨ

κʇʍᤡɊ‫ح‬ʣɪʉϖ᫙ɾʀʇʍϥ់Ɋዶɣ᯦

ᶴ̌ಏɫɾʂʅɣɾɫɊ᝷࠽ʍ֤ಏাʇ‫׽‬ɷᯞ౔ʏɶʅᖐ᭐ʱΎʩᢳɧʪ᜖ʇɣɥᶳʃʍɔʮɕʱɊ

ʆɡʂɾɲʇʊʉʪɋໄາ᜴࠿ʎ੍҈ʱᢲɧʅɊ

ሃऍʍᦪ᭐૗ʊᭂɥκɍʎకʊ᣸ʊʃɰʅɣɾʧ

ᯞ౔ʱ‫ݘ‬ɶʅɣɾɋ৊ఘʎʝɿҳɿʇ৲ʂɾɋ

ɥʆɡʂɾɋ

᭝࿔ᶳ̌ಏাʍᶶಏʊ࠷ఆɶɾᔵԔʱᇽʬɥ

᜴࠿ʱ‫ל‬ɰɾɳಢκɪʨɊ˲˿̉˜ʹʸʇɶʅ˗ʽ˙˅̀ˏ˞ʍᏃೖʎɊ
ɔͭࠪɕʡɔɥʃɕʡɔ༌

Ⴛۨʆ҇ɮ᜴࿔ۨ‫ݹ‬ʍκɾʀʊ‫؂‬ɰʅ௓࡭ɴʫʪ

ΕɕʡɊ੍҈ᥱʩ᝷࠽ʆʍ᭝࿔াᶲ̌ಏাʍᏃೖ

ҥɶɴɊψᒓʱோ୸ɸʪӌϹᆔʉ୸Օᜓթɫឍࡗ

ʧʩওɮᜟʫʅɣɾɋɼɶʅʉʊʧʩɊ
ɔ੠ψ৷ɕʆɬɾʍʎहɣʆɡʂɾɋ

ৃ࿢ʡᑳʱ૽ɣʅᱝɣђʱቌɶʅɣɾɋࠍʈʡɾ

²² ಏʊʎቬࣃᇊɣʮɬऐʍࡷࠜഊᶲഊʇͼࠜʀʎɊ᭝࿔̍ໄາ࿔࠿ʊʧʂʅওɣˏ˞̂ˏၤੳ

ഊᶱഊʆʡɊ
ɔᔵԔʱᇽʬɥ˗ʽ˅̀ˏ˞ɕʱЋʂʊɡʩʉɫʨɊψᒓʱ௥ɣɊψᒓʍɾʠʊʉʪɲ

ɾˏ˞̂ˏ˴ˣˎ˷̉˞ʍ୏උɫᜓʮʫɊጅᒓʎ

ʇʱ႟ҳɶʅ࠷ᜓɶʅɣɾʍʆɡʪɋ

ᬎᄉɾʀʇӁՏЀඋʇᏃೖʍ௨Ⴞʱ૜ϧɣɊோ୸ຫʱɩϧɧɶɾɋׄᆌΟ௕ʇɣɥԠʍ᝸‫ی‬ʡӁʂɾቬࣃʍᢁ௶ɪʨʎɊɴʨʊওɣ᜚கʱ‫ל‬ɰɾɋࠍʈʡɾʀʍቌɸᱝɣɔɥʃɕʣɔ༌Εɕৃ࿢ʊʆʎʉɣɋɔ੠ψ৷ɕৃ࿢ɫɔͭࠪɕʇʇʡʊᱝ
ɣђʱቌɶɾɲʇʊ᜚கʱងɧɾʍʆɡʪɋ
शʱᢳɶɾ ³±²³ शᶱಏɊሃऍʍ A ࡷࠜഊʆΠ्ᆾʍɔᔵԔʱᇽʬɥ˗ʽ˙˅̀ˏ˞ɕʱʃɪʂ
ɾ୏උɫ࠷ఆɴʫɾɋ᭝࿔ʍᶳ̌ಏাɪʨᶹ̌ಏ
াʗʍ‫֊ݳ‬ʱʞʅ᱉ɣɾɋɲʍ᫙ʊɊϔឮ϶ࢍʗʍኌᤉɫ᥼ʞɊ϶შ݄ʎࡸɶʧɮʉʂɾʎɹɿʂ
ɾɫɊɔɥʃɕʇɔ༌Εɕᅖၤɫʧʩওʝʂʅɣ
ɾɪʨʆɡʪɋ᝷࠽ʍʇɬʎɊᶲ̌ಏাɪʨᶶ̌
ಏʊɪɰʅˏ˞̂ˏৃ࿢ʎʈʫʡϵͬɶʅɣɾʍ

‫ۑ‬ᶶɉሃऍऐዒ Â ࡷࠜഊɋໄາɫᝳʂɾీԬʆ
ీឞɫหʝʂɾʝʝɋɉɉɉɉɉɉɉ

ʇʎ‫ᦒށ‬ɣʆɡʂɾɋʇʎɣɧɊ
ɔᔵԔʱᇽʬɥ˗ʽ˙˅̀ˏ˞ɕʆ༨ʪɲʇɫʆɬʪᅖၤৃ࿢ʍ

Ż¡¶¡Ż˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬ᶴʃʠɔ੠ψ৷ɕৃ࿢ʡ‫ށ‬ɬɮ݇Ւɶɾɲʇʎࡸ

Ͻ៯ɿɫɊ᭝࿔ᇀাɔ᫻ቛༀᣈ‫ށ‬᭝࿔ʇࠍʈʡ

ɶ߿ɶɪʂɾɋࠍʈʡɾʀʍ৔ʍͼʊɊψᒓʗʍʍ৔᣸ɕɫ‫ݫ‬ʩԕʫɾʍʆ݇Ԩɸʪɲʇʊʉʂ

৲ɣʣʩɊӉ੡৷ʆቌɴʫʪ੠ψʍ৔ɫ᮵៬ʊ

ɾɋԨʩͫɫʪʝʆʍ᫙ɊᏲ৵ΟੳɿʇɣɥʍʆɊ

ᓑʂʅɬɾʇ৲ɧʪɪʨʆɡʪɋ

ᢁ௶ᭂʱ PDF ˫ʷʺ́ʊɶʅ࿵௶ӆ᫕ɶɾɣʇ
Ԏ၅቎ʊɩᯓɣɶɾʇɲʬɊַॎʊΛពɶʅɮɿ

᠘ཱাʍɲʇʇ੠ψʍ᥿់ɴʂɾɋ᭝࿔ʎԢᆯʱ्᥏ɶɶʅԢψ̍੠ψʍ৔ʱԎ၅቎ʊʡ‫ו‬ʛɶɾ᥿់ʆɡʂɾɋ

ɣʝጅᒓʎɊ᜴࿔ۨʍࠍʈʡɾʀʍˏ˞̂ˏᅖ
ၤʱʣʮʨɱɊ੠ψ৷ʱᓑʟɾʠʍ࠷ᣊ˭̃ˆ˿

௮ɉႈ˶ʱӂ‫۔‬ʊूʠʅɣʪɋ
ǋᔵԔʱᇽʬɥ˗ʽ˙˅̀ˏ˞ʱЋʂɾࡶӁᧅʍˏ˞̂ˏ૳୴ʇǌᏃೖ᥏ָʱɪʮɬʩʊɊǍˏ˞̂ˏˉ̎˪̉ˆʱ௟ɧʪɋɼɶʅ‫ۑ‬ᶷʊቌɸʧ
ɥʉǎͭࠪʱ૴ɧʪ̀˿˅ˑ̎ˍ˽̉ɊǏɥʃᅖၤʱ௑‫ٴ‬ɸʪʸ˅˜ʹ˯̎ˍ˽̉ຫʍиৃɊǐ༌Εʱᗹʀᇗɪɺʪ௮ᭂЀʩʱɩɲʉɥɋɴʨʊɊ

໒ࣽཿ‫̍״‬Ӆࡴᑵ౗̍໒ࣽ༊‫״‬ᶨ³±±¹ᶩᶮ Һዢಜʍ੠ψᜓթʇӉ੡৷ʊ᫟ɸʪᆌᦑᆔለኴᶮ ӊॏ௟ᓑ‫ށ‬ࠜለኴ᎚᝸ᶬ́´ᶬ́²-´¹ᶮಒᧅ቟ࠍ̍ࢡᄑӦᑬᭀᶨ²ºººᶩᶮ ᫻ቛༀᣈ‫ށ‬᭝࿔ʇࠍʈʡʍ৔᣸ᶮ ‫ࠜށ࢑פ׾‬Ԏ၅ϥͼಳᇍɉᶨ³±²±ᶩᶮ ቎ϥᆔӉᄉʍ৔Ⴞࠜᆔ‫ܛ‬ቃᶭ੡਺Ǒ੠ψ৷੡਺ʱᓑʟɾʠʍቍၤಅɬʇɊǒ᫾࿔̍ʍˉ˵˻ˡˇ̎ˍ˽̉ʇᦐৎᆔ੡਺ᶭᶮ ࠨᧉ࠽‫ށ‬༜࿔௟ᓑ˴ˡ˻ʸ́Ѐʩʇʆථીɴʫʪᶨࢡᄑᶬ

ࠜ‫۔‬ᬫࠜᧅለኴ៵ᭂᶬ́±ᶬ̧¶-¹·ᶮ

³±²²ᶻ³±²³ᶩɋ

PynoosᶬRᶮSᶮᶬGoenjianᶬAᶮᶬKarakashianᶬMᶮᶬManjikianᶬ᭝࿔ɪʨᶱशɫᦋɭɊʝɾౡɣ‫ݶ‬ʱ᥍ɧʧɥʇ

Rᶮ
ᶬManoukianᶬGᶮᶬSteinbergᶬAᶮMᶮ
ᶬ& Fairbanksᶬ
LᶮAᶮɶʅɣʪɋϔឮ϶ࠧɪʨͼࠜഊӑʍϔ௟࠺ʊ˦ˏ

ᶨ²ºº´ᶩᶮ Post-traumatic stress reactions in childrenʆᥱɥሃऍʍࠍʈʡɾʀʱࡩᡑʇɶɾɊɔᔵԔʱ
ᇽʬɥ˗ʽ˙˅̀ˏ˞ɕʱЋʂɾᶳ‫ۋ‬ᆾʍ୏උɫ
ʎɷʝʂɾɋˏ˞̂ˏᅖၤʎͥᥱʩɩɴʝʩʃʃ
ɡʪɋɶɪɶʝɿʝɿɊ᜴࿔ۨோ୸ʎ৕᝸ʆɡʪɋ
ࠍʈʡɾʀʍɔ੠ψ৷ɕɿɰʊᯈʂʅɣʅʎ৊ᕁ
ʎʉɣɋ

after the ²º¹¹ Armenian earthquakeᶮBritish Journal of
Psychiatryᶬ²·´ᶬ³´º-³µ¸ᶮS c h w a r t z ᶬS ᶮH ᶮ
ᶨ ² º ¸ ¸ ᶩᶮ N o r m a t i v e i n f l u e n c e s
on altruismᶮIn LᶮBerkowitzᶨedᶮᶩᶬAdvances inexperimental social psychologyᶬvolᶮ²±ᶬ³³³-³¹±ᶮNew
YorkᶺAcademic PressᶮࢡᄑӦᑬᭀᶨ³±±·ᶩᶮ JR ࢇࣉᰢᓴᏺᤉ᝺Ο௕ʱʈɥɥ
ɰʇʠɊʈɥᄉɪɸɪᶮѪ॓৔Ⴞࠜʍខ࿢ɪʨρʉʊɫಢঞʊ৕᝸ɪᶿɉˋ̉ˇʺంᒫᶴಏ ³¶ ఖɋࢡᄑӦᑬᭀᶨ³±²²ᶩᶮ ௑វ၅ɔࡷࠜᄉ၅̍᭝࿔ˏ˞̂
ˏˇʸ˴ˡ˻ʸ́௑វ၅ɕɉPGS ለኴϥɉɐhttp://webpgs.org/sme-guideV²².pdfɑ
ࢡᄑӦᑬᭀᶨ³±²²ᶩᶮ ೅ఖಢ‫ށ‬᭝࿔ʗʍࡩড়ᶺ֤शɫ
ɾʂɾρɲɼˏ˞̂ˏ˴ˣˎ˷̉˞௟ᓑʱᶺPGS ᆌ
ˏ˞˴ˣ௟ᓑለи˭̃ˎʽ˅˞ɉѪ॓௟࠺ᶬ·³ᶨ²²ᶩᶬº-²´ᶮࢡᄑӦᑬᭀᶨ³±²³ᶩᶮ¡ ᭝࿔ˏ˞˴ˣ௟ᓑ᷾ᶸ‫ۋ‬ʆʆɬ‫ۑ‬ᶷɉ᭝࿔ˏ˞̂ˏ˴ˣˎ˷̉˞௟ᓑʍǎ̀˿˅ˑ̎
ˍ˽̉ɊǏʸ˅˜ʹ˯̎ˍ˽̉Ɋǐ௮ᭂЀʩɉʪʆɬʪ᭝࿔ˏ˞˴ˣ௟ᓑʍ࠷ᬫ᷾ᶮѪ॓௟࠺ᶨ೅

Ż¡·¡Żࢡɉᄑᶺ࿔࠿ɪʨʍ৊ᕁʱோ୸ɸʪ˨˻̎˴̉ˇʸ᷾ᤡ̍‫̍ح‬ዶʍɲɲʬʆ᷾

ࢡಅ૖ᶩᶬ·´ᶨµᶩᶬº®²´ᶮࢡᄑӦᑬᭀ̍ᆐɍࡻᑬ̍‫ށ‬ᨂ‫̍ᦿރ‬ಒᧅ቟ࠍᶨ²ºººᶩᶮ¡᭝࿔ˏ˞̂ˏ‫ט‬ড়ʍᏀీᆔ‫֊ݳ‬ʊɩʧʛɸ᭝्ʇ৷
ʍম᮰ᶺˏ˞̂ˏ˴ˣˎ˷̉˞௟ᓑʍɾʠʍ‫ܛ‬ቃᢁ௶ᶮఖಢᄉႾκᯕࠜϥ៕ᶬµᶨ²ᶩᶬ³´®³¹ᶮ
¡

Ż¡¸¡Ż

˨˻̎˴̉̍ˇʸለኴɉዿ²´ऍɉዿᶱ‫׳‬³±²³शᶶಏɉ¹-²¸᮱Journal of Human Care Studies Vol. ²´ No. ²
June ³±²³, pp ¹-²¸Кᯈ៵௮೅ఖಢ‫ށ‬᭝࿔াʍቬࣃऐʆʍˇʸໍթʍ࠷ᣊʇɼʍ٨ᯌ࿢
ᯮܺɉᵀ᎚ «¡¡̍¡¡৙᡼ɉϑన ««ᶲᶩ˨˻̎˴̉ˇʸʊɩɰʪ࿔࠿ʍ଻ɧఄ

ᶱᶩ೅ఖಢ‫ށ‬᭝࿔ʍᆌᄉ¡¡³±²² श ᶳ ಏ ²² ఖ ֢ া ᶲ ీ µ· Ԕ ᮳Ɋ ࠽ ܏ ᇊ̍࿔࠿ʇʎɊɔᄴणʉᔵ࿷Ⴛᡑʣκ࿣ᆔׄ‫ی‬ʊࢫ૜ᇊ̍ቬࣃᇊຒʱɼʫɽʫ᭝ཆʇɸʪ˴ˆˡʧʂʅɊ቎ϥᄉໍʣκ‫ا‬ʍ‫ל‬ɰʪ᜴࠿ɕᶨू᤺ᖃ

˗˻̎˟ º.± ʍऄ‫ۨށ‬᭝ɫᆌᄉɶɾɋɲʍᮾ‫ܕ‬ʎዿΤ၅ᶩʇ࠳ᑵɴʫʅɣʪɋʝɾɊʮɫ‫۔‬ʊɩɰ‫ރ‬वຼ˭̂̎˞ᶨໟѮᶩɫ֋፥˭̂̎˞ᶨᬛۨѮᶩʪຫঽᶨ࿔࠿ࡩጐ‫ܛ‬ಢຫᶲ಻ዿᶱ‫׳‬Ɋ‫׽‬ຫఆᜓϑʊຌʞ᥈ʲʆɣʪ‫ܬ‬૗ʆɡʩɊড়Տᶨˏ˞̂ˏᶩ

ዿᶱ಻ᶩʊɩɣʅʡɊۨ᭝̍ໄາ̍ᡓ᭑̍‫گ‬࿏ጇɫɾʝʩʣɸɣɋঞԞʎ˴ˆˡ˗˻̎˟ ¸.¶ Գাʉʈʍᔵ࿷Ⴛᡑʊʧʪᔵ࿷࿔࠿ʇʇʡʊɊԝᤁ̍

ʍ࠽܏ᇊຒۨ᭝ɫ੍࠳ɴʫɊɼʍᆌᄉሯ႟ʎɲɲ

ᕑ኶෤ʍΟ௕ʉʨʒʊ‫ށ‬᝿ාʉ˜̃ʉʈʇɣʂ

´± शʆ º±% ኏्ʇʞʨʫʅɣɾɋ

ɾɊɣʮʥʪκ࿣ᆔʉׄ‫ی‬ʊʧʪ᜴࠿ʡ࿔࠿ʇɶ

ɶɪɶ࠷ᬫʊᢰɲʂɾʍʎɊ࠽܏ᇊຒ ²µ± ͡ʆʅ࠳ʠʨʫʅɣʪɋɉ

ʍ˭̂̎˞ʍɹʫʊየʱᆌɶɊࢫ૜ᇊɪʨᖦ܏ᇊ

³±²² शᶳಏʊᆌᄉɶɾ೅δ᭙Տቬࣃዿͥׄࠍ

ຒʊᔷʪʝʆʍ֪֋᎜ ¶±± ͡Ɋ೅᝷᎜ ³±± ͡ʍጳՏᆌ᭙૗ʍ௓࡭৷ၑᢑ཮໅ʎɊऄ‫ۨށ‬᭝ʇऄ‫ށ‬ໄ‫ې‬ʊʮɾʪ‫ށ‬नʉ˭̂̎˞ʍɹʫʍ᥸᪑ʆɡʩɊ

າʇɣɥᔵ࿷࿔࠿ʍͫʊঃɬᢰɲɴʫɾκ࿣࿔࠿ۨ᭝ʍ᝿ාʎ˴ˆˡ˗˻̎˟ᶹʊᔷʂɾɋɲʫʊ

ʆɡʩɊఖಢ‫۔‬ӑʍʞʉʨɹͳᄟͼʊ᜚கʱͮɧ

ʧʂʅ೅֋ۨఄɿɰʆʎʉɮɊ᫟೅̍ͼᧅۨఄʱɾɋɼɶʅɊɼʍ᜴࠿ʎᶱशϒͫᏀᦋɶɾႻ‫ۦ‬ʆ؉ʟᮂणʊूɣጳ‫ې‬ʆ‫ށ‬ɬʉۨ᭝ɫᄉɷɊ࠽܏ᇊ

ʡ‫י‬ಹɶɾʇʎលɧʉɣၤ຤ʆɡʪɋ

ʍӑᬛʆʎ᭝्ᶷɊɼʫϒ‫ݹ‬ʍ೅֋ۨఄʆʡ᭝्

ᥱणɊ࿔࠿ʊʧʩঃɬᢰɲɴʫɾᨁ‫ށ‬ɪʃ৵ྟᶶওɪʨᶶঐɊ᫟೅ۨఄʆʡ᭝्ᶵওʊᔷʪ‫ށ‬ɬʉၤ຤ʎɊీ᫙ʍᏀᦋʇʇʡʊ‫֊ݳ‬ɶʅɣɮɋ࿔

ʉ୻ʫʱϹ᰺ɶɾɋ

࠿ɫᆌᄉɶɾɼʍᇫ᫙ɪʨɊ৵৷ಜɊ੾৷ಜʱᏀ

ɲʍ‫ށ‬᝿ාۨ᭝ʊϪɣᱝɴ ²± ˷̎˞́ʱᢲɧ

ʅवኪʉၤੳʊ૕ʩɊӖʒΜಜʆɬʉɣ࿔࠿ʊѹʪໄາɫ೅֋̍᫟೅ۨఄʍ‫ރ‬वຼѮຣࢲᧅʱᝳ

ɧʪཇѹಜʗʇၤ຤ɫኌʩ‫ݳ‬ʮʂʅɣɮɋɲʫʎ

ɣɊ᎜ᶱͨᶹ֞κʊᔷʪึᒓ̍ᜓఄͭనᒓʱԎɶ࿔࠿ˋʺ˅́ʇ‫ئ‬ʏʫɊ࿔࠿ʊᦟᦆɶɾκʒʇʍɾɋʮɫ‫۔‬ʆʎ M ᶹʊᔷʪʧɥʉ‫ށ‬᝿ාʉۨ᭝̍

᣸Ϲᆔ̍ᎃቛᆔ‫֊ݳ‬ʊ‫׹‬ʮɺɾˇʸʱᜓɥᬫʊʡ

ໄາʎ ¹º· शʍᡤឍۨ᭝ϒಿɿʇលʮʫɊ²±±± शಐᄍʉᒑɧఄʆɡʪɋ࿔࠿ˋʺ˅́ʊ᝸ɸʪీ᫙

ʊ्ͥʍ‫ށ‬᭝࿔ʆɡʪʇលʮʫɾᶨ‫ށ‬ಟᒨࠍᶬʎɊ࿔࠿ʍኚᯕʣ᝿ාʊʧʩ‫ށ‬ɬɮᄴʉʪɋɶɪ

³±²²ᶩɋ

ɶɊ³±²² शʍ௓࡭৷ၑᢑʍ‫ށ‬ᨃ໐Ԏʊ᫟ɶʅល
ɧʏɊೖɾɶʅɡʍᶳಏʍ˷́˞˖ʼ̉ʍᇫ᫙ɿ
ɰɫɔᆌ࿔ీɕʉʍɪʇɣɥᅃ٨ʱʡʃᒓʡɣʪ

«¡¡ግາ‫ࠜށࠜށ‬ᬎκ᫙Ᏼ‫׹‬ቿࠜለኴቿᇉᠷቿࠜ࡬௒
«« ቬࣃ֚‫ށ‬ᇉᠷࠜᧅŻ¡¹¡Żᯮɉܺ̍৙ɉ᡼ᶺ೅ఖಢ‫ށ‬᭝࿔াʍቬࣃऐʆʍˇʸໍթʍ࠷ᣊʇɼʍ٨ᯌ࿢

ᶨቬࣃׄᆌΟ௕ၵዒ൮ា߆‫ى‬ϥɉ៬೿̍൮ា‫ؙܫ‬ᶳᶩ࿔࠿৵৷ಜʍၔ৏

ಅᶬ³±²³ᶩɋᶱशϒͫɫᏀᦋɶɾρʉɩ௓࡭৷ၑᢑ

࿔࠿৵৷ಜʇʎɊɩɩʧɼ࿔࠿ʍᆌᄉɪʨᶱˁ

ɫ໤ɧɹɊ᣸Ϲʗʍম᮰ʊͭࠪʱଂɬʉɫʨʍᄉ

ಏ኏्ʇᒑɧʨʫʪɲʇɫ‫ݼ‬ɣɫɊ࿔࠿ʍኚᯕʊ

ໍɫᏙɮၤ຤ʊɡʂʅʎɊᦪ᭐ʱϽҘʉɮɴʫɾ

ʧʩనʨɪʉీ᫙ʍ֙ԕʩʱʃɰʪɲʇʎ᭐ɶ

϶๥ʎʡʀʬʲɊీ᫙ɫหʝʂɾʝʝၤ຤ɫԳʊ

ɣɋʝɾɲʍ࿔࠿৵৷ಜʎɊɴʨʊตʍᶳʃʍ์

‫؂‬ɪʂʅ‫֊ݳ‬ɶʅɣʪʇʎ੡ɷʨʫʉɣʇ់ɴʫ

ᬤʊԔɰʪɲʇɫʆɬʪɋʝɹɊᆌ࿔ʊʧʪࡂ࢑

ʪκɫ‫ݼ‬ɣɋΟ࠷Ɋۨ᭝ʣໄາɫᆌᄉɶɾీʊᄉ

ш‫ݘ‬ʣໄາɊɼʫʨʊঃɬᏙɮ࿏࿔ʉʈʊʧʂʅ

‫ا‬ʍֵ෤ʊɡʪఄɍʱ௚Օ̍ˇʸɸʪʇɣɥ࿔࠿

ᄉ‫ا‬ʍֵ෤ɫᄉɷɊ௚Ԏ̍௚Օɫᜓʮʫʪᢲ৵৷

৵৷ಜʍၤ຤ʇʎɪʉʩᄴʉʪၔ฽ʉၤ຤ɫႻ‫ۦ‬ಜɋ௚Ԏাʍ௚৵֚ᅸɊᦧϹʍԂᑝɊᦪ᭐૗ʍዒ

ʡ᥼ᜓͼʆɡʪɋ

ʀͫɱɊࣿ‫ۋ‬឴ᅸʉʈɫᜓʮʫʪ৵৷ಜɋɼɶʅɊ

ᔵ࿷࿔࠿ʆɡʫκ࿣࿔࠿ʆɡʫɊɼʫʨʊʎ᜴

ᦪ᭐૗ʊɩɰʪ੡೮ࡩጐɊɲɲʬʍˇʸɊ੾৷ᅒ࠿ʱʡɾʨɸׄ‫ی‬ɫࠓ‫ۦ‬ɸʪɋ᫾࿔ࡩጐɊᜓ௔ࡩ

ਭਭᒓʗʍвѪବࡶʉʈʍໍթɫᜓʮʫʪΩ৵৷ড়Ɋ֚ᅸ෤᫟ʊɩɰʪֵ෤ጫႾʉʈɊʈʍѮᮅɪಜʆɡʪɋɲʍᒑɧఄʎɊీ᫙ʇʇʡʊ‫֊ݳ‬ɸʪʨ᝾ʪɪʊʧʂʅ࿔࠿ʍʇʨɧఄʎ‫ݳ‬ʮʂʅɮѪ॓٨ᯌʱΜ༨ɶɊ˕ʺ˶̀̎ʊࡩড়ɸʪɾʠʊ

ʪɋ೅ఖಢ‫ށ‬᭝࿔ʊ᝾ʪκౙʱᢲɧɾᔵ࿷ʍՏ

ᮂणʊಐᄍʆɡʪɋ

ʣɊׄࠍՏᆌ᭙૗ʍጫႾʉʨʒʊ৕᝸৷ʉʈɊ᜴

೅ఖಢ‫ށ‬᭝࿔ʆʎɊቬࣃऐӑʆʡ᭝्ᶶওʍᫎ

࠿ʱঃɬᢰɲɶɾׄ‫ی‬ʊɊκ᫙ɫρাʈʍʧɥʊ

ɣ୻ʫʱϹ᰺ɶɾɋൕʣಪʍͫʍၑɫᗹʀɊॱၑ

ዒʀ‫؂‬ɪɥʍɪʇɣɥខ࿢ʡᨁ᝸ʆɡʪɋ

ɼʍʡʍɫш‫ݘ‬ɸʪʍʆʎʉɣɪʇɣɥਆ৮ʍ

ɶɪɶɊ˨˻̎˴̉ˇʸʇɣɥខ࿢ɪʨ࿔࠿ʱ

ͼɊʝɹʎᔵԔʍ᣸ʍࠪӂʱሯвɸʪɲʇɫҳ຅ᒑɧʪʇɬɊ᜴࿔ɴʫɾκɍʍᄉ‫ا‬ʱࠩʩɊѪ॓ʆɡʂɾɋɼʍাʡϽ᭝ʎఀᏙᆔʊᏙɬɊ‫ܬ‬૗ʊᆔʉᄉໍʱ‫כ‬ʩ૕ɸɡʪɣʎᏢପʆɬʪʧɥʊɸ

ʧʂʅʎఀ๬̍ѩ᭙ɫᢰɬɊʝɾ΂᝸ᦐᣈɫࡧఀ

ʪɾʠʊʈʍʧɥʉோ୸ໍթʱɸʪʍɪʇɣɥɲ

ɴʫɾɾʠɊࡂఎʍࠪ؇ʡሯ៖ʆɬɹ‫ށ‬ɬʉͭࠪʇɫᨁ᝸ʉខ࿢ʆɡʩɊુɍʍᨁ᝸ʉ঱Ձʆʡɡ

ʇ࿶ʩɫհʪၤ຤ʆɡʂɾɋɲʍʧɥʊɊ࿔࠿৵

ʪɋɼʍᬫʊᒑɧʉɮʅʎʉʨʉɣɲʇʎɊ᜴࿔

৷ಜʍၔ৏ʇɶʅʎɊ˿ʺ˫˿ʺ̉ʍᥬᏒɊίᥱɴʫɾκɍʍ᜴࠿ʍӑࡄʊ᫟৔ʱʧɺʪɲʇʆɡ

෤᫟ʍᵀᅧʊʧʩवీʊ੍࠳ɴʫɾ௚୸ໍթʉʈ

ʬɥɋលɣ୳ɧʫʏɊɼʫʎ᜴࿔ɴʫɾఄɍʍ᣸

ɫ࠷ᜓʆɬʉɮʉʪɲʇɫɡɱʨʫʪɋɼɶʅɊ

ϹᆔɊ৔ႾᆔϹ᰺ʱᇽʬɥʇɸʪɲʇʆʡɡʪɋ

Ϻʧʩκɍʍᄉ‫ا‬ʱࠩʪ᝸ʇʉʪʘɬ֚ᅸ෤᫟ɫ

೅ఖಢ‫ށ‬᭝࿔ʆʎɊۨ᭝ɊໄາɊ௓࡭৷ၑᢑʍ໐

ᵀᅧɸʪɲʇɫ‫ށ‬ɬʉ٨ᯌʇʉʪɋʃʝʩɊᥱण

ԎʇɊ‫׽‬ɷᦪ᭐૗ʍʉɪʊϹ᰺ʍ‫ށ‬ɬɮᄴʉʪ

ʆɡʫʏ಍‫ށ‬ᬈʍ֚ᅸ‫ګ‬ಲʣ˴̉˧̅̎ʱᄍɣʅ

κɍɫ͹ʒɊɼʫɽʫʍ৲ɣʱៜʂʅɮɿɴʂɾ

ᭂͼᆔʊᄉ‫ا‬ʱ௚ɣࠩʪ௚৵֚ᅸɫᜓɧɹɊᬈʩ

ɲʇɫϺʧʩִᡑᆔʆɡʂɾɋκɍʍ৔᣸ʍѪ॓ɡʪᢁཆʍͼʆ಍‫ށ‬ᬈʍ‫ا‬ʱ௚ɣࠩʪ࿔࠿֚ᅸʗ

٨ᯌʊ᫟ʮʪુɍʊʇʂʅʎɊɔȾȾ࿔࠿ɕɔ᜴࿔

ʇ‫֊ݳ‬ɸʪɋ

ᒓɕʇʑʇɮɮʩʊɺɹʊɊͥκʑʇʩɫʈʍʧ
ɥʉϹ᰺ʱɴʫɾʍɪʱᇽʪɲʇɫ৕᝸ͭ‫׭‬ดʆᶴᶩ˞̀ʸ̎ˎඋլʊʃɮ֚ᅸᒓʍᗿᙸ
ૌা಍‫ށ‬ʍ࿔࠿ʇលʮʫɾ᫻ቛༀᣈ‫ށ‬᭝࿔ʆɡʬɥɋʎɊԞಜ֚ᅸϹԧʍᦅʫɫᄉɷɊᥱणʍ௚৵֚ᅸ
ɫᜓʮʫʅɣʫʏɼʍᄉ‫ا‬ʱ௚ɧɾʇɴʫʪɊɣŻ¡º¡Ż˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬ʮʥʪɔᦪɰʨʫɾึɕɫ៨ᯌʇʉʂɾɋɲʍɔᦪ

ʊᮀɪʆɡʩɊʟɶʬͭ๨‫ء‬ɴʱ੡ɷʪʚʈʆ

ɰʨʫɾึɕʱ᫾ɯɾʠʊɊ³±±¶ शʊ៙ᄉɶɾ

ɡʂɾɋᒁఖɊໄາʊʧʩέɮʉʂɾఄɫ‫ݼ‬ɮɊʍɫఖಢ DMATᶨDisaster Medical Assistant Teamᶬᢦʣᵄʍ˕˙ˆʆʎʉɮᵋ˕˙ˆʍᦞড়ʇʉʪ

࿔࠿໏ᦚ֚ᅸ˗̎˶ᶩʆɡʪɋɲʫʎ࿔࠿ీʊ᥌

ఄɍɫ‫ݼ‬ɪʂɾɲʇɊίᥱɫཡʩɊাఄஅᥡᶨ෤

ᥴᶨ඘ʌ µ¹ ీ᫙ϒӑᶩʊᰣɰʃɰʪ෤թ৷ʱପʂ

ᓧɫᵀᅧɶɾ᜴࿔ۨʍ֚ᅸ෤᫟ɪʨɊ˴̉˧̅̎

ɾ˗̎˶ʆɡʩɊ௚৵ຟᅸʍ࡬᫏ᆔʉឤᐆʱ‫ל‬ɰʣ‫ګ‬ಲɫҰ࠷ɶɾᦘఄʍᅕᬎʗҁᅕᒓʱஅᥡɸʪ

ɾ֚ज̍ᇉᠷज̍උլ៬௨‫ى‬ʆථીɴʫʪɋᔵ࿷

ɲʇᶩɫᇀʀʊᜓɧʪၤ຤ʆʎʉɪʂɾɲʇɊɼ

࿔࠿ʍ‫׹ܬ‬Ɋ᜴࿔ۨʆໍթʱᏙɰʪ֚ᅸᒓᔵ᣸ʡ

ʍɾʠʊɊ᜴࠿ʍ‫ށ‬ɬʉຣࢲʍᅕᬎɫᦋ᧥ʉၤ຤

ʝɾ᜴࿔ᒓʆɡʪɾʠɊɲʍʧɥʉ৵৷ಜʊ᜴࿔

ʊɡʪɲʇɫనʨɪʇʉʂɾɋɼʫʆʡʉɩɊ֚

ۨʊӁʩ֚ᅸໍթʱᜓɥ DMAT ʍࠓ‫ۦ‬ʎ৔ওɣɋ

ᅸᒓʇɶʅψʊϺɪʆɬʉɪʂɾʍɿʬɥɪʇɣ

ɉ࿔࠿৵৷ಜʊɩɰʪᨁ᝸ʉᶳʃʍ᝸ᎫʎɊɔ࿔

ɥ৲ɣʆᓥɫᅞʲɿɋ࠿֚ᅸʍᶳTɕʇʡ‫ئ‬ʏʫɊ˞̀ʸ̎ˎᶨTriageᶩɊড়৵ԂᑝᶨTreatmentᶩɊাఄஅᥡᶨTransportationᶩᶵᶩׄᆌΟ௕াʍ༌ΕᒁఖɊ೅δ᭙Տቬࣃዿͥׄᆌɫ๬Ꭻူᆌʱᢰɲ

ɫ؉ʝʫʪɋ
࿔࠿Ⴛ‫ܬ‬ʊɩɰʪ˞̀ʸ̎ˎʇʎɊ಍‫ݼށ‬௦ʍɸʇɊׄᆌ᥎ɮɪʨ฾ʩࡸʉɣ˂˓̀̉ʆʧɥʣ

‫ا‬ʱ௚ɥɾʠʊҁᅕᒓʍᨁᅖ्ɩʧʒຟᅸʍᏲ৵

ɮঞᬎʊɾʈʩᇗɬɊᦪ᭐ʱ๳ʠʅኾ‫ף‬ʊಿʨʫ्ʱీ᫙ʱɪɰɹʊԟԠɶʅɣɮɲʇʆɡʪɋҁʪఄɫᆾዒʃʧɥʊʉʂʅɬɾɋ‫ీ׽‬ʊɊ֚ᅸᒓ

ᅕᒓʊʃɰʨʫʪ˞̀ʸ̎ˎ˕˙ˆʎɊᵋᶨึέɊʆɡʪુɍʍͼʆʡ௓࡭৷ၑᢑʊʧʪম᮰ʍ਺‫ܫ‬ʝɾʎᄉ‫ا‬ұыɫʉɮ௚‫ا‬ʍ᝾᥈ʞɫʉɣʡʍᶩɊ

ʎ᩺ɼɥɶͭࠪɫᱝʝʂɾɋ‫׸‬૗ʊʆɬɾᦪ᭐૗ᢦᶨ௚‫ا‬ɫ‫׭‬ᓧʆᇀʀʊԂᑝʱɸʘɬʡʍᶩɊᵄ

ʆʎɊ᜴ʏɮᨃʍ൮೿ʱ‫ל‬ɰʅɪʨʆʉɰʫʏ‫ל‬ᶨᢦʚʈʆʎʉɣɫɊచಜʊԂᑝʱɸʘɬʡʍᶩɊ

ɰӁʫɫ‫ۏ‬᭐ʉၤ຤ʇʉʂɾɋɶɪʡɊɲʍ᮳ʎ

ᏵᶨρɸɯʍԂᑝʣஅᥡʍ৕᝸ʉɣʡʍᶩʊ֙Ԡ

ʝɿ‫ᦪ׸‬᭐૗ʣвѪ૗ɳʇʊᏺᨃឞɫឮᑝɴʫʅ

ɴʫʪɋɼɶʅᢦ̍ᵄ̍Ᏽʍ᮵ʊຟᅸʍҥҳ्ɫɩʨɹɊ൮೿ɫʆɬʪɼʍ‫ܬ‬૗ʍ਺‫ܫ‬ʡͥᕓʊ‫؝‬ᱝɣɋ²ºº¶ शʍቬᇽࢡᏺʍᓴᏺΟ௕ʍᬫʊʎɊ

ᇽɴʫʅʎɣʉɪʂɾɋ˞̀ʸ̎ˎଉঞᒓʆɡʪ

ʝɴɶɮɼʍΟ௕Ⴛ‫ܬ‬ʆ˞̀ʸ̎ˎɫᜓʮʫɾɋ

ુɍʎɊɼʍఄɍɫʈʍۨ֙ɪʨɬɾɪɾʉʍɪ

˴ˏˉ˵ɫ˩́ʍ࢑ͫɪʨ஢মɶɾɲʍీʍපࠍ

ʱϮɣɊ‫ۏ‬਽ɸʪলʨʊၤ຤ʱ៥నɶɊᤁʆʉɮʎ˜̂˩ʆʡ‫ᦐܫ‬ɴʫɾɋˬ́̎ˍ̎˞ʊීɾʮ

ʅʎɣɰʉɣᣁ᭏ʊɡʪɼʍᏺᨃ൮೿‫ܬ‬૗ʍۨ‫ۑ‬ʪҁᅕᒓʍ᜚கᆔʉర҈ʎɊκʍࡳ‫׎‬ʇʎϺɪʇʱɩ༠ɶɸʪɲʇɶɪʆɬʉɣၤ຤ʆɡʂɾɋɶ

ɣɥјႾᆔ٨ᯌʱુɍʊ૸ɱɪɰɾɋʝɾɊɼʍ

ɪʡঞԞɊુɍʎ᫾ᠷᄍʍʾ˭̃̉̍˴ˏ˅̍ᬫʊᵋ˕˙ˆʱʃɰɾ֚ᅸᒓʍᗿᙸʡাʊ‫ؙܫ‬ɴ˃˹˙˭̍૜ᜫʱᇗᄍɶɾߑʆࡩড়ɶʅɩʩɊও

ʫᶨ೔᭿Έᶬ³±±¹ᶩɊ֚ᅸᒓʊࡩɸʪɲɲʬʍˇʸɣᦒ‫ح‬੡ʇᗿᙸʱងɧɾɋ
ʝɾɊɲʍ᮳ʧʩຣࢲʍᅕᬎɪʨʍਭᒓʍ‫ל‬ɰʍᨁ᝸৷ʡໜɬপʩʇʉʂɾɋ
೅ఖಢ‫ށ‬᭝࿔ʍঞ‫ݾ‬Ɋጅᒓʨɫቬࣃᇊʍ࿔࠿‫ܛ‬Ӂʫɫ߂ʝʂɾɋᅕᬎʊᬯଢ଼ɸʪᇉᠷࠜᧅൖʍ࠷

ऺᅕᬎʊɩɣʅ˞̀ʸ̎ˎଉঞʱঃɬ‫ל‬ɰɾᬫʊᒂ࠺ʊʡॅʊ˴˙˞ɫ௪ɬ៊ʠʨʫɊ‫ݼ‬௦ʍਭᒓʎɊೖɾɶʅ৔ʱওɮвʀᦄᜓʆɬʪʍɪʇɣɥ

ʱ‫ל‬ɰӁʫɾɋɶɪɶɲʍ‫ל‬ɰӁʫʡɊাఄஅᥡ

ͭࠪɫ‫ށ‬ɬɪʂɾɋɶɪɶɊ࠷ᬫʊʎຣࢲɪʨʍ

ʍខ࿢ɪʨʎͥీᆔʉᏀᄒጜ૗ʊᦋɭʉɪʂɾɋ

ᣁ᭏ɫᦘɣঞቬࣃᇊዒ֚‫ށ‬ᅕᬎʍ‫ݾ‬᫙ኾ‫ף‬ʎᮂणకʊѪ॓٨ᯌʱଂɧɾɊၔʊᱝᵱʍఄɍʊʇʂ

Ż¡²±¡Ż

ᯮɉܺ̍৙ɉ᡼ᶺ೅ఖಢ‫ށ‬᭝࿔াʍቬࣃऐʆʍˇʸໍթʍ࠷ᣊʇɼʍ٨ᯌ࿢

ʅɊࡂఎʇ᭏ʫᦘᣁ᭏ʍኌթʱɸʪɲʇʊʧʪ৔

ǌϹᓑᰄʉʈʎԎӁʩ‫ף‬ʊᬤ์ɫɡʪɲʇɫ‫ݼ‬᣸ʍᡥଉʎ‫ށ‬ɬɣɋɼʍʧɥʉͼɊ˦ˏʊʧʪኌ

ɮɊᱝᵱᒓʣ᣸Ϲʊᬬ࠿ʍɡʪκʊʇʂʅʎ࢑‫ݹ‬թᥬͼʊਭᒓɫέɮʉʂɾʇɣɥˡ˻̎ˏʡʝɾ

ʊឮᑝɴʫɾፍప˞ʺ̂ʗʍኌթɫඐʠʅᡥଉʊ

‫ށ‬ɬʉ᜚கʆɡʂɾɋ

ʉʂɾɋǍᦪ᭐ঞԞʍᶴɊᶵఖ᫙ʎౢ૖̍ᯨ௶ʉ

ɾʇɧʏɊΟ௕ʱᢰɲɶɾዿͥׄᆌɪʨᶵ͡ϒʈʍ៬ᦑɫ᭐ɶɮɊɶɪʡɣʮʥʪᭉᲊࡕၤੳ

ӑʊɡʪ‫ח‬ᗼ‫׃‬ᄉᅕᬎʆʎɊᶳಏ ²³ ఖʍಚᶷీ

ʆɊ์˲̎́ʆ‫ࡂ׸‬ఎጇʍʾ̀ʸ̍˭˿ʺ˦ˍ̎

᮳ʊᔵ᜙ᬡʍᤁ͸ɫಿʅӁᬎਭᒓʱᅕൖɪʨᦉʒ

ɫвɾʫʪʧɥʊʉʩʊʎɶʏʨɮీ᫙ɫɪɪʂ

ԎɶɊ಍Ԟʊׄᆌɪʨ֋Ѯʊɡʪ໚๼ᄗʊɡʪᒐ

ɾɊʉʈʍɲʇʆɡʪɋ

κఆឮʊኌթɶΠ౒ʱᦋɳɶɾɋᶳಏ ²µ ఖʍ༈‫ᦪ׸‬᭐૗ʊʎвѪजʱͼ৔ʊɸʪᜓ௔ʍᒶ‫ى‬ɫ‫ݾ‬ʊʎ˦ˏʆตʍᦪ᭐ҳʆɡʪ֪ᇁᰚऐʊኌթɶ

ӁʩɊ΂ʊᜏ‫ۥ‬ጫႾʉʈʱᜓʂʅɣɾɋʝɾ᫕උ

௓࡭ᏺʍ൮೿ʱ‫ל‬ɰɾɋɼʍা ²¶ ఖʍಚʊᦵ᮶

֚ʱ΂ʊɸʪ˲˿̉˜ʺʸʍ֚ᅸ˗̎˶ɫͥఖʊ

ᄓࠍᱝׄʝʆᜓʂɾɫɊɼɲʊʎ֚ᅸূΟᒓɫɣ௦ీ᫙ཡ‫ۦ‬ɶɊᦪ᭐૗ʆʍ‫ݹ‬ಿᇁ៯ʣᙪၑʍԂఄʉɪʂɾɾʠɊʝɾঃɬ᥏ɶʅɣʮɬҴຼᱝഊʝʱᜓʂʅɣɾɋᦪ᭐ᒓʊ᫟ɶʅʎ֚ᅸᡸʎ࿵௶

ʆᦪ᭐ɶɾʇɣɥɋɲʍᶴఖ᫙ʚʛӁᬎᇗʍʝʆɊঞԞʎϒԳʍԂఄጝɫɡʫʏ֚जʍంɶɣԂʝɊᯨΟʡགᢷʊʇʫɹɊʝɾஉञ᭙់ʡͭᥱʆ

ఄɫʉɮʇʡᙪࢋʆᶳఖԔʍᙪၑʱ૜ʊӁʫʪɲɡʂɾɾʠɊӁᬎਭᒓɾʀʎࡐɴ̍኶ᔉ̍᥸Ꮘʍ

ʇʡʆɬʪᏲ৵ᦪ᭐ᆔʉୡᑝʡᜓʮʫʅɣɾɋʝ

‫כ‬ʫʉɣͭࠪʆɣʂʐɣɿʂɾʇɣɥᶨಟಳᘣ

ɾᦪ᭐૗ɫࠜഊʍϹᓑᰄʍ‫׹ܬ‬Ɋɼʍࠜഊʊ࢙ɸ

ࠍᶬ³±²³ᶩɋʪ᯷ᠷ௟᠂ɫ΂ʊ৔ʍ٨ᯌʍˇʸʊঞɾʂʅɣɾɋ

ᶶᶩቬࣃऐӑʆʍᦪ᭐૗ʍឮᑝ

ᶷᶩᦪ᭐ᒓʇɲɲʬʍˇʸʍ࠷ᬫቬࣃऐӑʆᶳಏ ²² ఖϒᬆɊᦪ᭐૗ʇɶʅ෤ᓧ

ጅᒓʨʎɊቬࣃᇊɲɲʬʍˇʸ˗̎˶ʍͥ‫ى‬ʇɶɾʍʎɊࠜഊʍϹᓑᰄ̍ऐʣᇊʍϹᓑᰄʣӆ๥ɶʅɊᆌ࿔ ²± ఖᆾɪʨ΂ʊቬࣃऐӑʊឮᑝɴʫ

ᰄ̍ᭂϥ‫ܬ‬ʉʈʍӆӉఆឮʆɡʪɋ

ɾᦪ᭐૗ʱॲʩɊɼɲʆకʊˇʸʊ៌ঞɸʪʇвɼʫʨʍఆឮʊᦪ᭐ɶɾʍʎɊǋቬࣃऐӑʆۨѪजʣ᯷ᠷ௟᠂ɫԟఀɶɾκʱ಍ԞʊɊตʊɊᦪ

᭝ʍ᜴࠿ʊʧʂʅ϶ࠧɫӂ֤‫ݘ‬ɶɊঞᮅʍ϶ࢍʱ᭐૗ʱ᝾༠ɶʅʉʊɪ٨ᯌʍɡʩɼɥʊ৲ɧɾκ‫ވ‬ʂɾκɾʀɊǌໄາʣۨ᭝ʍ᜴࠿ʊʧʂʅࡂʇ

ʱᨁ࿢ᆔʊᮅଢ଼ɶɾɋ

ࡂఎʱ‫ވ‬ʂɾ΂ʊ֪ᇁᰚऐʣ໚๼ᄗʍκɾʀɊǍໄາʣۨ᭝ʍ᜴࠿ʊʧʂʅࡂʱ‫ވ‬ʂɾ΂ʊ֪ᇁᰚᷡᶩ᭝࿔ ²± ఖᆾʊᮅଢ଼ɶɾ A ɴʲ‫ߧބ‬ऐʣ໚๼ᄗʍκɾʀɊǎׄᆌΟ௕ʊʧʂʅওԧᆔ

º± าʍ‫ބ‬ʇ ¹¶ าʍ޾ʍ‫ߧބ‬ʎຣࢲʍᄗԎ᣸ʆʉᦪ᭐ۨ‫ܕ‬ʊବ࠳ɴʫɾׄᆌɪʨʍ֤স ³± ͡ϒɡʂɾɋԳ‫ݾ‬Ɋº± าʍ‫ބ‬ɫ‫ݩށ‬ʆ৬᳠ʩɊ៖ᇽ

ӑʊࢍ϶ɸʪκɾʀʆɡʂɾɋ

ᅖʍᆌᅖʱᅃʂɾ᯷ᠷ௟᠂ɪʨʍϧᦑʊʧʂʅᮅ

ɲʫʨʍ‫ᦪ׸‬᭐૗ʊӉᥱɶɾʍʎɊǋ๬ᦐɫఀଢ଼ɫᜓʮʫɾɋ

๬ɶʅɣɾʍʆɊӁໞʎʡʀʬʲ૜຿ɣʣ຿ᮅɊ

ۨ᭝ɫᆌᄉɶɾీԬʊɊ‫ߧބ‬ʎᔵԔʍࡂʊɣ

˞ʺ̂ɫʆɬɹɊᔵຟϹʣᔵ᜙ᬡʊʧʂʅᏋ๬ᤁ

ɾɋۨ᭝ʊʧʂʅᔵࠧʎʑʒɫӁʩɊ‫ށ‬ᨃʍ˸ˤɫ᧖ᑝɴʫɾʩɊፍప˞ʺ̂ɫឮᑝɴʫɾʩɊӁɫᗹʀɾɫहɣʉɲʇʊ৺ુʎʉɪʂɾɋʝɾࡂ

ໞឮѹɫʆɬʪʝʆʍ᎜ᶱ᥻᫙ʎၔʊ୔ລʊ᫟ɶ

ʎໟɪʨ᭏ʫʅ‫ᦐ۔‬ᶶ‫׳‬ᏺʱ᝷ʊᢳɧɾࢡѮʊʅ‫ށ‬ɬʉᖐ՜ɫɡʂɾɋ

ዒʂʅɣɾʍʆໄາʊʧʪ᜴࠿ʎʉɪʂɾɋ

Ż¡²²¡Ż

˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬

ᶳಏ ²² ఖʍ‫ݾ‬ʎɊѩ᭙ɶʅɩʩ˿ˎˀʱᒫɬ

ɣʍɿɊʇ᠂ɶʅʡɊ௔ोɫលɥɔɾɿʀʊ᣸Ϲʉɫʨ၄ʄɰɾᧅ࢑ʆࡕɾɋ௓࡭ᓧΟ௕ʊ᫟ɸʪ

ʊম᮰ɫʉɣ̂˯́ʍ௓࡭ᓧɕʆɡʪʉʨᔵԔʎ

਺‫ܫ‬ʎϺʡӁʂʅɲʉɪʂɾɋ²³ ఖʍఽɳʬɣ

टʪʇលʂʅɬɪʉɣɋ

ɬʉʩʣʂʅɬɾ௚৵ᬡʊʧʂʅׄᆌΟ௕ʱᇽʨ‫ބ‬ʊʉɻԳఖʍ‫ݾ‬Ɋ‫ݩށ‬ʆ৬᳠ʂɾʍɪʱᒫɮ

ɴʫɊɔᔵԔʎʡɥशɿɪʨɲʍࡂʆ౫ʨɸɪʨɕ

ʇɊटʩɾɣʇɣɥʔɥʊ޾ʊ់ɸʇɊɣʃʡʍ

ʇលʂʅͥగʎ௚৵ᬡʎटʂɾɫɊɼʍাӖʒឭʧɥʊ᠂ɴʫʅɊᏃࢋԔɪʂʅʡʨɧʉɪʂɾɪ

ʫɔᏒࡩɲɲʱ᭏ʫʉɣɕʇ‫ש‬ʲɿʊʡɪɪʮʨ

ʨɿʇɣɥɋ

ɹଂɬɪɪɧʨʫʅᤁʊӁʫʨʫɊͥగࢡʍఄʍ

ᇍᮅᆾʆԀठᮅʉ৷ഓʍପʀ΂ʍ‫׹ܬ‬Ɋ‫ވڄ‬ϒᦪ᭐૗ʊஅᥡɴʫɊɼʍাɊಂʊᦘɮʍቬࣃऐʍ

Գʍᦋ‫א‬ʊࡩɸʪ৙‫؂‬৷ɫᱝɣɲʇɫ‫ݼ‬ɣᶨಟಳᦪ᭐૗ʊஅᥡɴʫɾʇɣɥɋ

௙ᶬ²º¹¶ᶩɋׄᆌΟ௕ʊʧʂʅɣɹʫʊɺʧ௦श᫙

‫ބ‬ʎԳዒᔊᓊ‫ށ‬ɫɡʩࢊੜɫᯇᐡʆɊᬤ์ʱ

ʎटʫʉɣʆɡʬɥુɫࡂʆᄉໍɶʅɣɾᔵԔɲ

Ћʂʅ˞ʺ̂ʊኌթɸʪʍɫ‫ݳށ‬ɿʇɣɥɋ޾ʎ

ɼɫ಍ʡᔵԔʨɶɣʇ੡ɷʉɫʨɊʡʎʣɼʫɫ

ᮀɪʉκʆɊញɫ຅ʠɾᐈᎻʆ‫ބ‬ʇ᝾‫׹‬ɣᏃߥɶ‫כ‬ʩ᥏ɶɫʃɪʉɣʇ੡ɷʪਲɶɴʱ޾ʊӉ੡ɶʅɊ‫ބ‬ɫ ¶± าʊʉʪʝʆ‫ߧބ‬ʆ೅δʆχዒʅ࢑ʅธɶɪʂɾʍɿʬɥʇព᧽ɶɾɋ

ʍχΟʱɶʅɬɾʇɣɥɋ‫ބ‬ɫ˞ʺ̂ʊዒʂɾీ

޾ʊʎɼʍʧɥʊϧɧɊ‫ބ‬ʍលɥɲʇʱɴɧɭ

ʊɊ৵ʊɔቼʎɲʍκʇᏃߥɶɾɪʂɾʮɰʆʎ

ʨɹʊ҂ᒴɸʪʧɥʊʇնʠɾɫɊตʍఖ᫟೅ۨ

ʉɪʂɾɋ߱ʊᜓɮʍɫߵʆͪఖͪ౒ຳɣʅɣɾ

ఄʊ‫϶ۦ‬ɶʅɣʪᄋɫɲʍ‫ߧބ‬ʱឭʌʅɬʅɊɶ

ʨ‫ۊ‬ఖᆾʍಚʊျញʊ൐ʆʑʂʐɾɪʫʅຳɮຳ

ʏʨɮʍ᫙ᄋʍࡂʊʣʂɪɣʊʉʪɲʇʊ់ɫ᥼

ɮ߱ʊಿɾʲʆɸɕʇᦋ‫א‬ʱ௟ɧʅɮʫɾʍɫִ

ʞɊᦪ᭐૗ʱাʊɸʪɲʇʊʉʂɾɋ

ᡑᆔʆɡʂɾɋ
‫ބ‬ʎ‫ܛ‬ಢᆔʊᇍᮅᆾʆԀठᮅʆʈʀʨɪʇɣɥ

ᷢᶩ᭝࿔ ²² ఖᆾʊᮅଢ଼ɶɾ B ɴʲͥࡂʇᛧᥱʍԢɪʉɣ৷ഓʆɡʪɋ¶± าʍ᮳ʊ्ͦ

ቬࣃऐӑʍԠʍᱝഊʍϹᓑᰄʍᦪ᭐૗ʆɊψʍᄉࡂʊᬯଢ଼ɸʪ‫ށ‬ဍᄗʣ‫ח‬ᗼᄗʊׄࠍՏᆌ᭙૗ɫ

ࡂఎɪʨࡸɶ᭏ʫʪʧɥʊɶʅɊᶶᄵʚʈʍ˩

ʆɬɊɼɲʆ҇ɮκʍԧಒʱЀʂɾʩɊиႾʱɶˡ̎́ˍ̎˞ʱʑɣʅॎʂʅɣʪᶳκʍާ৷ɫɣ

ɾʨɣɣɿʬɥʇɣɥᇽκʍնʠʆᄉʝʫɾᄗʊ

ɾɋͥκʎ ·± ϐʆɊ์˲̎́ʆЀʂɾಪʍͫʆ

૕ʩɊɴʂɼɮࡂʱॱʅɊɼɲʆᐖᝒඋʱ ¸± าૻʩ˛́ʱૻʂʅɣʪɋ฾ʩʍΠκʍᖏɣާ৷ʍ

ɮʨɣʝʆ‫ډ‬ʞɊɡʇʎᢵ‫ء‬ʍᨐʩʉʈʱɶʅ౫

ɥʀͥκʎ࿵ᜟ਺ʆɊʡɥͥκʍᖏɣާ৷ɫ់ɶ

ʨɶʅɣɾʇɣɥɋ

ɪɰʅʡጏɧʉɣʆͥ࿢ʱ᝾ʃʠɾʝʝʆɡʪɋ

‫ބ‬ʎɔʇʊɪɮࡂʊटʩɾɣɕʇɣɥɋᔵԔɫ·± ϐާ৷ʍఄʊ᥎ʄɣʅɔ‫ݳށ‬ʆɶɾʌɕʇ‫ݩ‬ॱʅɊ᎜ µ± श᫙ᄉໍɶʅɬɾࡂʆɲʫʝʆʍʧ

ʱɪɰʪʇɊ৵ʊ‫ݩ‬ʱɡɱʅຳɬɿɶɊ
ɔࠞʡ˖ɥʊव‫ح‬ʉᄉໍʱɶɾɣʇɣɥɋᦪ᭐૗ʍᄉໍ

̉ˠʡɣʉɮʉʂɾʲɿɕʇលɥɋɲɲʊɣɾާ

ʎɊ˞ʺ̂ɲɼͭУʆʎɡʪɫɊᯨΟʡᯯʞၑʡ

৷ɾʀʎɊ·± าʊʉʪ๖ʇɊɼʍᫎᄕʍ߱ʇɊ

᧖ᏋɴʫɊ˿ˎˀʣంᒫʆ਺‫ܫ‬ʡӁʪʍʆ‫כ‬ʩዒɼʍ࠷ʍ߁ʆɡʪʇɣɥɋቬࣃᇊຣࢲᧅʍᄗʊ϶ʅʅߵʉʮɰʆʎʉɣɫɊʣʎʩ‫׽‬ɷ๝ऑʊɮʪ

ʲʆɣɾɫໄາʆࡂʱ໐ɴʫɊ‫ބ‬ʇɊΠκʍࡷࠜʝʂʅීʊʉʂʅɣʪʊɶʅʡࡂʍఄɫɣɣʇɣ

ᄉʍࠞʱ‫ވ‬ɣɊɼʍΠκʍɥʀʍͬʍ޼ʎᦧϹʆɥɋ᝾ʃɪʂɾɫɊͫʍүʇɊᔵԔʍ‫ބ‬ʎʝɿ᝾ʃ

޾ɫɊׄᆌɪʨ௓࡭৷ၑᢑɫ཮ʫʅɣʅटʫʉ

ɪʂʅɣʉɣʇɣɥɋૻʩ˛́ʎ๗ಚచɮᆾងʠ

Ż¡²³¡Ż

ᯮɉܺ̍৙ɉ᡼ᶺ೅ఖಢ‫ށ‬᭝࿔াʍቬࣃऐʆʍˇʸໍթʍ࠷ᣊʇɼʍ٨ᯌ࿢

ɾʇɬʊ೅ʱ‫؂‬ɣʅɔρఖɲɼࠞʇ‫ބ‬ɫ᝾ʃɪʩ

ᇗँɸʨɴʫɹɊɲʍీ࿢ʆʎ๥᫙ʍ᡿ᡷ϶ࠧʱʝɸʧɥʊɕɔέɮʉʂɾࠞɫ‫۔ނ‬ʊᜓɰʝɸʧ

ᇊʣ‫۔‬ɫюʩͫɱʪʇɣɥ់ʡԎʅɣʉɪʂɾɋ

ɥʊɕʇቒʪʧɸɫʇɸʪʍɿʇɣɥɋᫎᄕɫျ

ɣʃʝʆɲʍՓ਱ʉშ݄ʍͼʊᑝɣʅɩɮʍɪɊ

ញʇਘࠍʱ୛ɶʊ໕ᥱʩʝʆԎɪɰʅɣʅɊᔵԔ

ʇɣɥੜ‫ء‬ʆ C ɴʲɫ৬ʂɾʍɫ֝ԔႾពʆɬɾɋ

ɾʀʡᜓɬɾɣʍɿɫᤁʊ˂˓̀̉ɫʉɮɊᝆҰC ɴʲʎঈʱ᝾ʎʉɸʮɰʊʎɣɪʉɣʇលʂ

ʡʆɬʉɣʍʆቒʪɶɪʉɣɊࠞʍϐʮʩʊᔵԔ

ʅɊ᫟೅ۨఄʊ߱ɣɿߖ‫ߧބ‬ɫɔᔵԔɾʀʍࡂʊ

ɫึʲʆɶʝɧʏʧɪʂɾʇលʂʅຳɮɋ

ᦪ᭐ɸʪʧɥʊɕʇ៥ৃɶʅʡᒫɲɥʇɶʉɪʂ

ᶲᷭɮʨɣ᭏ʫʅ់ʱᒫɣʅɣɾ˾˷ʎӂɮʍ࿵ᜟ਺ʆɊᇍʂᆏʉᜏʍ๨ʍʉɣᯐʍʝʝɊ໪ʡ

ɾɋC ɴʲʍ޾ʎʆɬʫʏߖ‫ߧބ‬ʍʇɲʬʆᄉໍ
ɶɾɣʇɣɥੜ‫؂‬ɿʂɾɋᇊʍвѪजʇᇁ៯ɶɊɲʍʝʝʆʎ C ɴʲ‫ߧބ‬ɲʛɴɹɊʉʊʱɬɣʅʡɔ‫ބͩށ‬ʆɸ‫ބͩށ‬ʆɫшʫʅɶʝɥֵᬜ৷ʍɡʪɲʇɊC ɴʲʍঈʊɸɕʇ໤ɧӁʪʧɥʊጏɧʪɿɰʆɡʂɾɋ
ɲʍࡂఎʎʇʩɡɧɹɲʍᦪ᭐૗ʊʇʈʝʪ

ʎʅʲɪʲʍᅖၤʡɡʩႻ‫ۦ‬ᙪɫԕʫʅಒᄍʆɬ

ɫɊ᥎ఖͼʊਘࠍʎχΟʍɡʪ໕ᥱʩʊ૕ʪɲʇ

ʅɣʉɣɲʇɊɲʍʝʝɲʍᦪ᭐૗ʊɣʅʡࡂఎ

ʊʉʂɾɋвѪजʊঃɬᏘɣɿɫɊਲ‫ف‬ʍχΟᶨࡷӂ‫ى‬ɫᅋॺɶʅɶʝɥɲʇʱ C ɴʲʊ៥నɶɊвอಟɊ²º¸ºᶩʊʡʝɿӁʫʉɣʇɣɥʇʅʡᤸɣ

Ѫजɫঈɴʲʱͥీᆔʊʆʡ᮹ɪʂʅɮʫʪఆឮ

ၤ຤ʊɡʂɾɋɉ

ʱ୛ɸɲʇʱ᎜ಹɶɊ຅ɶʅঈʱ᝾ʎʉɸʮɰʆ
ʎʉɣɲʇʱ C ɴʲʊႾពɶʅʡʨʂʅɊC ɴʲ‫ߧބ‬ʎߖ‫ߧބ‬ʍʇɲʬʊᦪ᭐ɸʪɲʇʊ຅ʠɾɋ

ᷣᶩ᭝࿔ ²³ ఖᆾʊᮅଢ଼ɶɾ C ɴʲ
C ɴʲʎቬࣃዿͥׄᆌʍዒۨᄗʆɡʪᄗʍԎ᣸ρ‫ۋ‬ʍ᭝࿔ʆʎɊʇʊɪɮᦪ᭐ɸʪɲʇɫҥҳʆɡʂɾɋᦪ᭐૗ʊʉʂʅɣɾऐӑʍᱝഊϹᓑᰄɴʫɊӁᬎ̍Ӂ૗ɶʅɣʉɣᬬ࠿ᒓʣᱝᵱᒓʎѪʍӁʩ‫ף‬᥎ɮʍᯞɫӁʪɡʝʩ಻ϗʍᕩɮʉɣʇ

णᒓʇ‫׽‬ɷʧɥʊӁ‫ף‬ʊ์आʍɡʪᦪ᭐૗ʊ៚ࡶ

ɲʬʊ C ɴʲ‫޾ބ‬ʇᓵ৷ʝʑʍঈʍᶳκʆͥធʱɴʫɾɋ֯ʠʅɣɾɋᶳಏ ²³ ఖʍచಚʊ঱‫ܬ‬ɪʨʍ˦ˏ

᭝࿔া ²± ఖԳাʆ༌ΕɫʝɿᏙɣʅɣʪీಜ

ʆቬࣃऐӑʊᦪ᭐ɶʅɬɾʇɣɥɋጅᒓɫɔɲʲʇʎɣɧɊʅʲɪʲʱЇᆌɶʅɣʪᓵ৷ᵀᅧਭᒓ

ʊʀʎɕʇលʂʅ˩ˡ̎́ˍ̎˞ʆ֙ԕʨʫɾࢍ

ʊࡩড়ɶɾఆឮɫธɶɣАʆɡʂɾɋ
ɉ϶֙‫ܕ‬ʊӁʂʅɣɮʇɣɬʉʩɔಿʪʍɫᦅɣɕ
ʇ৬᳠ʨʫɾɋɔ‫ݳށ‬ʆɶɾʌɕʇ‫ݩ‬ʱɪɰʉɫ

ᷤᶩ᭝࿔ᶶ᥻ᆾʊᮅଢ଼ɶɾ D ɴʲʨ់ʊӁʂʅɣɮʇɊC ɴʲʍ৬ʩʍׄ‫ی‬ɫ᝾ɧD ɴʲʎໄາʆɾɮɴʲʍκɫၝၒʊʉʂɾۨʅɬɾɋC ɴʲʎ ¸³ าʆɡʩɊᓵ৷ᵀᅧʍঈʎ‫ܕ‬ʍκʆɡʂɾɋ᭏ߥำɫɡʩɊͼࠜᄉʇࡷࠜᄉ

¶¹ าʆɡʪɋशᵱɫ᭏ʫʅɣɾʍʆ C ɴʲʎᔵԔʍɲʈʡʎ᫟೅ۨఄʍញ૆ʍࡂʊᦪ᭐ɴɺʅɊ

ʆʎฯɰʉɣঈʱࡷɴɣʇɬɪʨញϐʮʩʊᮅшᢁഓʱ‫כ‬ʂʅᄉໍʱᏢପɴɺʪɾʠʊ F ऐӑʍ࡬ʱ᝾ʅɬɾɋC ɴʲͥࡂɫᦪ᭐ɶʅɣɾʍʎӁ‫ף‬᫏ࠜഊʊᥱɣᏙɰʅɣɾɋD ɴʲʊʎࠜഊʱ֧උ

ʊͪ์ʍˉ̉˅̀̎˞ʍᬤ์ʍɡʪॱၑʆɊঈɫ

ɶɾʨᏃߥɸʪɲʇʱ᎜ಹɶɾᇁ૜ɫɣɾɋɼʍ

˞ʺ̂ʊɣɮੜ৙ʱ᝾ɺɾీʊɊ¸³ าʍ C ɴʲᇁ૜ʍκʡຣࢲᧅʊᔵࠧʇχΟ‫ܬ‬ɫɡʪκʆɊɲʎᱝഊʍᄕࠍʍҳᄉʇᶳκʆ๗‫ۋ‬ɊᤁൣࠍʊΎɺʍκɫɊۨ᭝ɫɡʂʅ‫ށ‬ໄາᠯ‫ܫ‬ɫԎʅɣɾీ࿢

ɾঈʱϹᓑᰄʍ‫ݹ‬ʊɡʪ˞ʺ̂ʝʆͫɱɩʬɶʱ

ʆɊɔͥ‫ࡂۋ‬ʊटʂʅɪʨᦪ᭐ɸʪɪʨɕʇɣɥ

ɶɊɪʉʩᅋʫʅɣɾʍʆɡʪɋʝɿϔឮ϶ࠧʎ˷̎́ʱࡉɲɶɾʝʝໄາʊऍɬ᥈ʝʫʅɶʝʂŻ¡²´¡Ż

˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬ʍឞᶴκʆᄉໍɶʅɣʪɋ

ɾʇɣɥɋࡂʊटʂʅɊᡰᨅᥱठʣঞॎʍɩᨅʱᄍੜɶʉ

E ɴʲʎ᭝࿔ʍీʊɊ्ͦញ૆ʍᒐ‫ߧބ‬ʍʇɲɰʫʏʇ୛ɶʅɣʪɥʀʊໄາɫಿʅɶʝʂɾʍ

ʬʆɩᖭʱᯯʲʆɣɾʇɣɥɋۨ᭝ɫᢰɬɊໄາ

ɿɋᠯ‫ܫ‬ɫԎɾీʊɊE ɴʲʎᒐ‫ߧބ‬ʱ᥸ʫʅࠍʈʡ

D ɴʲʎɼʍ˷̎́ʱ‫ל‬ɰ‫כ‬ʂɾʇɬʊɊ‫ށ‬ໄɾʀʱ᥍ɧʊࡷࠜഊʊᜓɲɥʇɶɾɋɶɪɶᒐ‫ބ‬າᠯ‫ܫ‬ɫԎʅɣʪɲʇʱᇽʨɹʊɔԔɪʂɾɊ๨

ߧʎ‫ބ‬ʍఄʍᢷɫ਱ɮɊฯɮɲʇʎʝʝʉʨʉɣ

ʱʃɰʅʌɕʇ᥏ΟɶʅɊɼʍাͥԕ᥸Ꮘɫᥬԕ

ၤੳʆɡʂɾʇɣɥɋᔵթᤁʆಿʅɣɾʮɰʆʉ

ʫɾʇɣɥɋ

ɪʂɾ E ɴʲʎᒐ‫ߧބ‬ʊɔໄາɫಿʪɪʨᥢɱʧ

লʍɳᦧϹʎ᭝࿔াᶳ᥻ᆾʊᆌ᝾ɴʫɾɫᓻ௝

ɥɕʇϺ्ʡϺ्ʡɺɪɶɾɫɊᒐ‫ߧބ‬ʎɔᢷɫɫྟɶɮɊলާʊʎলɿʇʎԔɪʨʉɪʂɾʇɣ

਱ɮʅթɰʉɣɪʨɲɲʆපࠍʱ᝾ʪɪʨɕʇ

ɥɋᏃࢋ DNA ᪽࠳ʆߥ᎜ᒓɿʇԔɪʩɊᮅଢ଼ɶ

លʂʅᥢɱʧɥʇɶʉɪʂɾɋχఄʉɮ E ɴʲʎɾตʍఖʊʎᘆҘɫΜ࠳ɴʫʅɣɾɋ

᢫ʂʅࡷࠜഊʊࠍʈʡʱ᥍ɧʊᜓʂɾɫɊଶʩ

D ɴʲʎলɪʨʍ˷̎́ʊɊɸɯʊᥢɱʅʇ᥏
ΟɶʉɪʂɾɲʇʱʇʅʡਦʲʆɩʩɊɡʍʇɬ

᥏ʂʅʞʪʇɴʂɬʝʆɣɾᒐ‫ߧބ‬ʍࡂʎໄາʊ
‫؛‬ʝʫʅɣɾʍɿʇɣɥɋ

ʊᥢɱʅʇʑʇɲʇលʂʅɩɰʏʇɊྟɶɮᔵԔ

E ɴʲʎᶱशɾʂɾρʆʡɊᔵԔɫᒐ‫ߧބ‬ʱᑝʱᡭʠʅɣɾɋᯨธʎ‫ވ‬ʮʫɊᇎʫʉɣఖɍɫᏙ

ɬ‫א‬ʩʊɶɾʇɣɥᔵᡭ৤઄ʊਰʝɴʫʅɣʪɋ

ɬɊ‫ͼݾ‬ʊᧅ࢑ʍ၄ᬞʊলɫಿɾʧɥʉ๨ɫɶʅ

ᔵԔɫɡʍʇɬɩɷɣʀʢʲʱᓗᡥʂʅɊɩʏɡ

Ϻ्ʡᆾʱងʝɸʇʡɣɥɋᮅଢ଼ɶɾఖʍলާʍ

ʀʢʲʍ૜ʱʑɬɊᥢɱʫʏໄາʊ‫؛‬ʝʫʪɲʇ

಍ʡ‫ށ‬ɬʉ٨ᯌʎɊɔᔵԔʍʧɥʊলʊᥢɱʅʇ

ʎʉɪʂɾʍɿʇ໪ʱɲʛɸɋీʊᒐ‫ߧބ‬ɫ‫ݿ‬ʊលɧʉɪʂɾʡʍɫলʍᘆҘʊԎʅᕩɣʍɿʬɥ

Ԏʅɬʅɔʡɥɼʲʉʊຳɪʉɮʅɣɣʧɕʇ

ɪɕʇɣɥʡʍʆɡʂɾɋ

លʂʅɮʫʪɫɊᡥɣᆾɫࢉʱঃɣʅɣʪʇɣɥɋ

ᨁ᝸ࡩᡑʍ‫ވڄ‬ʊϪɥ৵৷ʍ૴ɥʃʇɊ‫ވڄ‬ʱE ɴʲʎᯨธϵͬʇᇜᇎᬬ࠿ɫɡʩɊ૴ɥʃʱ

៖ʠɾɮʉɣ৔ʍɡʩʧɥʊʃɣʅ៥నɶɊᘆҘᅃʂʅ‫ל‬឴ʱᙥʠɾɫɊɔᔵԔʍᡭϙʆ᝾๎ɶʊ

ʊԎʅলɫɣʉɮʉʂɾɲʇʊɬʀʲʇ‫؂‬ɬ‫׹‬ɥɶɾʍɿɪʨɕʇɣʂʅ‫ל‬឴ʱɲʏʲʆɣʪɋɲʇʆɊলʱਸʟɲʇɫʆɬʪʇ៥నɶɾʇɲ
ʬɊᎡৃɶʅɮʫʅᘆҘʊԎझɸʪɲʇʊʉʂ

ᷦᶩ᭝࿔ᶱशাʊ᭙់ᇁ៯ɶɾ F ɴʲɾɋᘆҘʊԎझɶɾাʡলާʍʉɪʆʎਲɶʞʊ

F ɴʲʎ H ᄗԎ᣸ʍ ¸± ϐʍ΂ߧʆɡʪɋໄາʊ

֙ԕʩɫʃɮʮɰʆʡʉɪʂɾɫɊিɍʊɥʃၤ

ʧʪ᜴࠿ʎҸʫɾɫɊ௓࡭ᓧ཮ʫʊʧʪᦪ᭐ʆᶲ

ੳʎᤏɮʉʂʅɬʅɊ᭝࿔ᶱशাʍႻ‫ۦ‬ʆʎɊࠍ᥻᫙ʚʈቬࣃऐӑʍᦪ᭐૗ʆಠߥʍตާʇΠκʆʈʡʱ࠷ࡂʍɡʪຣࢲᧅʍᄗʊ‫ئ‬ʒ૕ɶɊ᥻ಡɳ

ᄉໍɶɾɋɼɲʗ೅δʊ߱ɣɿᫎާ‫ߧބ‬ɫ᥍ɧʊʇʊटʂʅɊࡂఎʆɣʪɲʇʱ‫ށ‬Οʊɶʉɫʨᄉ

ಿʅɊɔ೅δʍᔵԔɾʀʍࡂʆ౫ʨɺʏɣɣɕʇ

ໍɶʅɣʪɋ

លʂʅɮʫɾʍʆ೅δʊᦪ᭐ɸʪɲʇʊɶɾɋɼ
ʍీᫎާʍ‫ބ‬ɫɔᯨᡸʎૠʂʅʡʨɣʝɸɪʨɕ

ɉʇ᫕‫ͥף‬ᄰលʂɾʍɫִᡑᆔɿʂɾʇɣɥɋ೅δᷥᶩ᭝࿔ᶱशাʊ᭙់ᇁ៯ɶɾ E ɴʲ
E ɴʲʡຣࢲᧅʍᄗԎ᣸ʍ ´± ϐʍ΂ߧʆɡʪɋ

ʆͥᧅ࢑ʱɡʅɫʮʫɊตާʇᄉໍɶʅɣʪɥʀ

ࡂɫໄາʆ໐ɴʫɾɾʠɊ᭝࿔ᶱशাʍႻ‫ۦ‬ʆʡʊɊᫎާʍ‫ބ‬ɪʨಏ ²± ͨʍᯨᡸʍ៰๳ɫɬɾɋ

ቬࣃᇊӑʊឮᑝɴʫɾϔឮ϶ࠧʊ‫ބ‬ɊࠍʈʡΠκ‫ݼ‬ɣʇʎ৲ʂɾɫɊͳ់ʊʉʂʅɣʪɪʨʇ৲ɣ

Ż¡²µ¡Ż

ᯮɉܺ̍৙ɉ᡼ᶺ೅ఖಢ‫ށ‬᭝࿔াʍቬࣃऐʆʍˇʸໍթʍ࠷ᣊʇɼʍ٨ᯌ࿢

លʮʫʪɫʝʝʊૠʂʅɣɾɋɼʍɥʀ೅δ᭙Տɼʍʧɥʉខ࿢ɪʨʎɊᦪ᭐૗ᄉໍʍԞಜʊɩ

ɪʨʍϔૠɣᝆңᨅ ²±± ͨӒɫଶʩ᥈ʝʫʪʇᫎ

ɣʅɊᒿញʍʞʱᯈʪʍʆʎʉɮɊ๥᫙ʍʸ˧̎ާ‫ߧބ‬ʎಏ ²¶ ͨʍᄉໍᡸʱ᝸๳ɶʅɬɾɋɲʫ

˞ʱᇊɫюʩͫɱʪʇɣɥఄᨌɫచ৵ʊ୯ቌɴʫ

ʆʎвាᨅʡʉʊʡӂʅᫎާ‫ߧބ‬ʊ‫כ‬ʨʫʅɶʝ

ʅɣʫʏɲʍʧɥʉ٨ᯌʎᢰɬʉɮʅʡ༔ʲɿʍɥʇ৲ɣɊρशʊʉʂʅɪʨ I ऐʊʸ˧̎˞ʱюɪʡɶʫʉɣɋᆌ࿔ঞԞɪʨɣɪʊ᜴࿔ᒓʍᔵዒ

ʩʅঃʂᢳɶʅᄉໍɸʪɲʇʊɶɾɋF ɴʲʎɔᨅʱᒑɧʪɪɊɼʍ́̎˞ʱሯвɶʅɩɮɲʇɫ࠷

ɫɪʨʟʇɊ࠷ʍߖʡߖʆʉɮʉʂʅɶʝɥɋׄ

ʎɪʉʩ‫ށ‬ɬʉ٨ᯌʆɡʪʇɣɧʧɥɋᦪ᭐๥ʇ

ᆌʍɩɪɱʆࡂఎ᫟Фʝʆ‫ݘ‬ʫʅɶʝʂɾɕʇ

ɣɥ‫ל‬ɰ᣸ᆔʉࠓ‫ۦ‬ᶨˑ̀ˆ˴̉ᶬ
²º¹¶ᶩʊɶʅ

លʂʅ໪ʱ໐ɸɋ

ɶʝɥʍʆʎʉɮɊᔵ΂ᆔʊ৲ᒑ̍ᜓթʆɬʪ቎
ϥᆔʉ୸ՕϹԧʱᎻʟʘɬɿʇ৲ɥɋ

ᶸᶩ࿔࠿ˏ˞̂ˏʇਲ‫ف‬ʍχΟࡂఎʣᨁ᝸ʉ੠ᇗʍࡩᡑʱ‫ވ‬ʂɾਲɶʞʎɊ

ᶹᶩκʍࡳ‫׎‬ʇ࿔࠿ీʍˇʸ˃˻̎ˬ˿̍̃ˏᶨ²º·ºᶩʊʧʂʅɔ‫טވڄ‬ড়ɕκʒʇʍѪ॓٨ᯌʊɪɪʮʪુɍʊʇʂʅɊʈ

ʇᜟႻɴʫɾɋʝɹˍ˽˙˅̍؇៖ʍీಜɫɡʩɊ

ʲʉీʆʡ৚ʫʅʎɣɰʉɣɲʇʎɊɼʍఄɍʍ

ตʊʉʲʆቼʍࡂఎʊɲʲʉɲʇɫʇɣɥႾͭ࢈

ࡳ‫׎‬ʱᨁខɸʪɲʇʆɡʪɋ

ɴʍ੡਺ʇɊ৬ʩ̍௒கᶨᔵᡭᶩʍీಜɫɡʩɊ

κʍࡳ‫׎‬ʊʎɊɔ֝ԔʉᯨΟɕɔᯯʞ๬ɕɔ϶ࢍɕ‫כ‬ʩঃɬʍీಜɫɡʩɊᏒಙʍీಜʊᔷʪʇɣɥɋ

ɔ᜙ᄉɕɔ֚ᅸˋ̎˩ˏɕ
ɔѪӂʉშ݄ɕ
ɔ௟ᓑɕɔࢂҳ኏ʍ B ɴʲࡂఎʍʉɪʆʍɩ߱ɴʲʍቌɶɾඋɕɔфκᆔࠪӂɕʍɊᶹʃʍ᝸Ꭻɫɡʪʇɣʮ

ၤੳʎʝɴʊ؇៖ʊ៌ঞɶɊA ɴʲʍ‫ބ‬ʍ‫ט‬ড়ʎ

ʫʪᶨDiczfalusyᶬ²ºº¸ᶩɋɲʫʨʎɊκɫᄉɬʅႾͭ࢈ɴʍᜟႻʆɡʬɥɋC ɴʲʍ‫׹ܬ‬ʡ‫׽‬පʆɣɮɲʇʊᇀଢ଼Ꮓʒʃɣʅɣʪʇᒑɧʪɲʇɫʆ

ɡʪɋD ɴʲʍ‫׹ܬ‬ʎɊᆌ࿔াᶶ ᥻ʆʍᔵᡭ৤

ɬʪɋʃʝʩɊુɍʍໍթʎɊࡩᡑʇʉʪκʒʇ઄ɫᯑᗾʆɡʂɾʇលɧʧɥɋᶱशাʊ់ʱᒫɣʍᄉ‫ا‬ʱࠩʪɲʇɊɼɶʅᄉໍʱࠩʪɲʇʆɡʪ

ɾ E ɴʲʍ‫׹ܬ‬ʎɊฬणਲ‫טف‬ড়ʇលɥʊʎ኏्

ʇʡɣɧʪɋ࿔࠿ీʊʎɊɲʫʨɸʘʅʍ᝸Ꭻɫ

ɫᨁɸɭɊʣʎʩ૴ɥʃၤੳʆɡʂɾʇᒑɧʪʍ

ᓩɪɴʫʪɋρ‫ۋ‬ɊુɍʎᏲ৵ʆԳАʍʉɣ࿔࠿

ɫ޸ঞɿʬɥɋಢಿʉʨʏ࡬᫏֚ʱ‫ל‬឴ɶʅʡʨ

ʊԎϥʂɾɫɊɼʍీʊᒑɧʨʫʪ಍‫ٴ‬ɪʃ಍‫ށ‬ɥʍɫɣɣʍɿɫɊ᭙់ᇁ៯ʍᬈᄟʆɊಢκɫ؇ᬈʍఄຫʱᒑɧʅɊɲʫʝʆᔴ෤ড়‫ݳ‬ʊໍթʱᏙ

࠳ɶʅɶʝɥʇɼʫϒͫ‫ל‬឴ʱնʠʪʍʎ‫ۏ‬᭐ʆɰʅɬɾɋ᜴࿔ɴʫɾఄɍʍκʇɶʅʍࡳ‫׎‬ʱвɡʪɋ੾৷ಜʊᔷʂɾ‫׹ܬ‬ʍˇʸʍͥʃʍ٨ᯌʆ

ʃɲʇɊɼɶʅɼʫɽʫʍఄɫ‫ވڄ‬ɶɾͳᄟʱᇽ

ɡʪɋʩɊ᧖઄̍ࡳᨁɸʪɲʇɫणʊ๳ʠʨʫʅɣɾʧ

᭝࿔াᶱशʆʍ F ɴʲʍʧɥʉˇ̎ˏʡ֝Ԕɡ

ɥʊ৲ɥɋɼɶʅɼʍɲʇɫɊ҄ɪʆʡ᜴࿔ɴʫ

ʩɥʪɋρ‫ۋ‬ʍ᭝࿔ʍၔ৏ʍͥʃʎɊ᜴࿔ᒓʊࡩ

ɾఄɍʱநᠷɶɊʝɾිԢʱвᠷɸʪɲʇʊʡʃ

ɶʅ೅δ᭙Տɪʨᢌңᨅɫோૠʮʫʪʇɣɥɲʇ

ʉɫʂʅɣɾʍʉʨᕩɣʇ৲ɥɋ

ʆɡʪɋF ɴʲʍ‫׹ܬ‬ɊԞʠɪʨ I ऐʊʸ˧̎˞ʇʎɣɧɊᆌ࿔াᶱशʱᦋɭɾρʆʡ‫ݼ‬ɮʍᦪʱюʩɾʚɥɫɲʍʧɥʉᨅᩏ˞˿ˬ́ʎᢰɲʨ

᭐ᒓʍఄɫ৔᣸ʍͭ៬ʱឱɧʅɣʪɋɼʍ‫ݼ‬ɮɫʉɪʂɾʇʡɣɧʪɫɊႻ࠷ʊᦪ᭐૗ᄉໍʱɶʅ

ࠍʈʡʍѪ॓ʣ௟ᓑʇ௓࡭ᓧʍ٨ᯌʆɡʂɾʩɊ

਺‫ܫ‬ʡʉɣʝʝɊᫎާɪʨ៚ɣɫɡʫʏͳ់ʊʉ

ࢂඋɶɾɮʅʡϔឮ϶ࠧʣюʩͫɱ϶ࠧʍ᥎ɮʊ

ʪʍɫঞ࿷ɿʬɥɋ

ʎᒶ‫ܬ‬ɫʉɣʇɣʂɾႻ࠷ᆔʊព຅‫ۏ‬᭐ʉ٨ᯌʱ

Ż¡²¶¡Ż

˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬ʪɋɪɪɧʅɣʪɋ
व ી ³µ श ᶴ ಏ ᶱ ఖ ʊ ʎ ɲ ʫ ʝ ʆ ᠯ ૂ ֙ ‫ ܕ‬ʆɾʇɧʏवી ³µ शᶴಏᶱఖʍ֢া ²² ీ᮳Ɋቬɡʂɾۨ֙ʍͥᧅʆዒʀӁʩɫ៖ʠʨʫʪʧɥʊ

ࣃᇊຒʱ᭝ཆʇɸʪ˴ˆˡ˗˻̎˟ ¶.º ʍۨ᭝ɫʉʂɾɋटʂɾκɫʝɹ಍Ԟʊɶɾʍɫɩ݆‫ב‬ʩᢰɬɊቬࣃዿͥׄᆌʍᬯᄗʆɡʪࡎࢨᄗʆ᭝्ᶵ

ɿʂɾʇɣɥɋᶱशϒ݆ͫ‫ב‬ʩʡʆɬʉɣၤ຤ʊ

ঐʱឧ᩻ɶɾɋɼʍᬫʊɪʮɴʫɾ˚ʺ˙˕̎ʱɡʂɾʍʎɊҳ቗ʇʍᎽʱᨁ᝸ខɸʪ೅֋ۨఄʍ

ʞʪʇɊɔᶴ‫׳‬෤ʎ‫ބͩށ‬ɪᶿɕʇɣʂɾӑࡄɫκɾʀʊʇʂʅʎᒗɧɫɾɣɲʇɿʂɾʇɣɧ

‫ݼ‬ɪʂɾɋɼʫɿɰ๬Ꭻူᆌʆॱ࢑ɫࣖʫɊЋᄍʪɋˏ˪̀˗˻ʸ́ʉࡳ‫׎‬ʍᏢପʇលɥੜ‫ء‬ʆʡ༔ʞမ௶˭̎́ɫʟɬԎɶʊʉʂʅɣʪᶴ‫׳‬෤ʊɩ݆ʣϴ၇ʊࡩɸʪ᧖઄ɫᨁ᝸ʆɡʪɋ

᫟ɸʪͭࠪɫᱝɣʍɿʇୟ༨ʆɬʪɋ
ɼʍʧɥʉͭࠪʣͭдʍʉɪɊࡷɴʉࠍЙʱɪɪɧʪ֚ᅸূΟᒓʍϺՁɪɫ໕ᥱʩɪʨᦪ᭐ɶɊ

²±ᶩ֚ᅸᒓʊࡩɸʪɲɲʬʍˇʸɉ‫ీ׽‬ʊɊ‫׽‬ɷʧɥʊ᜴࿔ɶɊɼʍͼʆ֚ᅸໍթ

ʝɾɼʫʱᝆҰʆɬʪκ‫ى‬ʡӁʨʉɣɾʠɊᏃೖ

ʱᏙɰʅɲʨʫɾఄɍʍϹ᰺ʎʈʍʧɥʉʡʍ

ᆔʊᇉᠷजͭᢷʊᔷʂɾʇលʂʅʧɣɋρ‫ۋ‬ʍׄɿʂɾʍɿʬɥɪɋׄࠍՏᆌ᭙૗ʍ๬Ꭻူᆌʇɣ

ᆌΟ௕ʎκᯕɫᦟᦆɶɾɲʇʍʉɣΟੳʆɡʩɊ

ɥɪʃʅʉɣ࿔࠿ʡᆌᄉɸʪʉɪɊ֚ᅸᒓʇɶʅ

্ᨃ௓࡭ᏺɫκϹၔʊޯߧʣࠍʈʡʊͮɧʪম᮰

ʍЋ‫ا‬੡ɫɊࡂఎʱ৔᧖ɶࠩʩɾɣʇ৲ɥ๨ପʀ

ʊʃɣʅʍనሯʉ˝̎˕ʍᝁϊɰɫʉɣʍʡΟ࠷ʱଆɴɧʅմլʱᏙɰʪɲʇʱ຅ੜɴɺɾɋɡʪ

ʆɡʪɶɊᶴ‫׳‬෤ʉʈɫρাʈɥʉʪɪʡρাʍɣʎਭᒓʱ૜ᬫʧɮᦪ᭐ɴɺʪʍʊӂՏʱʃɮɶ

ۨ᭝ʣໄາʇɣɥΜ༨ʆɬʉɣ࿔࠿ʇʍ᫟᥸ʆͭ

ɾɋɡʪɣʎɊఀ๬̍ѩ᭙̍ࡐɴʍʉɪਭᒓʍᄉ

ሯ࠳ʆɡʪɋʃʝʩቬࣃʆʎͭሯ࠳ʉႻၤʱʈɥ

‫ا‬ʱࠩʪɾʠʊᔵԔɾʀʍᯨ௶ʣ᜞ᯕʱआɶԎɶព᧽ɸʪɪɫ٨ᯌʊʉʂʅɣʪʍʆɡʩɊព᧽ʆ

ɾ֚ᅸᒓɾʀʡɣʪɋ

ɡʪϒͫɊͭࠪʣਆ৮ʉʈʍ੡਺ʍম᮰ʱ‫ל‬ɰʣρ‫ۋ‬ʍ᭝࿔াɊ
ɔᎽɕʇɣɥលᗼʱ‫ݼ‬ɮᒫɮʧɸɣɋɼʍʧɥʉខ࿢ɪʨʎ֚ᅸূΟᒓʊࡩɶɥʊʉʂɾɋᬯκɊۨ‫ܕ‬Ɋɼɶʅఖಢ‫ۨ׸‬ɪʨʍʅɊቿࠜᆔʉʸ˭̃̎˗ʍʞʉʨɹɊ৔Ⴞࠜᆔʉ

ோ୸ʱ‫ל‬ɰʅɬɾુɍʊʇʂʅʎɊϺʧʩ࠷੡ʇʸ˭̃̎˗ʡᒑɧʪ৕᝸ɫɡʪɪʡɶʫʉɣɋ

ɶʅ৔ʊ᮰ɮលᗼʆʡɡʪɋɶɪɶ‫ీ׽‬ʊɊఖɍʝɾɊ‫ݼ‬ɮʍҁᅕᒓʱᆾʍঞɾʩʊɶʉɫʨ

‫ݳ‬ʮʪၤ຤ʍͼʆͥ᏶ʊໍթɸʪ֚ᅸᒓ‫ݥ׽‬ʍੜʡɊ࿔࠿֚ᅸʍၔ฽৷ɪʨຟᅸʍҥҳ᮵ϴʱʃɰ᝾ʍᯨɣᦒɣʣМђឍʍᦒɣʎɊ֚ᅸϹԧʍɔᎽɕ

ʉɮʅʎʉʨʉɪʂɾϹ᰺ʉʈʡʝɾɊ֚ᅸᒓʍ

ʱ୻ʪɫɸɿɰʆʉɮɊͥκͥκʍ৔ʊᗿᙸʱᄉ

৔ʊᗿᙸʱᄉɷɴɺʪ᝸‫ی‬ʊʉʂɾʎɹʆɡʪɋ

ɷɴɺɾʍʆʎʉɣɪʇʡ৲ɥɋુɍʎ֚ᅸᒓʆ

ρ‫ۋ‬ʍ࿔࠿ʊɩɣʅ֚ᅸᒓɫϹ᰺ɶɾᗿᙸʍӑɡʪɫʥɧʊɊᓗ౔ʊɡʪᄉໍᒓʇɶʅʍΣɣʍࡄɫͥϹʈʍʧɥʉʡʍʆɡʂɾʍɪɊɼʫʎʈ

ࡳ‫׎‬ʱ৚ʫʅɶʝɥɲʇʡɡʂɾʍɪʡɶʫʉɣɋ

ʍʧɥʉথʆព໤ɴʫɾʍɪɊɡʪɣʎ٨ᯌʇɶ

Ⴛ‫ۦ‬Ɋቬࣃᇊʍ໕ᥱʩʎ֚ᅸࣖ‫ݘ‬ʍֵ෤ʊɡʪ

ʅ฾ʂʅɶʝʂɾʍɪʱᇽʪɲʇʎɊρাʍ࿔࠿ʇលʮʫʪɋၔʊᇉᠷजͭᢷɫᆾዒʃʇɣɥɋɼ

֚ᅸʊɩɰʪ֚ᅸᒓᔵ᣸ʍɲɲʬʍˇʸໍթʍ‫ۦ‬ʍ಍ʡ‫ށ‬ɬʉႾᄒʎͥీʊ๚ɶʅ௓࡭ᏺᨃɫͬ

ʩఄʱᒑɧʪɥɧʆʡʇʅʡ‫ށ‬ԕʉɲʇʆʎʉɣ

ɫʂɾʇɶʅʡɊʝɿ‫י‬ಹɶɾʇʎʇʅʡលɧʉ

ɿʬɥɪɋɣቬࣃዿͥׄᆌΟ௕ʊࡩɸʪͭࠪʣଔ؇‫ט‬ড়ʆɡŻ¡²·¡Ż

ᯮɉܺ̍৙ɉ᡼ᶺ೅ఖಢ‫ށ‬᭝࿔াʍቬࣃऐʆʍˇʸໍթʍ࠷ᣊʇɼʍ٨ᯌ࿢

ঃᄍ௮ႈ
Diczfalusy Eᶨ²ºº¸ᶩᶮ In search of humam dignityᶺ
gender equityᶬreproductive health and healthy agingᶬInternational journal of Gynaecology and Obstertricsᶬ
¶ºᶬ²º¶-³±·ᶮቬࣃׄᆌΟ௕ၵዒ൮ា߆‫ى‬ϥᶨ³±²³ᶩᶮ ៬೿̍൮ា‫ܫ‬‫ؙ‬ಅᶬ೔ɉɉ᭿Έᶨ³±±¹ᶩᶮ ˞̀ʸ̎ˎ ʊɩɰʪ᠈٨ᯌᶬ
EMERGENCY CARE ³±±¹ ‫݇࠙ݶ‬ԗᶬ³³µ-³´±ᶮಟಳɉɉ௙ᶨ²º¹¶ᶩᶮ¡ᇀଢ଼৷ʍᅕႾɉআ௮‫ܞ‬ಟಳɉᘣࠍᶨ³±²³ᶩᶮ¡´̍²² ‫ށ‬᭝࿔Ϲ᰺ឧɉᮂ‫قݫ‬ɉ˃˻̎ˬ˿̍̃ˏᶨ²ºº¹ᶩᶮ¡ ึʋᇫ᫙Żึʇɼʍᦋ኏
ʊʃɣʅɉ៦‫ݫ‬ంᒫ቎‫ށ‬ಟɉᒨࠍᶨ³±²²ᶩᶮ¡ ᢲऄ‫ۨށ‬᭝ʊᥖʪŻఖಢԝࣃʆ
ϺɫᢰɬʅɣʪʍɪɉNHK Ԏ၅ࡷอಟ௥ؓᶨ²º¸ºᶩᶮ¡ ࡩᡑ‫ވڄ‬Żਲɶʟʇɣɥɲʇɉ
ͼӆంಅˑ̀ˆ˴̉ M.E.Pᶨ²º¹¶ᶩᶮ¡ ɥʃᅕʍᜓթࠜɉ៝дಅ૖Ż¡²¸¡Ż

˨˻̎˴̉̍ˇʸለኴɉዿ²´ऍɉዿᶱ‫׳‬³±²³शᶶಏɉ²¹-³¸᮱Journal of Human Care Studies Vol. ²´ No. ²
June ³±²³, pp ²¹-³¸Кᯈ៵௮᭝࿔াʍ৔ႾᆔˇʸʍɡʩఄᶭϹ᰺ʱɲʇʏʊɸʪʇɣɥɲʇᶭ

ࡷࣽɉɉਚᶪ

A way of psychological disaster assistanceᶭ Verbalization of disaster experiences ᶭSatoshi Ogawa*

Abstract
After East Japan great earthquake disasterᶬthe wordžcareſis in the confusionᶮCaring of the disasteremergency correspondence period is watching agreement to usežPsychological first aidſ
ᶨPFAᶩᶮ
Its basic strategy is to support the needs of the victim of disasterᶬand to support the self-care actionof the victimᶮManuals were unifiedᶬand the superficial use was fixedᶮHoweverᶬthe contents were
multifariousᶮBecauseᶬeach supporter watches were often different from the core idea that should careᶮCaring for PTSD means therapy in the psychological disordersᶨDisease modelᶩᶮCaring to a loss
experience is compassionate oneselfᶮAnd there is another caringᶬlike as the social support for the
purpose of the readaptation to the community againᶨWelfare modelᶩᶮThese are all caringᶬand all
are needed in the situation of confusion of disasterᶮBut for the professional helpersᶬeach contexts aredifferent each otherᶮEverybody insists on one's viewpointᶮFor usᶬlife support is basics of the psychological caringᶮUnder the situation of outreachingᶬunlike
normal caringᶬstructures of psychotherapy are hard to be establishedᶮBecause there are limitation of thenumber of timesᶮFor the support of disaster assistanceᶬin the viewpoint of psychological aidᶬto follow
talking through what victim experienced is important caringᶮBecauseᶬacts of talking sustain sense ofcoherenceᶮThese narrative coherence give newborn identity for whom alive on the community after thedisasterᶮ
key wordsᶺdisaster assistanceᶬPsychological ¿rst aidᶬout reachᶬnarrative coherenceᶮϺʧʩʡᄔɶͫɱʉɮʅʎɣɰʉɣʍʎɊέɮʪɋ‫ۑ‬ᶱᶩʍ‫ܛ‬ಢఄᨌʎϒͬʍᶸʃʊᭂ᎜ɴʫʪɋ

ʉʨʫɾఄɍʗʍ‫ف‬ਸʆɡʩɊ᜴࿔ɫρʉɩᏙɮǋோ୸Ѯɪʨ᜴࿔ᒓʊ᥎ʄɬɊໍթʱ߂ʠʪʸʼͼʆᦋɳɴʫʪఄɍʗʍɩ᝾ᕎɣʆɸɋ

˞̀̎˗ᶨɲʀʨɪʨɊ᜴࿔ᒓʍ๳ʠʊড়ɷʪɾ
ʠʊԎ‫؂‬ɮড়৵ோ୸ʆɡʪɋ᜴࿔ᒓʊᡥଉʱɪɰ

ᶱɉˋʺˉ̃ˎˁ́̍˫ʷ̎ˏ˞ʾʺ˟ʍႾ৤

ʉɣӉ੡ᆔʉੳ्ʆɲʀʨɪʨ૜ʱɴɶʍʘʪᶩɋ
ǌࠪӂʇࠪ৔੡ʍ୯Йᶨঞᮅʍࠪӂʱሯɪʉʡʍ

Psychological ¿rst aidᶨ³±±·ᶬϒͬ PFA ʇᄬឧɸʊɶɊ᜴࿔ᒓɫ৔᣸ʱϤʠʨʫʪʧɥʊɸʪோ୸

«¡¡¡໺ৎ‫ࠜށ‬Ᏼ‫׹‬ቬቓࠜᧅᶨÔéöìöõðìö¡Öïê÷æóôêõú¡óâåöâõæ¡Ôäéððí¡ðç¡Êïõæèóâõæå¡Éöîâï¡âïå¡Ôðäêâí¡Øæíçâóæ¡Ñôúäéðíðèú¡ÅæñâóõîæïõᶩŻ¡²¹¡Ż

ࡷɉࣽᶺ᭝࿔াʍ৔ႾᆔˇʸʍɡʩఄŻϹ᰺ʱɲʇʏʊɸʪʇɣɥɲʇŻ‫ۑ‬ᶲɉ࿔࠿‫ט‬ড়Ɋ৔ʍᐂʣɪʉ‫ۋ‬৊ᦋ኏ϒͫʱ᝸᎜ɸʫʏɊPFA ʎ᜴࿔ʊʧʂʅ༜ঐɴ
ʫɾфɍκʍႻ࠷ࡩԂᓧՏʍ݇ওʱ‫׭‬ᓧʇɸʪʧ
ɥʉோ୸ʆɡʩɊᨁɬʱфκʍშ݄ʗʍᦞড়ʊɩ
ɣɾ˓̎ˍ˹́ˋ˳̎˞ʇɶʅʍோ୸ʆɡʪɋɶ
ɪʡɊ࿔࠿ʍϹ᰺ʍీ᫙ᆔ‫֊ݳ‬ᶨ‫ۑ‬ᶲᶩʱੜᠪɶ
ʅᎻʞዒʅʪ৕᝸ɫɡʪɋɼʍɾʠɊఄຫ៵ʣථ
᥵ʡɊ༈ɴʇ໠ᥨ৷ʱᆾବɶɾᥱणʍфԠɡʪɣʎᭂ‫ۍ‬ᅸຫᆔʉ৔Ⴞᔴॅʊɩɰʪ৔Ⴞᆔோ୸ʇʎ
ᄴʉʪ࿢ɫ‫ݼ‬ɣɋɲʍ࿢ʊɩɣʅɊρ‫ۋ‬ʍ೅ఖಢ‫ށ‬᭝࿔ʊɩɰʪᦉᄍʍɴʫఄʊɩɣʅʎɊɲʍआ

‫ۑ‬ᶱɉˋʺˉ̃ˎˁ́̍˫ʷ̎ˏ˞ʾʺ˟

ᄴɫੜᠪɴʫɹɊᥱणʍ৔Ⴞᔴॅʍᒑɧఄʇʍ

ʱᆾ෋ʇɸʪᶩɋǍࠪ࠳֊ʱ‫ۑ‬ʪோ୸ᶨ‫ۥ‬шɴʫᦒɣɫႾពԎಿɹʊໍթᶨၔʊ᥸உʊɩɣʅᶩ

ʅɣʪ᜴࿔ᒓʍ༌Εʱ᪘ʠɊ᝾ᥱɶɫʡʅʪʧɥ

ʊ༌Εɫᄉɷɾɋၔʊ‫ݹ‬ҁাˏ˞̂ˏᬬ࠿ᶨPostʊோ୸ɸʪᶩɋǎɣʝ৕᝸ʉɲʇɊ‫ۏ‬ʂʅɣʪɲ

Traumatic Stress Disorderᶬϒͬ PTSD ʇᄬឧᶩʍʧ

ʇʍ਺‫ܫ‬ʱᭂʠʪᶨ‫؝‬᥆਺‫ܫ‬ʱᭂʠɊ᜴࿔ᒓɫɣ

ɥʉ৔Ⴞᆔʉᬬ࠿ʍఄʊঃɬࡉɺʨʫɾႾពɫʉ

ʝ৕᝸ʇɶʅɣʪɲʇɊ‫ۏ‬ʂʅɣʪɲʇʱ૳୴ɸ

ɴʫɊᦞԕʇʎលɧʉɣˇʸ୯ЙʇʉʂɾѮᮅɫʪɋɼʍɥɧʆɊɼʍκʊɡʂɾ PFA ʱᎻʞዒʅ

ɡʂɾɋɲʫʨʍ༌Εʱ؉ʠɊ࿔࠿ோ୸ʇɶʅʍ

ʪᶩɋǏႻ࠷ᆔʉ٨ᯌʍព຅ʱՕɰʪᶨɣʝ৕᝸৔ʍˇʸʍఄ‫؂‬ʱᒑࡗɶɾɣɋ

ʇɶʅɣʪɲʇɊ‫ۏ‬ʂʅɣʪɲʇʊ‫כ‬ʩᎻʟɾʠ
ʊɊ᜴࿔ᒓʱႻ࠷ᆔʊோ୸ɸʪᶩɋǐ‫ې؝‬ʍκɍᶲɉড়৵ࡩড়ಜʍᏴ‫׹‬ᆔʉˇʸʇʍ᫟ʮʩʱХ᥼ɸʪோ୸ᶨࡂఎ̍‫ז‬κʉʈ᣸᥎ʊɣʅோɧʅɮʫʪκʣɊۨ‫ܕ‬ʍ୸Օ෤᫟ʇʍ᫟

᫾࿔ࠜʆʎɊ‫ۑ‬ᶳʍʧɥʊᆌ࿔া ²±±± ీ᫙ʝʮʩʱХ᥼ɶɊɼʍ᫟ФɫᫎᏙɬɸʪʧɥ୸Օɸ

ʆʱড়৵ࡩড়ಜʇ‫ئ‬ʕɋ᜴࿔ᒓʍ৔Ⴞၤੳʱᨁខ

ʪᶩɋǑࡩԂʊ঱ዒʃ਺‫ܫ‬ʍ୯Йᶨᖐᅞʱʣʮʨ

ɶɾ Raphaelᶨ²º¹·ᶩʎɊ‫ۑ‬ᶲʍʧɥʊɊɲʍీ

ɱɊᦞড়ᆔʉ෤ᓧʱᱝʠʪɾʠʊɊˏ˞̂ˏ‫ט‬ড়ಜʱ࿔࠿˼̎˞˪ʸಜʇɸʪɋᆌ࿔ɪʨ ²±±± ీʇࡩԂʍఄຫʊʃɣʅᇽʂʅʡʨɥᶩɋǒᎶςʇ᫙ᶨµ² ʉɣɶ µ³ ఖᶩʍీ࿢ʆʎɊీ᫙ʍᏀᦋʇ

ঃɬᏘɭʍ୯Йᶨ᜴࿔ᒓɫɣʝ৕᝸ʇɶʅɣʪɊ

ӉʊనʨɪʉߑʱႻɸ᜴࿔Ϲ᰺ʇɶʅʍ‫ވڄ‬ʇɊɡʪɣʎ࡯ಿ৕᝸ʇʉʪˋ̎˩ˏʱᎶςɶɊঃɬ˞˿ʼ˴Ϲ᰺ʇɊᄉໍ‫֊ݳ‬ʍম᮰ʇɶʅʍ᜴࿔া

Ꮨɭʱᜓʉɥᶩɋ

ʍΠตᆔˏ˞̂ˏʍᶳʃʍఄ‫؂‬ʎɊʝɿಠԔ֊ʆ

Ż¡²º¡Ż

˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬ɡʪɋӂʅʍ༌Εʎ৔ႾᆔʊʎɊ‫ۑ‬ᶳʍʧɥʊɊ

ʪɋɲʫʨʍ৔Ⴞᆔˏ˞̂˙ˋ̎ʊʧʂʅ‫ט‬৊ɶ࿔࠿াʍྡྷࡋʉ৔Ⴞᆔీ᫙Ꮐᦋᶨ೔ᶬ
³±±´ᶩʍͼʅᄉɷʪթ୻ʇ༌ΕɫɊSelyeᶨ²º´·ᶩʍ๴ᦞড়ᅖ

ʊ૸ɱ᥈ʝʫʅɣʪɋɼʫ௕Ɋড়৵ࡩড়ಜʍɔ࿔

ы ᑳᶨGeneral Adaptation Syndromeᶬϒ ͬ GAS ʇ࠿ˏ˞̂ˏɕʇͥଟʩʊɶɊ‫כ‬ʩɡɧɹʍࠪӂሯᄬឧɸʪᶩʍˍ˽˙˅ᇁʇ‫˅˙˽ˍט‬ᇁɪʨʉʪ

вʱᆾବɸ PFA ʍோ୸ʍɡʩఄʎᦞԕʆɡʪɋ

ᠯ‫טؙ‬ড়ಜ̍ˏ˞̂˙ˋ̎ʗᦞড়ɶɾଃૺಜʇɶ

ড়৵ࡩড়ಜʎ৔ႾᆔᏲ঒ʇɣɥᮅʆʍඐᬈಜʆ

ʅ៥నɴʫʪɋɼʫ௕Ɋɲʍీಜ PFA ʍǍɔࠪɡʪɋˏ˞̂ˏʺ̉˧˅˞ʍʡɾʨɸᏲ঒ʎࡄప

࠳֊ɕʍᨁ᝸৷ɫ݇ɶɊǎǏʊՒɧʅɊᔵइ՞Տ

ʊᐂ‫ح‬ɶʉɣͫɊ੿ʫʉɣᦪ᭐ᄉໍʆʎɊీɍ

੡ʱ݇ɸɾʠʍǑɔၤ຤ࡩԂʊ঱ዒʃ਺‫ܫ‬ɕʉʈԬɍʇ‫ݳ‬ʮʪၤ຤ʊʧʪం‫ގ‬ԫྟʊెɴʫɊ৔᣸

ʍᦐӌᆔ˓̎ˍ˹́ˋ˳̎˞ʣɊࠚዒʊʧʪ˓̎

Ӊɍʍࡩড়ʱᥖʨʫʪɋɲʍీಜʍ৔᣸ᇁ᫟ᆔʉ

ˍ˹́ˋ˳̎˞ϵ༜ʱ᫾ɯʧɥʉǐɔ‫ې؝‬ʍκɍᏲ঒‫ט‬ড়ʎɊૺᎃቛᅕᙪʍఄຫ៵ʇɶʅ A̍˿˲ʇʍ᫟ʮʩோ୸ɕʉʈʍᔵዒோ୸ɫᨁ᝸ʇʉʪɋ

̀ɫСᝳাͭ៬‫ح‬ଶթ‫ט‬ড়ʇɶʅʝʇʠɾʧɥ

᫻ቛ‫ށ‬᭝࿔ʆʎɊϔឮ϶ࠧӁࢍা᭝࿔᫟᥸ึɫ‫ݼ‬ʉɊɔ‫ט‬கʍථɧ̍᫳Νɕɪɔ࢏ಒʍථɧ̍ᦃ᢫ɕ

ᆌɶɾɫɊɼʍΜ᫾ʊᨁ᝸ʉខ࿢ɫǐɔ‫ې؝‬ʍɪɔӻᏃɕʊʉʪྟ‫ݳ‬ʍ᥸Ꮩʆɡʪɋɼʫ௕Ɋ

κɍʇʍ᫟ʮʩோ୸ɕʆɡʩɊɼʍӌϹᆔఄຫɫ

PFA ʍǌɔࠪӂʇࠪ৔੡ɕʱ੡ɷʨʫʪʧɥʉᏲ

ǏɔႻ࠷ᆔʉ٨ᯌʍព຅ɕǑɔၤ຤ࡩԂʊ঱ዒʃ঒ᤏ༜ɫ಍ᨁ᝸៨ᯌʆɡʪɋࠪӂʱᔵងʆɬʪɾ

਺‫ܫ‬ɕʇǒɔᎶςʇঃɬᏘɭɕʇɣɥ᜴࿔ˉ˵˻

ʠʍɾʠʊʎǎɔ৕᝸ʉ਺‫ܫ‬ʱᭂʠʪɕɲʇɫᨁˡ˜ʹӖථጶʍɾʠʍᎽʄɮʩʆɡʪɋ
GAS ʍੜᑵʎɊ৵৷ˏ˞̂ˏ‫ט‬ড়ʇɣɥ៧ʍ

᝸ʆɡʩɊǏɔႻ࠷ᆔʉ٨ᯌʍព຅ɕɫ੡ɷʨʫ

ᆾʊʡ᝾ɧʣɸɣీಜʍବ஍ɿɰʆʉɮɊӖᦞড়ʪీɊǍʍɔࠪ࠳֊ɕɫੜᠪɴʫʪɋ
ড়৵ࡩড়ಜʍ ²±±± ీ᫙ʱᢲɧʪʧʩᫎɣీ᫙

ʇɣɥᦋ኏ʊɩɣʅ᝾ɧʊɮɣ৔ႾᄉႾᆔᡥᖻɫ

ʊɩɰʪ᣸Ϲᆔʉম᮰ʱᒑɧʪͫʆʎɊᄉႾࠜᆔ

ɡʪɲʇʍବ஍ʆɡʪɋʝɾɊɼʍࡩԂʍ‫ވ‬௝ʍʉ˱˷ˀˏ˕̎ˍˏʍˋʺ˅́ʊᇗᆾɸʪʇᕩ

ᏃೖɊˏ˞̂ˏᒗ৷ɫϵͬɸʪᅋઐಜʇɣɥ‫ۏ‬᭐ɣɋRaphaelᶨ²º¹·ᶬ‫ۑ‬ᶲᶩʍ़མಜʍͼ഑ʇʉɫɡʪɲʇʱও៬ɶʅɣʪɋ᫻ቛ‫ށ‬᭝࿔ʍᶲ̌ಏ

ʪ৔Ⴞᆔʉ˜̎˴ʎɊ‫ވڄ‬ʗʍਲ‫ڗ‬ʇᅽɧʉɣ˞

ϒᬆʊᱝᵱᒓʍ᭝࿔᫟᥸ึɫ݇ՒɶɾɲʇɫɊɲ

˿ʼ˴Ϲ᰺ʇଞ‫ށ‬ɸʪΠตᆔˏ˞̂ˏʍᶳʃʆɡ

ʍీಜʍ‫ۏ‬᭐ʱও៬ɸʪӍ‫ۿ‬ΟАʆɡʪɋড়৵ࡩ
ড়ಜʊᄉɷʪᦪ᭐ᄉໍʍᏲ঒੡ʍପᏙɫɊྟ‫ݳ‬ɶɾშ݄ʗʍంɾʉᦞড়ʊ‫؂‬ɪɥ˱˷ˀˏ˕̎ˍˏ
ʍᆌթʱ᫿ሢɸʪʇɣɥථ‫ۑ‬ʍႾ៵ʆʡɡʪɋ
ɲʍʧɥʊ᜴࿔ʱˏ˞̂ˏ‫ט‬ড়ɪʨʞʪʇɊ‫ڄ‬‫ވ‬ʣ˞˿ʼ˴ʣӖᦞড়ʍᏲ঒ʍᐂ‫ح‬ʱᆾବɶɊˏ
˞̂ˏପᏙʍ਱ম᮰ʱᤏ༜ɸʪɲʇɫዿͥᆾ෋ʇ
ʉʪɋᄉႾࠜᆔʉ‫ܛ‬ᆺʱࠪ࠳ɴɺʪɲʇɫዿͥ
ʆɊɼʍͫʆໍթ΂ϹʇɶʅʍᔵइʍᏎৈ੡ងʣ
ͥᡬ৷ʱвପɸʪʧɥʉ‫ވڄ‬ʣ˞˿ʼ˴ʗʍˇʸʱᜓɥʇɣɥ‫ܛ‬ಢᆔʉႾពɫோ୸ʍ‫ܛ‬ಢʇʉʪɋ
ɼʍੜ‫ء‬ʆ PFA ʍʧɥʊɊᄉໍோ୸ʇͥϹ֊ɶɾ‫ۑ‬ᶳɉ᜴࿔ᒓʍీ᫙੡ង

৔Ⴞᆔˇʸʱ੍࠳ɸʪɲʇɫᦞԕʆɡʪɲʇʎ៵

Ż¡³±¡Ż

ࡷɉࣽᶺ᭝࿔াʍ৔ႾᆔˇʸʍɡʩఄŻϹ᰺ʱɲʇʏʊɸʪʇɣɥɲʇŻʇᦋɳɸ᜴࿔ᒓʆʡɡʪɋ

ʱহɾʉɣɋ
ɔ¿rst aidɕʇᩊ૟ʫɾʧɥʊɊோ୸ీ᫙ɫᬈ
ʨʫɾ࿔࠿௚୸ʍɡʩఄ௕Ɋ৵৷ಜʍ٨ᯌʗʍோ

ᶳɉ᜴࿔াʱ౫ʨɸɲʇʱᒑɧʪ

୸ɫᨁខɴʫʪʍʎঞ࿷ʆɡʪɋɼʍᬫʊɊనሯ
ʊ᝾ɧʪʡʍʇɶʅʍˏ˞̂ˏ̍ʺ̉˧˅˞ʗʍ

࿔࠿Ϲ᰺ʍ˞˿ʼ˴ɫᄉʞԎɸ PTSD ʍΜ᫾ʇ᣸ϹᆔᏲ঒‫ט‬ড়ᤏ༜ʱ૨ɥɲʇʡɊ˞̀ʸ̎ˎʍɣɥខ࿢ʎɊ࿔࠿ோ୸ʊɩɣʅʎᨁ᝸ʆɡʪɋɶ

ׄԯʊɪʉɥɋρ‫ۋ‬ɊPFA ʱԢᄍɶʉɫʨɊɔ৔

ɪɶɊ˞˿ʼ˴ɫও៬ɴʫʪᦋ኏ʆɊ‫ވڄ‬ʗʍʍˇʸʍˡ̎ːʎ΋ɶɪʂɾɕʇ‫ؙܫ‬ɶɾ˗̎˶

ਲ‫ڗ‬ʇӖᦞড়ʇɣɥಢಿʍ᜴࿔Ϲ᰺ʍᶲʃʍ៨

ʊɩɰʪ৔Ⴞᒶʣᎃቛቿ֚ʎɊӖᦞড়ʱ᫿ʟᏲ঒

ᯌɫᤏខɴʫʣɸɮʉʪɋɼʫʱиฬɶɾʍɫ

᝸‫ی‬ᐂ‫ح‬ʱूɮ‫כ‬ʪԳ୯ʊዒʂʅɣʉɣʇᒑɧʨPFA ʍዒ‫ܬ‬ʆɡʪɋɲʍ࿢Ɋ࿔࠿ড়৵ಜʊɩɣʅ

ʫʪɋলʨʎɊ᭝࿔ϒԳʍ‫ݹ‬ҁϹ᰺ʍక঴Ɋড়৵

ʡ PTSD Μ᫾ɫᨁខɴʫͥκฯɬɸʪɡʩఄʎɊ

ࡩড়ಜʆʍព᭏ᅖၤԎႻɊ‫ݹ‬ҁᆔԎಿΟʗʍ؇࠳

PFA ɫᆾବɶʅɣɾᄉໍோ୸ʇɶʅʍɲɲʬʍˇ

ᆔ៖ᇽ҂‫؂‬ʇϵɣ˓̎ˍ˹́ˋ˳̎˞ᶨᫎ๼ᶬʸʇᄴʉʪɲʇʱବ஍ɶɾɣɋጅᒓʎɊ᜴࿔ʇɣ

³±±¶ᶩʣ༌ΕʍᯑᗾʉΟАʉʈɊPTSD ʍ˥ʺ̀ɥԎಿΟʱ‫ވڄ‬ʗʍਲ‫ڗ‬ʇۨ‫ܕ‬቎ϥʗʍӖᦞড়ʇˏ˅ᑳʍˋʺ̉ʱͥตΜ᫾ʍࡩᡑʇɶʅໍթɶʅ

ɣɥϹ᰺ʍᦋ኏ʇϴᑝʄɰʪɋɼʫ௕ɊфɍκʊɣɾʍʆɡʬɥɋʡʀʬʲɊɼʫʊʎ PTSD ʱ௚ɩɣʅɊΣɣʱථીɶ‫׹‬ɥលᗼʍɪɰ‫׹‬ɣᶨˠ˿৵֚ᅸʍࡩᡑʇʞʉɸഒଝɫɡʪɋఖಢʆʎᶱश

˜ʹˬᶩʱᥱɷʅᔵԔʍ๨ପʀʱʝʇʠʅɣɮᔵ

াʊᔴॅ‫ܛ‬ཇʱགɾɸ PTSD ʎ ²±ᶥ኏्ʍᆌᅖʇ

इຟᅽʣᇁΣˇʸʍɡʩఄʱᨁខɸʪɋɲʍខ࿢

᝾ከʡʨʫʅɣʪᶨᨅᶬ³±±²ᶩɋʝɾɊʸ˷̀ˁʍɪʨɊ˞˿ʼ˴ˇʸʱᨁខɶɾ PTSD ʍও៬ʎಙ

ᏘᏙ៬೿ʆʎɊ឴ఀɴʫɾᒓʍᶱ/ ᶳʊ ²± शাʡʝɶɮʉɣʇᒑɧʪɋ

PTSD ᅖၤʱ៖ʠᶨKesserᶬ²ºº¶ᶩɊᏀ༔ᆔ୽‫ވ‬ɫ‫ށ‬ɬɣʇɣɥ៵ଝʇʉʂʅɣʪɋ

ዿᶱʊɊಢಿɊᆌ࿔াʍ᜴࿔Ϲ᰺ʍᦋ኏ʆɊфκᆔʊ࠳ϴɫ᥼ʟ‫ވڄ‬Ϲ᰺ʇ‫ڄ‬ʍЀඋʍੜ‫ء‬ɫᤏ

ɶɪɶɊPFA ʱԳ୯ʇɶɾɔɲɲʬʍˇʸɕʍខɴʫʣɸɣɿɰʆʉɮɊ‫׹ܬ‬ʊʧʂʅʎ᫿ሢɴ

ɡʩఄʍႾពʊɩɣʅʎɊPTSD ˥ʺ̀ˏ˅ᑳʍ

ʫʪɋͥκʆɊɡʪɣʎញɶɣκɾʀʇɊ‫ވڄ‬Ϲᨁខʎͭᦞԕʆɡʪɋড়৵ࡩড়ಜʍᏴ‫׹‬ᆔʉˇʸ᰺ʱᐴʩ᥏ɶ᥉ʪɲʇʇಒ‫ڄ‬ʱɸʪʇɣɥᦋɳɶ

ʊɩɣʅͭࠪʣᏲ঒ʱनूɮࡩᡑʇɶʅɣʫʏɊ

ఄʎɊᔵʨʍκᄉᕑᣈʍሯ៖ʇӖ࠳ϴʆɡʪɋɲ

ࠍʈʡʍᥠᜓʣᏲ঒Ɋᱝᵱᒓʍࡘթʱ߂ʠɊ‫ݼ‬පʍʧɥʉϹ᰺ʍከʞᨁʌʱᏀʅɊκʎᔵងᆔʊӖʉ৵৷ˏ˞̂ˏ‫ט‬ড়ʊᦟᦆɶɾᬫɊɼʫʨʱ᝾ᗹ

ᦞড়ఄ‫؂‬ɫ࠳ʝʪɋʇ‫ీ׽‬ʊɊɲʍʧɥʉໍթʱ

ʇɴɹɊΠต᜴࿔ʍΜ᫾ᆔˇʸʱɸʘɬࡩᡑʇɶ

ӉʊɸʪૻጱʊɩɣʅɊᔵइຟᅽɡʪɣʎӉ‫׽‬Ϲʅʸ˅ˑˏԎಿɾʎɹʆɡʪɋʝɾɊͼΥᶨ³±²²ᶩʇɶʅʍᇁΣʊᅽɸᜓ࿣ʍ‫ܬ׸‬ᮅʱɊκɍʎᔵइɫ᫻ቛ‫ށ‬᭝࿔াʊឧɶɾឧ᩻ʣɊ֋ໟᦐ֪᝷ຒۨ

຅࠳ɶɾᦋ኏ʇੜᠪɸʪʍʆɡʪɋɼʍੜ‫ء‬ʆɊ᭝াᶶशাʊ࠷ఆɴʫɾ௑វԎಿΟʺ̉˧˅˞ࢅ

ᥟ੍ʣಒ‫ڄ‬ʉʈɊψᒓʱ߫ςʇɶʅ‫ݹ‬ҁϹ᰺ʱᮀ्ʆʎ᜴࿔ᒓʍ ³³.¶ᶥʊಐੜआɫ៖ʠʨʫɾʧɥ

ɪʊӉಐɶʉɫʨ‫ט‬৊ɶᅽɸᦋ኏ʇɶʅʍҘॾɫʊᶨᙸ൛ᶬ³±±±ᶩɊ᜴࿔ᇀাʊ໏૜ʉ༌Εʱቌɸɲପʃ௮֊ᝀᑝʇɶʅʍੜᑵɫੜᠪɴʫʪʘɬʆɡ

ʇʆΟА֊ʇɶʅၔ࠳ɴʫʉɮʅʡɊΠต᜴࿔ʍ

ʪɋPTSD Μ᫾ɫលʮʫʪీɊфκʍᅕႾᆔʉϹͼʆᐂʣɪʉ PTSD ʱਭɥκʎ‫ݼ‬௦ɣʪɋলʨʎ

᰺ɫও៬ɴʫʪɾʠɊӉ‫׽‬Ϲᆔʉᅽɶʎς‫ۦ‬ɶ᜴࿔ᇀাʎ٨ᯌ̂˯́ɫϵɮɊ࿔࠿ড়৵ಜʱༀɍ

ʊɮɮʉʪɋ᫻ቛʆʡɼɥʆɡʂɾɫɊRaphaelŻ¡³²¡Ż

˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬

ᶨ²º¹·ᶩʍବ஍ɸʪʧɥʊɊ‫ݼ‬ɮʍ࿔࠿ʊɩɣʅɊ

ʍ‫ؙܫ‬Ɋ˞˿ʼ˴ɔᅖၤɕʍବ஍Ɋ˞˿ʼ˴ࡩԂ੠ᇗʍɡʪκʇʍ᥸ᏈɫࡋʆɡʩɊ˓̎ˍ˹́ˋ

ʍɔ௟ᓑɕɊ৔ႾᆔᎹᏃʱࡶɮɔ̀ʾ̉˞̀̎ɕ

˳̎˞ɫɡʪఄɫˏ˞̂ˏ‫ט‬ড়ʍฬण֊ɫХ᥼ɴʱ֫‫ᜓۋ‬ɥςӁʆɡʪɋ
Litzᶨ³±±³ᶩʎɊ˷˕ព೒ʆ CISD ʍ PTSD Μ᫾ʫʣɸɣɋዿ ᶲ ʊɊPTSD ɫ ਱ ɶ ɬ ៥ న ˸ ˝ ́՞ೖʊબᅃᆔʉ˝̎˕ʱቌɸɋɶɪɶɊ‫ీ׽‬ʊ

ᶨKleinmannᶬ²º¹±ᶩ ɡ ʪ ɣ ʎ ᅕ ɣ ʍ ៜ ʩҮɍӿᭂ৷ʍᱝɣɊ‫ͥ׽‬ᒶᓧᭂ‫ۍ‬ʊɩɣʅʎɊ‫ۍ‬

ᶨKleinmannᶬ²º¹¹ᶩʊʉʪֵੈʱᒑɧʪɋ᜴࿔াɊ

ᏃՏ‫ͫ؂‬ʣ᜴࿔ᇀাʍʸ́ˉ̎́Εᄍ᫾หʊʎ՞

৊ᕁಜʗʍӖᦞড়ʇɣɥᫎɣᏀᦋʊɩɣʅʎɊ᜴

ೖᆔʆɡʪʇɸʪɋCISD ʎɊಢಿɊ᜴࿔ᇀাʍ

࿔ʊʧʂʅͭࠬӂʊʉʂɾфκʍ৔Ⴞ቎ϥᆔ̀លៜ֊ᓧՏʍᱝɴʣᭂ‫ۍ‬ʍӿᭂ৷ʇɶʅʍ᫟Ф৷˓̎ˏɫ໤ᒚɶɊɼʍᏃೖంɾʉˏ˞̂ˏ‫ט‬ড়ʇʣᏘᏙ৷ʱើМɶʉɫʨᦞᄍɸʘɬʆɡʪɋթ୻

ɶʅʍΠตˏ˞̂ˏɫᄉɷʪɋɲʍΠตˏ˞̂ˏ

ɸʪκʱଂɧʪშ݄ʱԳ୯ʇɶɾᔵՕʍͥᧅʇɶ

ʎ˿ʺ˫ʺ˯̉˞‫ۿ‬ʆʎʉɮɊ˝ʺ̀̎˥˙ˏ́ʅៜʩ‫׹‬ɥ૜ຫʆɡʪɋకʊ᫟Ф৷ɫɡʪᭂ‫ۍ‬ʆːʍᘡከʆɡʩɊលៜ֊ɶʊɮɣɋɼʍɾʠɊͭ

ʎɊ؇៖ʇɣɥ᫾᜙෤ԧʱᢲɧɊӿᭂ৷ʱ‫ͫ؂‬ɶɊ៬ʱងɧɾκʎᔵʨʍͭ៬ʱ៥నɸʪ˸˝́ʱणᇁΣព຅ʊɩɣʅಐ՞ʉ૜์ʆɡʪɋɶɪɶɊԞ

ʊऔ๳ɺɵʪʱɧʉɣɋɼʍʧɥʉ࿵ੜᠪʍˡ̎ʠʅԎϥɥ᫟Фʆʎ֫‫ۋ‬ʍςӁʆʎɊ؇៖ʱΎʩːɫ˞˿ʼ˴ʊʧʪ PTSD ʇɣɥ‫ی‬ೖ៵ʱ៥న˸

ᢳɧӿᭂ৷ɫᱝʝʂʅʡɊɼʍাʍᇁΣˇʸɫᆌ˝́ʊᦦʕׄթՏʇʉʪɋɼʍᬫɊΠตˏ˞̂ˏ

ᦑɶʧɥɫ࿵ɣɾʠɊɪɧʂʅ˞˿ʼ˴᜴౻ᆔʉ

ʊʧʪᦞড়ᬬ࠿ᆔʉᅕႾʍᄉીʇɣɥႾពɫᤏɮ

Ꮓೖʱଚɮɲʇʊʉʪʍʆɡʪɋºᶮ²² ΟϗʆʎɊ

ʉʂʅɶʝɥɋంɶɣၤ຤ʗᦞড়ʱ‫ۑ‬ʪᬫɊᦞড়

ಢಿӿᭂ৷ɫϵɣᭂ‫ۍ‬ɫ᜴࿔ɶɾ࿢ʊၔ৏ɫɡ

ʍ‫ۏ‬᭐ɴʎលៜ֊ɶʅ៥నɴʫʊɮɣɋɼʫ௕ɊʩɊCISD ʍᦞᄍࡩᡑʆʎ࿵ɣɋԞʠʅϥɥຟᅸׄ‫ی‬୛ɶʇɶʅʍ᜴࿔ঞԞʍ‫ݹ‬ҁʍম᮰ʍၑៜʎ

ᒓʇ˿˳̎́ʱጶɮʇɣɥੜ‫ء‬ʆʎɊᶱࡩᶱʍᮅ៥న˸˝́ʗʇᏃ࠷ɶʣɸɣɋ‫ݼ‬පʉᡥᖻʍʡɾ

ଢ଼ʱᜓɣɊͭࠪɫᤏ༜ɸʪʍʱሯ៖ɶʉɫʨ ²±ʨɸᏴ‫׹‬ᆔʉ‫ۏ‬᭐ɫɊPTSD ʇɣɥ˞˿ʼ˴ၑៜ

‫ۋ‬Գাʍˑ˙ˍ˽̉ʱᜓɥʺ˅ˏ˳̎ˎ˹̎ຫ

ʗʇɩɬಌɧʨʫʣɸɮʉʪɋɲʫʨʎɊ᜴࿔ۨ

ᶨprolonged exposureᶺPEᶩ ʍ ఄ ɫɊ ՞ ೖ ɫ ᱝ ɣʍฬण֊࠹លাɊӖᦞড়‫ۏ‬᭐াʊΟА֊ɸʪɋɼ

ʇɴʫʪʍʡ࠵ʉʪɪʉʆɡʪɋ

ʍీɊႻᜓʍ PTSD ʍ឴ఀ‫ܛ‬ཇʆʎɊ᜴࿔ঞԞʎ

ϒͫʱᣐʝɧʫʏɊ᜴࿔ᒓʱۨ‫ܕ‬቎ϥʊ܎ʠ૕ᜟʊԎʅɲʉɪʂɾʡʍɫᦅᆌɶɾʇɴʫʪɲʇ

ɸʧɥʉςӁʍͼʆʎɊӿᭂ৷ʍᱝɣᭂ‫ۍ‬ʊɩɰʊʉʪɋɲʫʎ PTSD ᅖၤʍˏ˜ʹˆ˴֊ʍខ࿢

ʪ់ɶ‫׹‬ɣʱˇʸᆔʊථીɸʪ෤ϥʎᨁ᝸ខɸʘ

ʆʡີੜɸʘɬʆɡʪɋ

ɬʆɡʪᶨCSID ʍׄຫʱ‫ࡋ׎‬ʊɸʪ৕᝸ʎӂɮɲ ʍ ʧ ɥ ʉ ខ ࿢ ʊ ዒ ʃ ీɊMichellᶨ²º¹´ᶩʉɮɊͥᡬ৷ʣӿᭂ৷ʱੜᠪɸʪʡʍʇʉʪɲʇ

ʍᏲ৵ీˏ˞̂ˏ̍˝ˬ̀̎˫ʹ̉ˆᶨCriticalʊੜ‫ء‬ɫɡʪɋɼʍੜ‫ء‬ʆʎ talking through ʍఄ

Incident stress Debrie¿ngᶬϒͬ CISD ʇᄬឧᶩʊϐɫɲɲʆʍ૨ɣʊ᥎ɣᶩ
ɋɩɼʨɮɊρাɊࠜഊᜟɴʫʪ PTSD Μ᫾ጐʇɶʅʍ৔Ⴞᆔ˝ˬ̀̎‫ܬ‬ᮅʣۨ‫ܕ‬ʍឧ৤ॾӍʊɩɣʅɊៜʩ‫׹‬ɣɫᔵ࿷˫ʹ̉ˆʎɊᔵՕХ᥼ʇɣɥᒑഛᒓᦑʍ੍࠳ɶ

ᆌᄉɸʪɋɼɲʊᄉʝʫʪΣɣʍၑៜʊʈʍʧɥ

ɾ࡬᫏ࡂʊʧʪோ୸ʇʎᦒɥԂʊМђɫɡʪɋʊ᫟ʮʪɪʣɊɼʫʊԎϥɥ௟जʣ֚ᅸ᫟Фᒓʣ

CISD ʎɊCISD ʍɔᎶςɕɊ˞˿ʼ˴ᆔɔΟ࠷ɕӆլ‫ى‬ʉʈʍ૔਽ɣʊጏɧʪ࡬᫏ࡂʇɶʅʍ᝾ᠪ

ʣ˞˿ʼ˴ʊࡩɸʪɔ៖ᇽ‫ט‬ড়ɕɔ਺թᆔ‫ט‬ড়ɕɫ৕᝸ʊʉʪʆɡʬɥɋ

Ż¡³³¡Ż

ࡷɉࣽᶺ᭝࿔াʍ৔ႾᆔˇʸʍɡʩఄŻϹ᰺ʱɲʇʏʊɸʪʇɣɥɲʇŻ࿔࠿ோ୸ʆʎ PTSD Μ᫾ɫɲɲʬʍˇʸʍɡʩʪɋʝɾɊ᭝࿔ʎਆʬɶɣၤ຤ͬʆʍɊɶɪʡᔵ

ఄʇ‫ͥ׽‬ខɴʫʪʍʎϺ௕ʆɡʬɥɪɋ᜴࿔ᒓ

Ԕʊᡭϙɫɡʪʇᒑɧʣɸɣၤ຤ʊɩɰʪ‫ވڄ‬ϹфɍκʍκᄉᕑᣈʊɩɣʅɊ᜴࿔ʎ‫ޔ‬෤ʆɡʩɊ

᰺ɫ‫ݼ‬ɣɋʝɾɊ឴ఀ‫ܛ‬ཇʊɩɣʅʎɊ৵৷ˏ˞

‫ވڄ‬ʇӖᦞড়ʇɣɥ‫ݹ‬ҁʱᔵԔʍκᄉᕑᣈʊʈʍ

̂ˏᬬ࠿ᶨAcute Stress Disorderᶬϒͬ ASD ʇᄬឧᶩʧɥʊϴᑝʄɰʉɩɸʍɪʇɣɥ៨ᯌʆɡʪɋɶ

ʊɩɰʪʚʈព᭏ɫనሯʊ؉ʝʫʅɣʉɣɾʠɊ

ɪɶɊ᜴࿔ʇɣɥោᐆʱঃɬ‫ל‬ɰʪɣʮʫʍʉɣ

ͭࠪీʡលៜ֊ɸʪᓧՏʍɡʪᤏɣ̂˯́ʍ‫׹ܬ‬࿵᤹ʍ๥ʊɔ᜴࿔ʎ‫ޔ‬෤ʆɡʩɊ‫ވڄ‬ʇӖᦞড়ʇ

ʍ PTSD ɫ؉ʝʫɥʪɋϺʧʩɊΠตˏ˞̂ˏʆ

ɣɥ‫ݹ‬ҁʱᔵԔʍᄉʊʈʍʧɥʊϴᑝʄɰʉɩɸ

ਲ‫טڗ‬ড়ɫɲɷʫʪκʍͼʊɊᦅᆌ৷ʍ PTSD ɫʍɪɫ៨ᯌʆɡʪɕʇோ୸ᒓɫϧɧʪɲʇʎɊϽ

༌ɷʪɋʩʊʡ‫׎‬ɶɣᇀᮅ֊ʆɡʪɋɡʪੜ‫ء‬Ɋ٨ɣᏙɰ

ɼʍᏃೖɊਲ‫ڗ‬ʊࡉʩ༐ɥˇʸʧʩ˞˿ʼ˴

ɾʩ‫ڗ‬ɣɾʩᥛʂɾʩʇɣɥ࠷ࠓᆔʣʩʇʩʊʉ

ʍຟᅸຫʇɶʅʍ౭᭭ᅸຫʇ EMDRᶨᥱኋ EyeʨɵʪʱৃʉɣɋɼʫʎɊᖐɶʞʣਲɶʞʇӉʊ

Movement Desensitization and Reprocessingᶺ ᇖ ႼࢍʪీʊԞʠʅ‫׭‬ᓧʇʉʪʧɥʉᢑʍோ୸ʆɡ

ᦉթʊʧʪᓴ੡ЀʇӖԂႾᶩɫնʠʨʫʪʧɥʉ

ʪɋϧɧʪѮɫӖᦞড়ʍ‫ܬ‬ʊɼʍκʇӉʊࢍᏙͭᦞԕʉˇʸɸʨɡʩৃʪᶨಢκɫɲʍᶲʃɫᦞ

ɰɊᜓɬʃ૕ʩʃɶʉɫʨɼʍκᔵ᣸ʆᇀᮅ֊

ԕʉຟᅸຫʆɡʪʇ០៖ɸʪ‫׹ܬ‬ʡ‫׽‬ɷʆɡʪᶩ
ɋɶɊᦦ૾ʱɸʪʍʊ‫׽‬Ϫɸʪងਫɫ৕᝸ʊʉʪɋ

࡬᫏ࡂʇɶʅʎɊ˞˿ʼ˴ʍຟᅸຫɫ৕᝸ʉʍɪ

ɼʍʧɥʉᡥଉ௕Ɋড়৵ࡩড়ಜʍ᜴࿔Ϲ᰺ʍͼ‫ء‬ਲ‫ڗ‬ʊࡉʩ༐ɥˇʸɫ‫ށ‬ԕʉʍɪ᝾ඐʠɊʈɲʊ

ʊʎភʫɹɊᜟᮅᆔʊɔࠪӂ̍ࠪ৔ɕʱϧɧɊႻᨁɬʱᑝɣʅࡩԂɸʪʍɪɫɊ৕᝸ʇʉʪɋ

࠷ᦞড়ʱͫɱʪʧɥʉோ୸ʇɶʅᎻʞዒʅʨʫɾ

PTSD ʍ˷ˁˡː˶ʆɡʪឧઠ᎘ʍᬬ࠿ϔ៥ɫ

PFA ʱɊɼʍీಜɫᦋɭɾʊʡ᫟ʮʨɹᦞᄍɸʪ

నሯʊʉʂʅϒᬆ࠳ᇗɶɾɊ౭᭭ᅸຫʇ EMDRʇɣɥɲʇʡᄉɷɥʪɋɼʍᏃೖɊ৔Ⴞᆔড়৵ୡ

ɫ PTSD ʗʍᦞԕʉຟᅸຫʆɡʪʇɣɥႾពʎɊ

ᑝʎ˞˿ʼ˴Ϲ᰺ɪʨʍ PTSD Μ᫾ʇ‫ͥ׽‬ខɴʫ

PTSD Μ᫾ʇՒᅸɫຟᅸᒓʍ࡬ಐ૮᜖ʆɡʪɪʍ

ʪ҂‫؂‬ʇʉʪɋɼʍੜ‫ء‬ʆɊோ୸ɸʪѮʊʎɊ᜴ʧɥʉႾពʱᄉʞԎɶʅɣʪᶨАɧʏɊɲʫʨຟ

࿔ᒓʍ‫ۋ‬৊ʎфκआɫ‫ށ‬ɬɣɲʇʱႾពɶɊɼʍ

ᅸɫಐ՞ɿɫɊɼʍ࡬᫏ࡂʎఖಢʊ௦ɧʪʚʈɶ

κʉʩʍಒ‫ڄ‬ʱ‫ށ‬ԕʊɶɊ‫ۋ‬৊ʱহʃʇɣɥ࿔࠿

ɪɣʉɣɊጇɍʇɣɥంᒫ‫ᦐܫ‬ʉʈᶩɋɔPTSD ʊ௮֊ᶨ࿔࠿ோ୸ࠜᶩʇ‫ئ‬ʕʘɬ௟ᓑɫ৕᝸ʆɡʪɋ

ʎ࡬᫏ᒶʊʧʪၔԠʉຟᅸɫ৕᝸ɕʇɣɥ០ព
ʎɊਲ‫טڗ‬ড়ʗʍ‫ې؝‬ʍˇʸʣ࠰௟ᆔˇʸʉʈɊᶴɉਲ‫טڗ‬ড়ʇ ÑÕÔÅ ʍ༌‫׽‬ಢಿʍۨ‫ܕ‬቎ϥʍ̀˓̎ˏʍପʃຟᅽՏʱ԰ɯɲ
ʇʊʉʪɲʇʱֵੈɸʪɋ

PTSD ɫও៬ɴʫʪʡɥᶱʃʍ‫ށ‬ɬʉႾᄒʎɊ
ਲ‫טڗ‬ড়ʇ PTSD ʍ༌‫׽‬ʆɡʪɋ᭝࿔াʍড়৵ࡩ

ᶵɉ‫ీ׸‬ಜʱᄉɬʪᔵइʍͥᡬ৷ʇɣɥၑៜʩ
ʍᨁ᝸৷ড়ಜϒᬆʊᦟᦆɸʪਲ‫טڗ‬ড়ʎɊPTSD ʇ֙ԠɫʃɰʊɮɣɋɼʍɾʠɊˇʸɫ༌‫׽‬ɴʫɊPTSD
ʇɶʅៜʨʫʪɲʇʡ‫ݼ‬ɣɋႾᄒʎɊ؇៖ʣͭдɊ࠷ᬫʍ᜴࿔ᒓʊɩɣʅʎɊড়৵ࡩড়ಜʍᆾͬʍ

੡ង‫ވڄ‬ʣᮂႻ࠷੡ᶨʸ̉ˮ˟ˡʸᶩɊਲ‫ڗ‬ʊϪ৵ʎᄉ‫ا‬ʍࠪӂሯвʆɡʪɫɊɼʍা֤ɪʨ৊ᕁ

ɥᑛᡭ੡ʣᮂႻ࠷੡Ɋʇɣʂɾਲ‫טڗ‬ড়ʊɩɰʪ

ಜʊɪɰɊఖɍʍᄉໍʍӖථጶʊɩɰʪࠪ৔੡ʍ

਺᏶̍৲ᒑʍɡʩఄɫ PTSD ʇӉᥱɸʪɾʠʆɡ

औ๳ʍ๚ᨁɫ݇ɸɋᄉໍӖ᫕ʇʎɊᔵԔʍࡩԂᓧŻ¡³´¡Ż

˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬Տɫ‫֊ݳ‬ɶɾᄉໍშ݄ʇɣɥପᏙᆔʉˏ˞̂˙ପʣΜ༨ʇཇѹ‫׭‬ᓧ৷ᶩʇɣɥᏴ‫׹‬ᆔʉᓧՏʊɩ

ˋ̎ʊెɴʫᏙɰʪɲʇʆɡʪɋɼɶʅɊɼʍᦋ

ɰʪ࿵Տ੡ʊᖉʝʫʪీɊᔵइʍͥᡬ৷ɫвପԎ኏ʆᆌᄉɶᏙɰʪˏ˞̂ˏʎᘡከᆔʆɡʩɊ˞

ಿʉɣਆ৮ɫհʪɋࡩԂ૜์ɫ࿵ɣʇ੡ɷʪਆ৮

˿ʼ˴̍ʺ̉˧˅˞ʇɶʅ DSM- Ǝʆ୚ᄍɴʫɾ

੡ɫওʝʪీɊᔵԔʍ‫ۏ‬᭐ʱៜʪၑៜʇɶʅʍ

Hormes ᶦ Rhaeᶨ²º·¸ᶩʍˏ˞̂ˏ̍ʺ̉˧˅˞

PTSD ʗʍᦐɫ᫕ɪʫʪɋលɣఄʱ‫ݳ‬ɧʪʇɊࡩ

Ⴞ៵ʍʧɥʉথʱ‫כ‬ʩʊɮɣɋ‫ݹ‬ҁাʍ PTSD ʊԂ૜์ʱ‫ވ‬ɥၤ຤ʊɩɣʅɊPTSD ʇʎᅕɣʍៜ

Ӎ‫ۿ‬ᆔʉ‫ی‬ೖ៵ᆔʉথʱ‫כ‬ʩʊɮɣɋɼʫʎɊ

ʩʇʉʩৃʪʍʆɡʪɋKleinmannᶨ²º¹±ᶩɫ‫׮‬

Lazarusᶨ²º¹µᶩɫɔɼʍκʍׄթՏᶨresourcesᶩཀʆ᝾ɣԎɶɾʧɥʊɊɼʫʎᮂលៜᆔʉ᣸ϹᅕʊᡥଉʱɪɰɾʩɊᢁཆʱᢲɧɾʩɊहቬʱᓩɪ

ʇɶʅԎႻɶɥʪɋvan der Kolk ʍ PTSD ᶽឧઠᝀɶɾʩɸʪʇើМɴʫʪʡʍɕʇ࠳ᑵɶɾ˝ʺᑝʍ௕ᬬ៥ᶨাᥙᶩϒাɊPTSD ʍៜʩʇɣɥខ̀̎˥˙ˏ́ːʍᘡከʍʧɥʊɊᏘᏙɶᘡከɸʪ

࿢ʎͥᕓʊʎ؇࠳ᆔʆɡʩɊPTSD ʎᮂលៜᆔʉ

Ᏼ‫ح‬ʇɼʍើМɪʨᒑɧʪఄɫʔɴʮɶɣɋ

ᎃቛᬬ࠿ʆɡʪɋɶɪɶɊKleinmann ʍ‫ؙܫ‬ʱᐂጅᒓʎɊშ݄ʡфκᆔᢁཆʡ‫ށ‬नʊ‫ݳ‬ʮʪ᭝࿔ʣɪʉ PTSD ʇɶʅႾពɸʪʉʨɊᮂលៜᆔʉɔᅕ

ʇɣɥၤ຤ʱᒑɧʪʊʎ Hobsfallᶨ²º¹´ᶩʍɔࡩɣɕʍఄɫ PTSD ʍ࠷ੳʊ᥎ɣɋɲʍɊលៜʊʡ

Ԃ૜์вӂ៥ɕɫɊʧʩࡩԂᓧՏʱᄉʞԎɸ‫ܛ‬ᆺ᫕ɪʫɾᐂʣɪʉ PTSD ʱ៖ʠʉɣʇɣɥខ࿢ʡ

ʇʉʪфκɫ‫ܚ‬ʂʅɬɾфκᆔʉᏀ᰺ɫ࿵Տ֊ɸ

ɡʪʆɡʬɥɋɼʫʊࡩɶʅʎɊCrossleyᶨ³±±±ᶩʪɲʇʍੜ‫ء‬ʱᒑɧʣɸɣʇᒑɧʪɋκ᫙᫟ФʣʍʧɥʊɊ௮֊ʍ௮ᓬͫʆᔵइɫথીɴʫɊၑៜ

ࢍ϶ۨʣࡂʉʈɊ੠ᇗࡩᡑʇɶʅфκʍ‫ͥ׽‬৷ʨʫʪԧ᎜ɫɊऽࡸಜʍ৷ᆔᚑহʣᅕɣʍៜʩʍ

ᶨRicoeurᶬ²º¹¹ᶩʱвាɸʪ৔Ⴞᆔʉᢁཆʍྟ‫ݳ‬ʧɥʉ‫ܬ‬ᮅʆʡ˞˿ʼ˴ʍៜʩఄʱʡ᝿࠳ɸʪʇ

ʣ‫ވڄ‬ʎɊͭࠪʱ݇ওɸʪɿɰʆʉɮɊԎಿΟʗɣɥବ஍ʱ଱ɱʪɋ

ʍႻ࠷ᆔʉࡩԂᓧՏʱૠेɴɺʪɋɼʍీɊᢁᄊ

ᐂʣɪʉ PTSD ʇጅᒓɫ‫ئ‬ʕʡʍʎɊਲ‫טڗ‬ʗʍ૟கʣᒶඋʱ‫׭‬ᓧʇɸʪۨ‫ܕ‬ʍᏀ༔ᆔ‫ܛ‬ᆺʍড়ʆɡʪʇɣɥੜ᝾ʡɡʪʆɡʬɥɋɼʍੜ‫ء‬༌ΕʎɊ቎ϥᆔʉᢁཆʊɩɣʅʡࡩԂͭᓧʉΟੳ

ʆɊPTSD ʱឧઠᝀᑝʍ௕ᬬʇɶʅᶱʃʍᅒਭ

ʗʇኌᜓɸʪɋ቎ϥᆔᢁཆʍྟ‫ݳ‬ʣ‫ވڄ‬ʇɣɥϹ

ᶨdisorderᶩʇᒑɧʪɡʩఄʊࡩɶɊᦞড়ᬬ࠿ʣ

᰺ʱɣɪʊ‫ࡄל‬ɸʪʍɪʇɣɥΟੳʎɊ৔Ⴞᆔʊ

ਲ‫טڗ‬ড়ɫ༌ɷʪᅖыᑳʆɡʪʇɣɥខ࿢ʱও៬

ʡᡥଉʍ‫ށ‬ɬɣфκʊʇʂʅɊϽʩʊ‫ۏ‬᭐ʉ‫ࡄל‬ɶɾɣɋ‫ీ׽‬ʊɊড়৵ࡩড়ಜʍˇʸʍ៨ᯌʆɡʪ

ʇӖᦞড়ʇɣɥᶲʃʍ៨ᯌʇʉʩɊɼʍκʍκᄉࠪӂʣࠪ৔ʍሯвʎɊପᏙɸʪᏲ঒ϵ༜ʱᆾᆔʇ

ʍͥᡬ৷ʱ୻ʪɫɸɋɲʍᦋ኏ʎɊфκʊʇʂʅɶɾ࿢ʆ PTSD ʣᄴणਲ‫טڗ‬ড়Μ᫾ʍ᪌ʇʉʪɋ

ʎɊެϺʊᔵइʍͥᡬ৷ᶨAntonovskyᶬ²º¸ºᶩʱʝɾɊᄉໍ৊ᕁʍᦋ኏ʍీɍʊɩɣʅɊᦞԕʉˆ

вପɶʅɣɮʍɪʇɣɥᦋ኏ʆɡʪɋጅᒓʎɊ৔

̀̎˫̅̎˅ʍ᥼ᜓʱ‫׭‬ᓧʊɸʪʧɥʉӖᄉʍៜႾᅸຫʍɡʩఄʇɶʅɊᕫɍʉϹ᰺ʱɶʅɬɾʇʩᶨˠ˿˜ʹˬᶩʱԢᄍɶɾˇʸɫɊᔵइʣۨ‫ܕ‬ៜʪЀඋʱᥱɷʅɼʍ‫ܬ‬ʊɩɣʅᄉીɶɊ௑‫ݳ‬ɴ቎ϥʍͥᡬ৷ʍвʃͫʆ‫ށ‬ԕʆɡʪɲʇʱও៬ɶ

ʫɊвପɴʫʪᔵԔʍಢᢑʇɶʅʍɔៜʩ‫ף‬ɕʇɾɣɋɶʅʍˠ˿˜ʹˬͥᡬ৷ʍ੡ងʱᨁខɸʪɋ
ɲʍʧɥʉϹ᰺ʍᦋ኏ʆɊਲ‫טڗ‬ড়ʍ‫ۋ‬৊ͭӂᶶɉÑÕÔÅ ʍ৔Ⴞᅸຫʍ‫׭‬ᓧ৷ʇΠตᆔᄉໍˏ˞̂ˏʍଞ‫ށ‬ʇɣɥᶲʃʍϹ᰺ɫ‫׹‬ʮɴʂʅɊԎಿΟʍᏎৈ৷ᶨၤ຤ࡩԂᓧՏʍвŻ¡³µ¡Ż

ড়৵ࡩড়ಜϒᬆɊ࿔࠿ీ᫙ʍՒᥴʊড়ɷɊ৊ᕁ

ࡷɉࣽᶺ᭝࿔াʍ৔ႾᆔˇʸʍɡʩఄŻϹ᰺ʱɲʇʏʊɸʪʇɣɥɲʇŻಜʍ˷̉˕́ˮ́ˏʍ៨ᯌʎᶳʃʊԔ֊ɸʪɋᄉ

ɶɥʪ௮ᓬʊɩɣʅ࢘᫕ɶɾɋɼʍᬫʊɊфκʍໍӖॱᦋ኏ʊɩɰʪ‫ۏ‬᭐ɫʡɾʨɸΠตᆔʉᄉໍ

ᄉɬʪ௮ᓬ৷ʊល‫ו‬ɶɾɲʇʊᇗᆾɶɾɣɋল

ˏ˞̂ˏʍᤏ༜ɩʧʒӖ࠳ϴʗʍˇʸɊ‫ވڄ‬ʊʧʎɊఖಢʊʎ೯ᦐʣ‫ރ‬ᵡʉʈϧᏎᆔฮᦐʣ‫؎ئ‬ຫʪਲ‫טڗ‬ড়ʗʍˇʸɊ˞˿ʼ˴ʊʧʪ PTSD ʗʍɫɡʪɲʇʗʍល‫ו‬ɪʨ߂ʠɊ֪ʸ˫̀ˁʍยɣˇʸʆɡʪɋၔʊᄉໍˏ˞̂ˏʎψʍᶲʃʍɡʩ

ᣏʪᭂɣʣ˾˂ʍੜᑵʱବ஍ɶɾɋɲʫʨ௮֊ᆔ

ఄʊম᮰ʱ‫ו‬ʛɸɋɼʫʱ᝖ᭉ֊ɸʪ᝸‫ی‬ʎɊᩒໍթʍᬫɊᔵԔʆ๨Ԕʱᱝ୲ɴɺɾʩຌʠɾʩɸ

ၤ֊ᶨͼΥᶬ
³±²²ᶩʇ‫ئ‬ʏʫʪфɍκʍᄉໍ৊ఘ

ʪˉ̉˞̃̎́Ϲ᰺ʱɸʪɲʇɫɊ˞˿ʼ˴ʊʧ

ʍआʍଞ‫ށ‬ʆɡʪɋ‫׸‬κʍ៨ᯌʍआɫనሯ֊ɶɊ

ʪ࿵Տ੡ʍͼ഑ʆɡʪᔵइʣ‫ݹ‬ᄟʗʍˉ̉˞̃̎

᜴࿔ᒓ‫ݥ׽‬ʍᇁΣ๚ᤑɫɊᔵᡭʣ਒ʞʉʈ௨Ⴞ

́‫ވڄ‬੡ʱᝆңɶɊᔵइˉ̉˞̃̎́ʆɬʪʇɣ

ɶʊɮɣᖐᅞʱᄉʞԎɸɲʇɪʨɊᄉໍˏ˞̂

ɥ੡ងɫ‫ۋ‬৊ɸʪᦐʆɡʪ‫׭‬ᓧ৷ʱବ஍ɶɾᶨɲ

ˏʗʍᏘᏙᆔʉோ୸ɫ‫ܛ‬ಢʇʉʪɋʝɾɊvan derʫʎɊ௮֊ᝀᑝʇɶʅʍҘቍʍ෤ᓧɼʍʡʆɡ

Kolkᶨ³±±·ᶩɫବ஍ɸʪʧɥʊɊPTSD ʊʧʪີʪᶩɋጅᒓɫɲʫʱ‫׭‬ᓧ৷ɫɡʪବ஍ʇႾពɶɾ

ੜᭂͼ‫ۏ‬᭐ʇឧઠՏʍ୽ҁʎɊႻ‫ۦ‬ᢰɲʩʃʃɡ

ႾᄒʎɊǋ௮֊ʎᮂលៜᆔʉᡑ৏ʍϹ᎘ʆʡɡʪ

ʪɲʇʗ‫כ‬ʩᎻʟᓧՏʱ᫿ሢɸʪɾʠɊᄉໍˏ˞

ɫɊɼʫϒͫʊលៜᡑ৏ʍϹ᎘ʆɡʩɊǌព᭏‫؝‬̂ˏʱଞ‫ށ‬ɸʪ਱োშʱପʃɋ

᥆ɪʨʍᓴԎʎ EMDR ʊᡥɥʊɶʅʡɊႻ࠷ʍ

van der Kolkᶨ³±±·ᶩʎɊ˞˿ʼ˴ᆔϹ᰺ʍ੍ຟᅸʎ಍਱ͥᒓɪʨ߂ʠɵʪʱৃʉɮʅʡɊɼʫ

ᢰʎɊ੡਺ʱ‫״‬ʪ‫ױ‬ӑѮᇖዄԳᯃᨂ̍ࣃ̍૘ഘϹ̍ϒ‫ݹ‬ʍఖणᆔʉຟᅸʎ᣸Ϲលៜᆔʉ௮֊ᆔໍթʇ

ԳѮᯃᗼඐʱໍ৷֊ɸʪʇ‫ీ׽‬ʊɊ੡ង਺‫ܫ‬ʍӁɶʅɊΠᒓɡʪɣʎͪᒓʇɣɥ቎ϥ৷ʍͼʍໍթՏʇᦉթʍԎՏʍᏎ‫׹‬ʱɶɊᒿϹᆔᱝ୲ʍ៬௨ʱ

ʆɡʪɲʇʱੜᠪɶʅɣʪɪʨʆɡʪɋ

ɶʅɊϹ᰺ʱលᗼʆϧɧʪ෤ᓧʍͼ೚ʆɡʪˬ

van der Kolkᶨ²º¹·ᶩʍឧઠᝀᑝʍ௕ᬬ៥ϒা̃̎ˁᨂʍໍ৷֊ʱ༜ࡸɸʪʇɸʪɋ˞˿ʼ˴Ϲʍ PTSD ຟᅸʊɩɣʅʎɊPTSD ʍʈʍీಜʍຟ

᰺ʱ੍ᢰɸʪʇɊ੡਺ʱঃɬᢰɲɸᓵʍᮾ‫ܕ‬ɫໍᅸʱᜓɥʍɪɫᠳ៵ɴʫɹɊ༌Εీʍ៖ᇽʍᬬ࠿

৷֊ɸʪʇ‫ీ׽‬ʊɊ੡਺ʱ૴ԧɶɊលᗼʱЋʂʅʍຟᅸʇɶʅʍ EMDR ʣ౭᭭ᅸຫɫͥκฯɬɶϹ᰺ʱϧɧʪᓵʍ෤ᓧʍໍ৷֊ɫ༜ࡸɶɊ‫ۓ‬ʝʪʅɣʪɋɼʫ௕ɊႻʊᄉɬʅӖᦞড়ɶʃʃɡʪκɲʇɫ PTSD ʍ˷ˁˡː˶ʆɡʪʇɶɾɋɲʍᇽ

ʍ‫ۏ‬᭐ʱႾពɶɊρ‫ڗ‬ɬਲɶʟκʊࡉʩ༐ɣோ୸

᝾ɫɊ৷৵ʉ˞˿ʼ˴Ϲ᰺ʍលៜ֊ʎɪɧʂʅ˞

ɸʪຟᅸʍ˸˝́ɫดᗹɶʣɸɣɋɼʍᬫʊɊᚑ

˿ʼ˴ʱ༈ɮɸʪʍʆɊ౭᭭ᅸຫʉʈʍ CBT ૮হ᎘ʍ‫׹ܬ‬ɫӍ‫ۿ‬ʆɡʪɫɊ᜴ຟᅸᒓʍᄉɬපʍ

ຫʧʩʡ EMDR ʉʈ᣸Ϲ૮ຫɫᕩɣʇɴʫɊᅖ

ႾពʱดɣɾᅕႾ˸˝́ʍຟᅸ៵ɫ࢘᫕ɴʫʣɸ

ၤɫʧʩᄉၑࠜᆔʆᄴᢑʉ PTSD ʍຟᅸɿɰʎɊ

ɣɋɼʫʨʊࡩɶɊρ‫ۋ‬ʍ van der Kolk ʍ᠘ཱʎɊ

࡬᫏ᆔຟᅸʍࡩᡑʇɴʫʪഒଝʊʉʂɾɋɼʍɾ

PTSD ʱଂɧʅᄉɬʪʇɣɥᅕɣʍៜʩʱຟᅸᆔ

ʠɊPTSD ɫਲ‫טڗ‬ড়ʣᄉໍˏ˞̂ˏʇԠኚʍ٨

ʊ૨ɥ‫׭‬ᓧ৷ʱቌٖɶʅɣɾʇᒑɧʪɋ
ʝɾɊకʊᥙʘɾʧɥʊɊ឴ఀ‫ܛ‬ཇʱགɾɴʉ

ᯌʇ᝾ѨɴʫʣɸɮɊˇʸͫʍ᥸Ꮩ৷вପɫ‫ۏ‬᭐ɮʅʡᐂʣɪʉ PTSD ʱᏀ᰺ɸʪκʎ‫ݼ‬ɣɋɼɶʇʉʩʣɸɪʂɾɋ
van der Kolk ʎ ³±²² शᶶಏʍಿఖ᠘ཱʆɊPTSD

ʅɊলʨʊʎˏ˜ʹˆ˴֊ʱᦪɰʪੜ‫ء‬ʆʡɊʍ˷ˁˡː˶ព៥ʍԳাʊɩɣʅɊলɫ᣸Ϲ੡ង

PTSD ʇɶʅʆʉɣோ୸ɫಙʝɶɣɋɼʍʧɥʊ

ʇϹ᰺ʍӖᏎ‫׹‬ʣ࠳ϴʇɣɥຟᅸʍɡʩఄʱɊ

ᒑɧʪీɊ᣸Ϲ੡ងʍˉ̉˞̃̎́ʱᜓɥ௮֊ᆔ

²º¹· शʍᗾЀʊɩɰʪᏎৈ੡ងʍӖᆌ᝾ʇႾពʸ˅˜ʹ˩˜ʹʎɊPTSD ʊភʫʪɲʇʉɮɊۨ

Ż¡³¶¡Ż

˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬ɲʇʱᥱɷʅɊᔵʨʍ᣸Ϲ੡ងʣ੡਺ʱɡʪɣʎ

‫ܕ‬ʣࠜഊʉʈපɍʉ‫ܬ‬ᮅʆᜓʮʫɥʪɋʝ ɾɊ Ϲ ᰺ ʱ ល ᗼ ʊ ɸ ʪ ф Ԡ ৔ Ⴞ ᅸ ຫ ɫɊ࠳णᆔʊɊɡʪɣʎХ᥼ᆔʊɊɡʪɣʎᥠᜓᆔ

PTSD ʊʡᦞԕʉຟᅸʆɡʪɲʇʍ൮ឡʡ৕᝸ʆ

ʊɊɲʇʏʇɶʅᎬɭԎɸᬫʊᔵʨʍϹ᰺ʇɶʅɡʪɋঞఖʍ᠘ཱʊɩɣʅɊᶲАʍᮅଢ଼‫ܬ‬ᮅʍ˩੡ɷɊ΂Ϲᆔʊɼʫʨʍ੡਺ʱԧৈɸʪʇɣɥ᫟

˝ˀɫ୯ቌɴʫɾɫɊᶲАᆾʍ‫ט‬৊ɴʫɾᮅଢ଼ʎ

ʮʩఄʱ᝾ɧʅɮʪɋɼʫʨɫ PTSD ʱΜ᫾ɶɊቌٖ༈ɣʡʍʆɡʂɾɋ˩˝ˀʎɊ˞˿ʼ˴Ϲ᰺ɡʪɣʎ᣸Ϲ੡ងʊɩɣʅᔵइԧৈʆɬʪʧɥʊ

ʗ᥎ʄɮʺ̉˕˩˻̎ʍᬫɊᐴʩ᥏ɶᜟ਺ʍ‫֊ݳ‬࠳ϴɸʪੜ৲ʱᓑʟɲʇʆ PTSD ɪʨʍ‫ۋ‬৊ʱ‫ۑ‬ʱᥟɣɪɰʅɣɾɋ˅˿ʺʸ̉˞ʎᐴʩ᥏ɶɊᜟ

ʪɋɼʍʧɥʉ৔Ⴞᆔˋ˳̎˞ɫ᝾ɧʅɮʪɋϹ਺ʱ౵ʨɺɊɡʪɣʎᇮʱӑʊࡉɺɊᔵʨʍӑᮅ᰺ʱᔵԔʍʡʍʇɸʪɲʇʎɊϹ᰺ʱɔɲʇʏɕ

ʱ᝾ʃʠʧɥʇɶʅʎ૕ʪɲʇʱᐴʩ᥏ɶʅɣ

ʊɶʅɊᔵʨʍˠ˿˜ʹˬʍͥᡬ৷ʱᎬɭԎɸɲ

ɾɋvan der Kolk ʎɲʍ঴৊ʱɊ˞˿ʼ˴ʊʧʪ

ʇʆɡʩɊఖ᮳Ɋቼɾʀɫ࿵ᔵងʊᜓʂʅɣʪ௮

࿵Տ੡ʍͼ഑ʆɡʪᔵइʣ‫ݹ‬ᄟʗʍˉ̉˞̃̎́

֊቎ϥᆔʉᄉʍ‫ډ‬ʞʆɡʪɋʃʝʩɊਲ‫ڗ‬ʣᄉໍ‫ވڄ‬੡ʱᝆңɶɊᔵइˉ̉˞̃̎́ʆɬʪʇɣɥ

ˏ˞̂ˏʗʍ৔ႾᅸຫʇᏎ‫׹‬ɴʫɾɊणᠪᆔʉ৔

੡ងʱ‫כ‬ʩ૕ɸੜ‫ۑ‬ʇɶʅ៥నɶʅɣɾɋᥱणɊ

Ⴞᅸຫʇɶʅʍ PTSD ʗʍˇʸʣΜ᫾ɫථጶ‫׭‬ᓧϹ᰺ʱឧઠʊᗹʇɶ᥈ʟɾʠʊʎលៜᆔ௨Ⴞɫ৕

ʇᒑɧʪɋɼʫʎɊ೅֋ʍ௮֊ʊʎᕫྡྷɮ᝾ɣԎ᝸ʆɡʪɋɼʍᬫɊលៜɫ΍᭏ɶʅɶʝɥɲʇɫɊ

ɴʫʪ‫ډ‬ʞʆʡɡʪɋ

PTSD ʊɩɣʅ˫˿˙ˍ˻˦˙˅ɫᄉɷʪ˷ˁˡρাɊᄉໍோ୸ʱԳ୯ʇɶʉɫʨɊᔴॅᆔʉΟː˶ʊɡʪʇɸʫʏɊɲʍɊឧઠʱϹ᰺ʗʇᏃʒ

Аʊࡩɶʅʎ৕᝸ʊড়ɷʅಂʊᣐʞ᥈ʞɊఖणᄉ

ʃɰʪɾʠʍ੍ᢰʍᦋ኏ʊɩɣʅɊ᣸Ϲᆔʉໍթໍʇɶʅ˞˿ʼ˴Ϲ᰺ʱҶಒɶɊᔵइᏎৈ੡ងʱ

ʇɶʅʍ᣸ଶʩʣᜟ਺ʱ૜ɫɪʩʊᔵԔʍ੡਺ʍ

‫כ‬ʩ૕ɸɡʩఄʱˋ˳̎˞ɸʪɲʇɫ࡬᫏ᆔʉ৔

Μ༨ʱዒʅɊͥᡬɶɾၑៜᆔʉ໐ʫʇɶʅථીɸ

Ⴞᆔோ୸ʆɡʪɋʃʝʩɊఖ᮳ቼɾʀɫᇀᮅɸʪ

ʪɲʇʆ˫˿˙ˍ˻˦˙˅ʱଆɴɧɊលᗼʍ˂ʺ

ᄉໍˏ˞̂ˏʇۨᏙɬʆɡʪΟɫಙʝɶɣɋɣɣ

˟ʱᄍɣʉɫʨʡ᣸Ϲ੡ងʊɩɣʅሯɪʠʃʃឧ

ɪɧʫʏɊ˓̎ˍ˹́ˋ˳̎˞ʇˆ̀̎˫ˇʸʇઠʊʸ˭̃̎˗ɸʪ૮᜖ʎɊणᠪᆔʉ৔Ⴞᅸຫʆ

ͭࠪʗʍˇʸʍӂʅɫ৕᝸ʉΟੳɫഒɲɼɭϹ᰺ʡᄍɣʪʡʍʆɡʪɋɼʫʎɊʇʩʮɰɊ˫ʿ̎

ʇɶʅʍᔵ࿷࿔࠿ʍၔ৏ʆɡʪɋϒͫʍʧɥʉឍ

ˁˍ̉ˆʊɩɰʪ᣸Ϲ੡ងʺ˷̎ˎʱᮂលៜᆔʉ

࿢ɪʨɊቼɾʀɫɊ´ᶮ²² ϒাѻɶʅɣʪᔴॅࡂ

ᡑ৏ʍϹ᎘ʇɶʅໍᄍɸʪ૨ɣఄʊ᥎ɮɊࠓ‫ۦ‬ʇʍለኴϥɖऔಙʍɣʕɬɗʆʎɊPTSD ʍˇʸʱɶʅᄉɬʪɲʇʊ᥎ɣɲʇɫବ஍ɴʫʪɋ

˞˿ʼ˴ᒗ৷ʱও֊ɸʪɡʩఄʇɶʅʆʉɮɊˆ
̀̎˫ˇʸʣˠ˿˜ʹˬˑ˿˪̎ʉʈʍфԠ৔Ⴞ಍াʊᅸຫʍ௮ᓬʊɩɰʪៜʩʍՏʱᨁខɶʅɣʪɊၑ
ៜʱ௑ᐁɶʅʎɊӖ࠳ϴʱɮʩ᥏ɸ̀ˎ̀ʾ̉˞

ϒͫʍʧɥʊɊᄉໍˏ˞̂ˏӂᕓʊɩɰʪࠪӂʉˠ˿˜ʹˬͥᡬ৷ʍᄉીɸʪʧɥʉᏘᏙɸʪ‫ܬ‬ʍ୯Йʇͭࠪϵ༜ʇɣɥᄉໍோ୸ʇɶʅʍˇʸʊ᜴࿔াʍӖᦞড়ʍ៨ᯌʍҶಒʱᒑɧʅɣʪɋ

ʊɊPTSD ʗʍ᥼࢘ʱ᫾ɯ‫ܛ‬ಢᆔˇʸɫɡʪʇᒑ

ɲʫʝʆʍᦋ኏ʎ˱̎˶˰̎ˎᶨhttp://www.soc.

ɧʪɋ‫ీ׽‬ʊɊ˓̎ˍ˹́ˋ˳̎˞ʆɣɥᦐӌᆔ

shukutoku.ac.jp/kibounoibuki/ᶩʆʡӆᜟɶʅɣʪ

ˋ˳̎˞ᆔʉᄉໍோ୸ʇɣɥʣʩఄɿɰʆʉɮɊ

ɫɊಢᆌᜟʎɼʍͥშʆɡʪɋ

᫟ʮʩʍͼʆʣʩ‫כ‬ʩɴʫʪϹ᰺ʱɲʇʏʊɸʪ

Ż¡³·¡Ż

ࡷɉࣽᶺ᭝࿔াʍ৔ႾᆔˇʸʍɡʩఄŻϹ᰺ʱɲʇʏʊɸʪʇɣɥɲʇŻ௮ɉႈ

directionsᶮClinical Psychologyᶺscience and Practiceᶬºᶬ²²³-²´µ ᶮAaron Antonovskyᶮᶨ²º¸ºᶩᶮ Healthᶬstress and copingᶮ
Jossey-Bass Inc Pubᶮ
ᶬNew Yorkᶮ

RicoeurᶬPᶮᶨ²º¹¹ᶩᶮ The human being as the subject
matter of philosophyᶮPhilosophy & Social Criticism

ᶨʸ̉˞ˤ˫ˏ˃̎̍A ࢡࣉ‫ٽ‬๚‫׺̍פ‬Υ༒ࠍᶨឰᶩ
ᶨ³±±²ᶩᶮ Ѫ॓ʍ᠑ʱពɮŻˏ˞̂ˏࡩԂʇѪ॓вପʍ˷ˁˡː˶ ಐд‫ܞ‬ᶩɉ

April ²µᶺ³±´-³²¶ᶮMichellᶬJᶮTᶮ
ᶨ²º¹´ᶩᶮ When disaster strikesᶮᶮᶮ The
clinical incident stress debriefing processᶮJournal of

Crossleyᶬ
Mᶮ᷌ᶮ
ᶨ³±±±ᶩ
ᶮ Introducing narrative psychologyᶮ

Emergency Medical Servicesᶬ¹ᶬ́·-´ºᶮᫎ๼д‫̍ح‬ᨅ‫׺‬౗ᶨ³±±¶ᶩᶮ ࿔࠿ీʱ੍࠳ɶɾ‫ݹ‬ҁাOpen University Pressᶻ² editionᙸ൛‫ح‬ᑬᶨ³±±±ᶩᶮ ໄາ࿔࠿ɉͼഒҰ௮᯦᳙̍Υಙᐁɉᔴॅᎃቛ֚ࠜ᠘ॎᷓᶶɉ‫ݹ‬ҁাˏ˞̂ˏᬬ࠿
ᶨPTSDᶩɉͼࢡಅॉɉˏ˞̂ˏᬬ࠿ʍͥตΜ᫾ʊʃɣʅɉᎃቛвѪለኴᶬ¶²ᶬ
¹²-º±ᶮ
ͼΥ·‫ބ‬ᶨ³±²²ᶩᶮ ৊ᕁʍᦐʉɪʏʆɉʞɸɹಅ૖

೔లᄕᶨ³±±´ᶩᶮ ɣʍʀʱࠩʪۨ᭝᫾࿔ࠜɉࢫາಅॉ

National Child Traumatic Stress Network National Center

HobsfallᶬSᶮEᶮ
ᶨ²º¹ºᶩᶮ Conservation of resourcesᶮ

for PTSDᶨ³±±·ᶩᶮ Psychological First Aid Field

American Psychologistᶮµµᶬ¶²´-¶³µᶮ

Operations Guide ³nd Edition

HolmesᶬTᶮHᶮand RaheᶬRᶮHᶮ
ᶨ²º·¸ᶩᶮ The Socialᶨʸ˷̀ˁ‫۔‬ዒ PTSD ˑ̉˕̎̍ʸ˷̀ˁ‫۔‬ዒࠍʈʡ

readjustment rating scaleᶮJournal of Psychosomatic˞˿ʼ˴˜ʹ˙˅ˏ˞̂ˏ̍ˣ˙˞̅̎˅ᶮӊॏᇊResearchᶬ²²ᶬ³²´-³²¹ᶮ

৔ʍˇʸˑ̉˕̎ᶨឰᶩ
ᶨ³±±ºᶩᶮ ˋʺˉ̃ˎˁ́̍

KesserᶮRᶮCᶮᶬSonnegaᶬAᶮᶬBrometᶬEᶮᶬet alᶨ²ºº¶ᶩᶮ˫ʷ̎ˏ˞ʾʺ˟࠷ఆʍ૜ঃɬዿ ³ ၅ᶩɉ

Posttraumatic stress disorder in the national comorbidity

RaphaelᶮBᶮᶨ²º¹·ᶩᶮ When disaster strikesᶺ How

surveyᶮArchives General Psychiatryᶬ¶³ᶬ²±µ¹-²±·±ᶮ

individuals and communities cope with catastropheᶮ

KleinmannᶬAᶮᶨ²º¹±ᶩᶮ Patients and healers in thecontext of CultureᶮAn exploration of the borderland
between anthropologyᶬmedicineᶬand psychiatryᶮ

Basic Booksᶮ ɉᶨ˿˫ʷʾ́ᶬBᶮሃ΀ฬᶨឰᶩᶨ²ºº¶ᶩᶮ ࿔࠿ʍᝳɥ
ీɉʞɸɹಅ૖
SelyeᶮHᶮᶨ²º¶¶ᶩᶮ Stress and diseaseᶮScienceᶬOctᶮ̧ᶬᶻ

University of California Pressᶮᶨ˅˿ʺ̉˴̉ᶬAᶮ‫ށ‬෡ᖓࡪ̍Ѐᦐдς̍ᦘࢡ࠹‫̍ه‬ࣽಳᦶҴᶨឰᶩᶨ²ºº³ᶩᶮᔴॅκᯕࠜᶭ௮֊ʍͼʍᅕᒓʇຟᅸᒓɉআ௮‫ܞ‬ᶩ²³³ᶺ·³¶-·´²
van der KolkᶮBᶬAᶮ
ᶨ²º¹·ᶩᶮ Psychological traumaᶮ
American Psychiatric PressᶮWashington DᶮCᶮ

KleinmannᶬAᶮᶨ²º¹¹ᶩᶮ The illness narratinesᶬᶨ˯˙ˑ́̍A̍̊ʷ̉˖̎ˉ́˅ᐁᗾɉ᯦᳙Υಙ̍

sufferingᶬhealingᶬand the human conditionᶮBasicԳᄑฬຟ̍ಢಳᇀ᭿ᶨឰᶩ
ᶨ³±±µᶩᶮ ˋʺˉ̃ˎˁ́̍

booksᶬIncᶮ
ᶬNew Yorkᶮ˞˿ʼ˴ɉᨅԷԎ၅ᶩᶨ˅˿ʺ̉˴̉ᶬ
Aᶮ๼‫ף‬ᨁह̍ΤಟᄑᎴ̍ͫᨂᡓ৙

van der KolkᶮBᶬAᶮ
ᶨ³±±·ᶩᶮ Clinical Implication ofᶨឰᶩᶨ²ºº·ᶩᶮ ᅕʍៜʩᶭ੾৷ʍᅕʱࣿʪᔴॅκ

Neuroscience Research in PTSDᶮAnnᶮNᶮYᶮAcadᶮSciᶮ

ᯕࠜɉ៝дಅ૖ᶩ

xxxxᶬ²-²¸ᨅ‫׺‬౗ᶨ³±±²ᶩᶮ ‫ݹ‬ҁˏ˞̂ˏᬬ࠿᫟᥸ᬬ࠿ʍᅕੳʇ
ຟᅸ˂ʺ˟˿ʺ̉ʊ᫟ɸʪለኴᶨ৔ᆔ˞˿ʼ˴ʍႾពʇˇʸɉɷʚɥᶩ
LazarusᶬRᶮSᶮᶬ& FolkmanᶬSᶮᶨ²º¹µᶩᶮStressᶬappraisalᶬ
and copingᶮSpringerᶬNᶮYᶮ
LitzᶬBᶮᶬGrayᶬMᶮ
ᶬBryantᶬRᶮet alᶮᶨ³±±³ᶩᶮ Earyintervention for traumaᶺ Current status and futureŻ¡³¸¡Żᶨ˯˙ˑ́̍A̍̊ʷ̉̍˝̍ˉ̎˅ᶨ³±²²ᶩᶮ PTSD
ʊɩɰʪᓵቿࠜለኴʍᔴॅʗʍᒑࡗ ²-²·ᶩ˨˻̎˴̉̍ˇʸለኴɉዿ²´ऍɉዿᶱ‫׳‬³±²³शᶶಏɉ³¹-´º᮱Journal of Human Care Studies Vol. ²´ No. ²
June ³±²³, pp ³¹-´ºׄɉᗾᎃቛቿͼ‫ܟ‬ᇉᠷजʊʧʪᎃቛᬬ࠿ᒓʱႾពɸʪ
ᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʍථી᝸Ꭻʇ˭̃ˑˏ
ࢡͬɉӍࠍᶱᶩ¡¡̍¡¡ࢡࣉᆍ৙ࠍᶲᶩ

Experienced psychiatric nurses' communication
with clients by injecting themselves into their inner worlds
Noriko Yamashita １）ᶬToshiko Yamazaki ２）

Abstract
The purpose of this study is to clarify how experienced psychiatric nurses communicate with their clientsby injecting themselves into their inner worldsᶬand to specify the components and the process of thecommunicationᶮA total of 15 experienced nurses of a psychiatric hospital were interviewed for thisstudyᶬand the data gained were analyzed using the Modi¿ed Grounded Theory Approachᶮ
Revealing 16 concepts and 7 categoriesᶬthe result suggests the process belowᶮAt the core of thecategories lie nurses' antennasᶬaccurately sensing the signs of their clientsᶮComparing the antennas
with the other components in the course of the communicationᶬnurses accept their clientsŽopinions andpoints of viewᶬshare their inner worlds by describing their worldsᶬ
and evaluate their understanding fromthe standpoint of the clients by validating their own positionsᶮThe result also suggests the importance of preliminary steps toward reaching such communication stages
with clientsᶺžsuper¿cial communicationᶬſža wealth of experiences as a nurseᶬſandžoccasionsſᶮKey wordsᶺcommunicationᶬexperienced nursesᶬpsychiatric nursingᶬɉɉɉɉɉ Modi¿ed Grounded Theory ApproachᶮΣᶮʎɷʠʊ

ቛቿᇉᠷजɫӁᬎʱ৕᝸ʇɸʪ៖ᇽ̍৲ᒑᬬ࠿ʍ
ওɣਭᒓʱႾពɸʪɾʠʊʎɊਭᒓɫᜟԎɸʪʡᎃቛᬬ࠿ʎᅒਭʇ቎ϥᄉໍᬬ࠿ɫӉࠓɶʅɩʩ

ʍʱ଻ɧʪɿɰʆʎͭ֝ԔʆɡʩɊលթʍੜ‫ء‬ʱ

ᶨۭᄑᶬ
³±±±ᶻ๽་ᶬ³±±¸ᶩɊ቎ϥᄉໍ૮ᓧʍͼ഑ીɶʅɣʪӑᮅʗʍʸ˭̃̎˗ɫ৕᝸ʆɡʪɋ

ʇʉʪˉ˵˻ˡˇ̎ˍ˽̉ᬬ࠿ɫͼ৔៨ᯌʇʉʪ

ҳᜓለኴɪʨɊᎃቛᬬ࠿ᒓʍˉ˵˻ˡˇ̎ˍ˽ɲʇɫ‫ݼ‬ɣɋʉɪʆʡɊψᒓɫႾពʆɬʪʧɥʊ

̉ʍၔ৏ʇਭᒓႾពʍɾʠʊᜓʂʅɣʪᇉᠷजʍ

ᔵԔʍᒑɧʱᜟႻɸʪɲʇɫ᭐ɶɣʇɴʫʅɣʪ

ˉ˵˻ˡˇ̎ˍ˽̉ʇʱ඘ឍɸʪɋਭᒓʎᅕᆔ̍

ᶨKingdon ᶦ Turkingtonᶬ³±±³ᶩɋɶɾɫʂʅɊᎃ

Ѫ॓ᆔѮᮅɫ᝖ᭉʊࠓ‫ۦ‬ɸʪӑᆔͳᄟᶨͼΥ̍ᶱᶩၵዒᜓ௔ຫκ‫۔‬ዒᅕᬎ෤ථ᡼ᖚᎃቛ֚ᅸˑ̉˕̎ᶨNHO Kamo Psychiatry Medical Centerᶩᶲᶩूࣃ‫۔‬ᬫ‫ࠜށ‬ᶨHiroshima International Universityᶩ‫ל‬ኢ ³±²±.¸.³²ɉ‫ל‬Ⴞ ³±²³.².²³

Ż¡³¹¡Ż

ࢡɉͬ̍ࢡɉࣉᶺᎃቛቿͼ‫ܟ‬ᇉᠷजʊʧʪᎃቛᬬ࠿ᒓʱႾពɸʪᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʍථી᝸Ꭻʇ˭̃ˑˏ

ˇ̎ˍ˽̉ʍ˭̃ˑˏʱనʨɪʊɸʪɋ

ࢡ‫ף‬ᶬ³±±²ᶩʱᜟԎɸʪᬫɊ៖ᇽ̍৲ᒑᬬ࠿ʉʈ
ɪʨˉ˵˻ˡˇ̎ˍ˽̉ᬬ࠿ɫᄉɷᶨළ‫̍ף‬ኜ
ࢨᶬ³±±µᶩɊψᒓʊɥʝɮϧɧʪɲʇɫ᭐ɶɣɋ

Υᶮᄍៜʍ஬Ѐͫʍ࠳ᑵɼʫʊࡩɶʅᇉᠷजʎɊᎃቛቿᏀ᰺ʍከʞᨁʌ
ᶨೋࣉᶬ²ººµᶻͼࢡᶬ³±±¶ᶻ‫ށ‬᝷̍‫ح̍ࢨ׺‬ᄑ̍ೋᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ᶺᇉᠷजѮʍපɍᄑ̍᝷ᨂ̍ࢡಢ̍ࢨᧅᶬ³±±·ᶩɊᔵइໂࡗᶨቬᄑᶬ

ʉˉ˵˻ˡˇ̎ˍ˽̉Х᥼᝸‫ی‬ʱᄍɣʅਭᒓͳᄟ

³±±·ᶻ ࠪࢨᶬ³±±·ᶩɊຟᅸᆔˉ˵˻ˡˇ̎ˍ˽̉

ʱႾពɸʪɾʠʊᜓɥᇁΣЀᄍʆɡʩɊᇉᠷजɫ

૮᜖ᶨϟᙸ̍ᬀᚃ̍ᕼྙ̍᧘Υᶬ
³±±´ᶻປᄑ̍ᨂ

ᔵइʱЋʂʅਭᒓʊˉ˵˙˞ɶʅᶨᔵુ᫟ͮʱ༈

ಳ̍ᄑ᥆̍ࠨ᡼ቛ̍ࡷ೼̍ܽྙᶬ
³±±¶ᶻԳࣽ̍Υɮɶʅᶩᜓɥˉ˵˻ˡˇ̎ˍ˽̉ʆɡʪɋ

ᙸᶬ³±±¶ᶻ๼ࣉ̍ྰ̍ࣽ໚ᶬ³±±·ᶻ‫ݶ‬ᆾᶬ³±±¸ᶩɪͼ‫ܟ‬ᇉᠷजᶺಢለኴʆʎ Bennerᶨ³±±¶ᶩʍᇉᠷʨੜ‫ۑ‬ᆔ᫟ʮʩᶨೋࣉᶬ²ººµᶻ᭐າᶬ³±±¶ᶻᙸׄᶬ૮ᓧᒂৃ์ᬤʊɩɰʪͼ‫́˯̂ܟ‬ϒͫʍᎃቛቿᇉ

³±±¸ᶩʱʡʂʅਭᒓʱႾពɶʧɥʇɸʪɋɼʫʎ

ᠷजʱͼ‫ܟ‬ᇉᠷजʇɸʪɋBennerᶨ³±±¶ᶩʎɊਭᇁ૜ʍខ࿢ʊዒʀɊᇁ૜ʍӑᆔͳᄟʱႾពɸʪɲ

ᒓʍၤ຤ʱᏴ‫׹‬ᆔʊ଻ɧၤ຤ʊড়ɷɾԟఀɫʆɬ

ʇʆɡʩɊਭᒓʍͳᄟʊ᣸ʱ૸ɷɊీʊʎ୸Օᒓ

ʪᇉᠷजʱͼ‫́˯̂ܟ‬ʇɶɊᯕϯʍቿʍਭᒓʱ᎜

Ѯʍ೘Ꮋʞʱ‫ݳ‬ɧʪɲʇᶨᯮᄑ̍᝾ᙸᶬ²ºº¸ᶻᄑᶳ᷾ᶵश᫙ˇʸɶʅɬɾᒓɫɼʍ̂˯́ʊᦑɸʪ

ᄢᶬ²ºº¹ᶻའທᶬ³±±·ᶩʆʡɡʪɋ

ʇɶʅɣʪɋɼɲʆɊ̀̎˖̎ᆔ঱ՁʱଉɣɊᇉ

ͫᥙʍʧɥʊਭᒓʍˉ˵˻ˡˇ̎ˍ˽̉᫿࠿᝸

ᠷजʣᇉᠷࠜᄉʊࡩɸʪବࡶᏀ᰺ɫɡʩᔵइʍᇉ

‫ی‬ʣਭᒓႾពʍɾʠʍᇉᠷजʍˉ˵˻ˡˇ̎ˍ˽ᠷʱលៜ֊ʆɬʪʇᒑɧʨʫɾᒓʆɊᎃቛቿᏀ᰺

̉૮᜖ʊʃɣʅʎనʨɪʊɴʫʅɣʪɋɶɪɶɊ

ɫᶵशϒͫɡʪᇉᠷजʱͼ‫ܟ‬ᇉᠷजʇɶɾɋ

࠷ᬫʍᔴॅ‫ܬ‬ᮅʆᎃቛቿᇉᠷजɫʈʍʧɥʊˉ
˵˻ˡˇ̎ˍ˽̉૮᜖ʱᰣЋɶਭᒓʍӑᆔͳᄟʱΦᶮለኴఄຫ

ႾពɶʧɥʇɸʪʍɪɊ࠷ᬫᄍɣʅɣʪˉ˵˻ˡˇ̎ˍ˽̉૮᜖ʇɼʍ˭̃ˑˏʊʃɣʅʎనʨɪᶱᶮለኴ˝ˌʺ̉

ʊɴʫʅɣʉɣɋɼɲʆಢለኴʆʎɊᎃቛቿᇉᠷ

ಢለኴʎਭᒓʇᇉᠷजʇʍ቎ϥᆔᇁΣЀᄍʊᇗजɫਭᒓʍӑᆔͳᄟʱႾពɸʪɾʠʊᄍɣʪˉ

ᆾɶɊనʨɪʊɶʧɥʇɸʪႻᡑɫ˭̃ˑˏ৷ʱ

˵˻ˡˇ̎ˍ˽̉ʱᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉

ಐɸʪʇɣɥၔ৏ʱପʃɲʇɪʨɊˍ̉˲̀˙˅ʇɶɊᎃቛቿᇉᠷजɫ࠷ᬫ‫ܬ‬ᮅʆᜓɥᔵइ૸ӁˉᇁΣЀᄍ៵ʱႾ៵‫ܛ‬ᆺʇɶʅɣʪˆ˿ʼ̉˝˙˵˻ˡˇ̎ˍ˽̉ʍථી᝸Ꭻʇ˭̃ˑˏʱనʨɪ

˟̍ˑˀ̀̎̍ʸ˭̃̎˗ɫᦞɶʅɣʪʇԟఀɶ

ʊɸʪɋ

ɾᶨChenitz & Swansonᶬ²ºººᶻ֪ᶬ³±±¹ᶩɋʉɪʆʡɊˉ̎˝ʹ̉ˆʍᦋ኏ɫ๚ᤑᆔႾពɶʣɸɮɊ

Τᶮለኴᆾᆔ

Ԕ೒૜᮵ʣԟఀʍବ෋ʊʃɣʅˏ̎˧̎˦ʺːɫ
ৃʨʫʣɸɣɲʇɪʨɊಟͬᶨ²ºººᶬ³±±´ᶬ³±±¸ᶩᶱᶮᎃቛቿᅕᬎʊմլɸʪͼ‫ܟ‬ϒͫʍᇉᠷजᶨϒɫ୯ٞɸʪиฬ၅ˆ˿ʼ̉˝˙˟̍ˑˀ̀̎̍ʸͬɊͼ‫ܟ‬ᇉᠷजᶩɫᜓɥਭᒓʍӑᆔͳᄟʱႾព˭ ̃ ̎ ˗ᶨModi¿ed Grounded Theory ApproachɊɸʪɾʠʍᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʍථી

ϒͬ M-GTAᶩʱЋᄍɶɾɋM-GTA ʎˆ̂̎ˌ̎

᝸Ꭻʱనʨɪʊɸʪɋ

ʣˏ˞˿ʼˏɫ୯ٞɶɾˆ˿ʼ̉˝˙˟̍ˑˀᶲᶮᎃቛቿͼ‫ܟ‬ᇉᠷजʊʧʪᔵइ૸Ӂˉ˵˻ˡ̀̎̍ʸ˭̃̎˗ʱʧʩ࠷ᣊᆔড়ᄍɫ‫׭‬ᓧʉথॾŻ¡³º¡Ż

˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬ʇɶʅಟͬɫၵᔵʍព᧽ʱՒɧɾለኴఄຫʆɡʪɋ

ᶵᶮԔ೒ఄຫ
ͼ‫ܟ‬ᇉᠷजʍ࠳ᑵʊ‫ܛ‬ʄɬɊԔ೒࿶࿢ᒓᶨಟ
ͬᶬ³±±´ᶩʎ A ᎃቛቿᅕᬎʊմլɶʅɩʩɊᔵइ

ᶲᶮࡩᡑᒓA ᎃቛቿᅕᬎʊմլɸʪᇉᠷजʆɊለኴᒓɫͼʍᇉᠷʱលៜ֊ʆɬʪʇᒑɧʨʫɾᎃቛቿᏀ᰺श

‫ܟ‬ʇԟఀɶ‫׽‬ੜɫৃʨʫɾ ²¶ ‫׾‬ʱࡩᡑʇɶɾɋ

௦ᶵशϒͫʍᇉᠷजʇɶɾɋʝɾɊԔ೒˜̎˴ʱӂ‫ى‬ɫᇉᠷ࡬᫏ࠜഊᶳश៨኏֧ʆɡʩɊ³± ϐɪɔˉ˵˻ˡˇ̎ˍ˽̉ɫ‫ۏ‬᭐ʉᎃቛᬬ࠿ᒓʊᇉᠷʨ ¶± ϐʆɊᇉᠷजᏀ᰺श௦̍ᎃቛቿᏀ᰺श௦ʎ

जɫᔵԔʍˉ˵˻ˡˇ̎ˍ˽̉૮᜖ʱЋᄍɶਭᒓᶷ᷾ ´¶ शʆɡʂɾɋʉɩɊA ᎃቛቿᅕᬎʎӆዒʊˉ˵˙˞ɶʅɣɮ˭̃ˑˏʍ୛ኴɕʇɶɾɋ

ʍᎃቛቿ֫ቿᅕᬎʆɡʪɋۨ‫ܕ‬ʊɩɰʪᎃቛ֚ᅸ

ၵᔵʊ᫕ᆌɴʫɾԔ೒̅̎˅ˍ̎˞ʱЀીɶʅʍͼ৔ᆔ֚ᅸ෤᫟ʇɶʅϴᑝʄɰʨʫʅɩʩɊຟ

඘৤ʱᄉીɶɊɴʨʊ඘৤᫙ʍ᫟Фʱ൮ឡɶʅˁ

ᅸଃૺ৷ʉʨʒʊຟᅸ‫ۏ‬᭐ʉᎃቛᬬ࠿ᒓʍ֚ᅸʣ

˜ˊ̀̎֊ɶɊˏ˞̎̀̎˿ʺ̉ʇᏃೖ‫ۑ‬ʆ˭̃ᎃቛቿ௚৵ʊ‫כ‬ʩᎻʲʆɣʪᅕॅ௦ µ´± ॅʍᅕᬎˑˏʱనʨɪʊɶʅɣʂɾᶨಟͬᶬ³±±´ᶩɋϒͬɊʆɡʪɋᄉીɶɾ඘৤ʍᶱАʱᥱɶʅԔ೒ఄຫʱ៥నɸʪɋ
ᶱᶩࡩᡑᒓʱˉ̎˟֊ɶɊ᩻ᮬɶɾᮅଢ଼ӑࡄʱࡩᡑᒓԠʊᥩៜ᩻ʊɶɾɋԔ೒˜̎˴ʊ᫟᥸ɸʪ

ᶳᶮ៬೿ీಜɩʧʒ៬೿ఄຫ
³±±¹ शᶳಏ᷾ᶴಏʊ֤ථીᆔᮅଢ଼ʱ࠷ఆɶɾɋ

ጜ૗ʊᇗᆾɶʅɼʫʱӌϹАʇɶɊԔ೒̅̎˅

ᢑ٨ӑࡄʱ൮ឡɸʪɾʠɊᶱ‫׾‬ʊ˭̂˜ˏ˞ʱ࠷ˍ̎˞ʱᶱ඘৤ɳʇʊЀીɶʅɣʂɾɋԔ೒

ఆɶɾɋɼʍᬫɊਭᒓͳᄟʱႾពɶʅɣɮ˭̃ˑ

̅̎˅ˍ̎˞ʇʎɊ඘৤‫࠳̍׾‬ᑵ̍ӌϹА̍ˏʊʃɣʅʍៜʩʱৃʪɾʠੜ‫ۑ‬ɶʅɣʪɲʇʣ

Ⴞ៵ᆔ˷˸ʍᶴ᮴ᆾɪʨʉʩɊࡩᡑᒓʍៜʩ

࠷ᣊɶʅɣʪɲʇʉʈʊʃɣʅឮ٨ɶɾɫɊˉᶨ˝̎˕ᶩɪʨለኴᒓɫᇗᆾɶɾጜ૗ʱӌϹА˵˻ˡˇ̎ˍ˽̉ʍ႘ৃᦋ኏ʇਭᒓႾពʍɾʠʍ

ʇɶʅ௨Ⴞɶʃʃ඘৤ʱᄉીɸʪಅॾʆɡʪ

ˉ˵˻ˡˇ̎ˍ˽̉႘ৃᦋ኏ʇʱ֙Ԡɶʅጏɧʪ

ᶨಟͬᶬ³±±´ᶩɋАɧʏɊɖಿʅʧʌɊବ‫׾‬ɶʅɋɲʇɫ᭐ɶɪʂɾɋɼɲʆɊ‫ݼ‬ɮʱៜʂʅʡʨɥ

ਭᒓɴʲɫɼɥʣʂʅବ‫׾‬ɶʅɮʪʍʊʡੜ‫ء‬ɾʠʊለኴ˜̎˴ʍӑࡄʍʞʊᬈ࠳ɺɹᔵᄒʊ

ɫɡʪɰʲɋ
ɗʇɣɥᄉʍ˝̎˕ɪʨᇗᆾɶɾ

ៜʂʅʡʨɥɲʇʱᨁខɶᶨಟͬᶬ³±±´ᶩɊਭᒓʇ

ጜ૗ʱӌϹАญʊឧӁɶɊਭᒓɫᇉᠷजʱфκʍˉ˵˻ˡˇ̎ˍ˽̉ʆ‫ށ‬ԕʊɶʅɣʪɲʇʇɼ

ʇɶʅ៖ᠪɶɾᆌលʇᇉᠷजɫʇʨɧʅɣʪʇ

ʍႾᄒʣᔵइʍˉ˵˻ˡˇ̎ˍ˽̉ʍ‫ᦥݳ‬ʊʃɣព᧽ɶɾᶨᜟᶱᶩɋɼʫʇੜ‫ء‬ӑࡄɫᯕϯɶʅʅΟАʱɡɱʅʡʨɥɲʇʊɶɾɋ

ɣʪʇព᧽ɶɾ௮ᓬʱψʍ˝̎˕ɪʨ୛ɶɊӌϹАญʊᥟՒɶʅɣɮʇʇʡʊɊႾ៵ᆔ˷˸ญ
ʊɼʍাʍԔ೒ʍԟఀବ෋ʇɶʅፍ֫ʉ˷˸ʣ

ᶴᶮјႾᆔ᧖઄
ለኴᢵఙʇʇʡʊɊ֩Տʎᔵᄒੜ৲ʆɣʃʆʡ

ᅃ٨࿢ʱឧӁɶɾɋɲʫʨʍ඘৤ʎ࠳ಜᆔʊ

ͼห‫׭‬ᓧʉɲʇɊфκ‫׾‬ʎˉ̎˟֊ɶ֛‫׾‬৷ʱвˏ̎˧̎˦ʺːʱ‫ל‬ɰʉɫʨɊӌϹАʍੜ‫ء‬ӑាɸʪɲʇɊ˝̎˕ʎለኴᆾᆔϒ‫ݹ‬ʊᄍɣʉɣɲ

ࡄʊᇹᇃ࿢ɫʉɮʉʩ௨‫׹‬৷ɫʃɮʝʆԔ೒ʱ

ʇʣ‫׎‬ᨁʊጫႾɸʪɲʇʱɊ௮ಅʇ‫ף‬ᯃʆ៥నɶ

ᐴʩ᥏ɶɾɋ

ࡩᡑᒓʇ‫׽‬ੜಅʱίʮɶɾɋʝɾɊूࣃ‫۔‬ᬫ‫ࠜށ‬ᶲᶩᶱ඘৤ɫ៥నՏʱପʃʇԟఀɶɾీ࿢ʆɊ඘

ʇࡩᡑᅕᬎʊለኴјႾ࡟೿ʱᄔ៰ɶɊ૭៖ʱৃɾɋ

৤‫׾‬ʇ࠳ᑵʱ൮ឡɶɾɋАɧʏҳʚʈʍАʆʎɊӌϹАӂϹʱᜟႻɸʪ࠳ᑵʇɶʅɊਭᒓɫŻ¡´±¡Ż

ࢡɉͬ̍ࢡɉࣉᶺᎃቛቿͼ‫ܟ‬ᇉᠷजʊʧʪᎃቛᬬ࠿ᒓʱႾពɸʪᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʍථી᝸Ꭻʇ˭̃ˑˏ

ᜟᶱɉԔ೒̅̎˅ˍ̎˞ʍАᔵԔʍႾពᒓʇɶʅɼʍᇉᠷजʱ៖ᇽɶɔᇉᠷʆʎᢑᆔ˝̎˕ʍព᧽ɫͼ৔ʇʉʪɾʠɊԔ೒Ꮓ

जɴʲɕʆʎʉɮфκ‫׾‬ʆବ‫׾‬ɸʪʇɶɊ
ɔфೖʇព᧽ʱʝʇʠʅ៵ɷʪɋϒͬɊˁ˜ˊ̀̎‫׾‬κ‫׾‬ʆʍବ‫׾‬ɕʇɣɥ඘৤‫׾‬ʱЀીɶɾɋʎɘɉɉəɊ඘৤‫׾‬ʎɔɉɉɕɊ˝̎˕ɪʨʍঃᄍ

ᶳᶩ‫ᜓ᥼ీ׽‬ʆψʍ඘৤ʡЀીɶɾɋɼʍᬫɊၔ

ʎɖɉɉɗʱᄍɣʅ៥నɶʅɣɮɋ

ʊ඘৤᫙ʍ᫟Ф৷ʱੜᠪɶʉɫʨ඘৤‫׾‬ʱᄉીɶɾɋɲʫʊʧʂʅ඘৤ʍ௨ႾɊ຿ᐆʱᜓɣɊ

ᶱᶮᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʍථી᝸Ꭻ

‫ీ׽‬ʊˁ˜ˊ̀̎ʍЀીʱᜓʂɾɋ಍Ꮉ์ᬤʇ

ᶱᶩᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉႘ৃԳʍ์ᬤʍ

ɶʅᏃೖʱ௮ዞ֊ɶʅሯ៖ɸʪЀඋᶨˏ˞̎
̀̎˿ʺ̉ʍЀીᶩʱᜓɣɊᏃೖ‫ۑ‬ʱЀીɶɾɋථી᝸Ꭻɉɘᜟ࢜ᆔˉ˵˻ˡˇ̎ˍ˽̉ə
ɖᜟᮅᆔʊ᫟ʮʪ᫟ʮʩఄʱɶʇʂɾʲᶶᶮᏃೖʍ޸ঞ৷ʍ൮ា

ɷʢʬɥʉʇ৲ɥɋɼʍీɼʍీʆɋ
ɗʍʧԔ೒ఄຫʍ޸ঞ৷ʊʃɣʅʎɊለኴᒓϒ‫ݹ‬ʍɥʊɊᇉᠷजɫᔵइᜟԎʱ‫ۏ‬᭐ʇɶʅɣʪਭ

M-GTA ለኴϥ˷̉˦̎ᶱ‫׾‬ʊˏ̎˧̎˦ʺːʱ

ᒓʍលៜᓗ౔ʊɡʪഒಢᆔʉ٨ᯌʗʍខ࿢ʱ

‫ל‬ɰɾɋʝɾɊᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʍӑପʅʪʝʆʍɊਭᒓɫᜟԎʆɬʪᧅԔʍʞʊ

ࡄʍ޸ঞ৷ʊʃɣʅʎɊለኴᒓϒ‫ݹ‬ʍ M-GTA ለʇʈʝʂɾᜟᮅᆔʉˉ˵˻ˡˇ̎ˍ˽̉ʱᜓ

ኴϥ˷̉˦̎ᶱ‫׾‬ʍψɊಢለኴʊ᫟ʮʂʅɣʉɣɥˁ˜ˊ̀̎ʇɶɾɋɉɉɉɉɉɉɉɉɉɉ

ለኴᒓᶲ‫׾‬ʇለኴࡩᡑᒓʍͼɪʨ಍ʡ࠸ឍ৷ɫвǋɉɔਭᒓʇʍϥ់ᔵϹɫᆾᆔɕପʆɬʪዒ‫ܬ‬ʊɡʪᇉᠷजᶱ‫׾‬ʊˏ̎˧̎˦ʺː
ʱ‫ל‬ɰɾɋ

ɖਭᒓɴʲʇඕɶɮ់ɫʆɬʫʏᔵԔʆ
ᔵइགᢷɋɣɣˉ˵˻ˡˇ̎ˍ˽̉ɫʆɬ
ɾʂʅɋ់ɫɸɳɮඕɶɪʂɾʆᎹʮʂ

ΧᶮᏃೖɩʧʒᒑࡗ

ʅɋᔵԔʍͼʆˉ˵˻ˡˇ̎ˍ˽̉ʏʂʀ
ʩʧʂʅ৲ʂʅɾɋɗʉʈʍ˝̎˕ɪʨɊԔ೒˜̎˴ʊຣʂʅԔ೒ɶɾᏃೖɊ²· ʍ඘৤ਭᒓʇ់ʱɸʪɲʇᔵϹɫᆾᆔʇʉʂʅɩ

ʇᶷʃʍˁ˜ˊ̀̎ɫᄉીɴʫɾᶨᜟᶲᶩ
ɋɲɲʩɊˉ˵˻ˡˇ̎ˍ˽̉ɫᭉ៯ʍጳ‫ې‬ʊʇŻ¡´²¡Ż

˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬ᜟᶲɉˁ˜ˊ̀̎ʇථીɸʪ඘৤ͥជ

ʈʝʂʅɣʪɲʇʱੜ‫ء‬ɸʪ඘৤ʇɶɾɋ

ʍીᫎʣᡋࡎʉᏀ᰺ʱከʞᨁʌʪ৕᝸৷ʱ
ႾពɶɊκᄉᏀ᰺ʱᡋɪʊɶʅɣɮɲʇʱ

ɉǌɉɔᇉᠷजʍͥఄ‫؂‬ᆔព᧽ɕɖᅕၤʆɼɥលʂʅʪʂʅɣɥᯞʊʎঞ

ੜ‫ء‬ɸʪ඘৤ʇɶɾɋ

ీ৲ɧʅʉɣɋ৮ɣκʇɣɥʍɫҳʊዒʂ

ɉǌɉɔᔴॅᏀ᰺ʍከʞᨁʌɕ

ʅɊᅕ๨ɫ਱ɮɶʇʪʇɪɊᅕ๨ʆԔɪʨ

ɖᏀ᰺ɫʡʇʆᔵԔʍͼʆᒑɧʨʫʪʧ

ʲၤੳʊʉʂʇʪʇɪɣɥᯞʊʎႾពʆɬ

ɥʊʉʪʲʧʌɋɲʍʝʝɣʂɾʨɲɥʉ

ʲɪʂɾɋɗɊɖਭᒓɴʲʍᤸɴʇɪᖐɶʞ

ʪɿʬɥʇɣɥΜ੍ʇɊɲɲʆԕʂɾʨᇁ

ʇɪɼʂʀѮʊዒʂʅᒑɧʪɲʇɫʆɬʲঞͭགʊ৲ɥɿʬɥʇɣɥɋɗʉʈʍ˝̎

ɪʂɾʲʧɋɗʉʈʍ˝̎˕ɪʨɊਭᒓɫ

˕ɪʨɊᇉᠷजɫфɍʍਭᒓʇʍˉ˵˻ˡᜟԎʆɬʪጳ‫ې‬ӑʆʍʞʣʩʇʩɶɊᇉᠷ

ˇ̎ˍ˽̉ʱড়ᄍɶʅɣɰʪʧɥɊᔴॅᏀ

जɫͥఄ‫؂‬ᆔʊព᧽ɸʪɲʇʱੜ‫ء‬ɸʪ඘᰺ʱᡋɪʊɶʅɣɮɲʇʱੜ‫ء‬ɸʪ඘৤ʇ

৤ʇɶɾɋ

ɶɾɋ

ɉɘঃɬԎɶʍከʞͫɱə

ɉɘɬʂɪɰə

ɖҳɫ៦ʠʉɣɪʨᮅᆏɣɰʈɊɼʍҳʍɖᔵԔʍీɿɰଔᙪɸʪਭᒓɴʲɫɩʂҳʍҳʝʆʍঃɬԎɶʱᄍੜɶʇɪʉɣʇࡩ

ʅɋʆʡɊҳᤠʍీʎᶱᆌᆾʆᯯʟʲʧɋɲড়ʆɬʉɣɋɗʇɣɥ˝̎˕ɪʨঃɬԎɶʇʍᦒɣʎϺʉʲɪɋɼʫɫɬʂɪɰʆҳᤠʊɣɥᜟႻʱ˃̎̅̎˟ʇɶɊਭᒓႾពʍɾʠ

ᇁ៯ɶɾʨɊ౓์ʣʂʐʩ់ɶ᥈ʲʆʉɣɰʊᇉᠷजɫᏀ᰺ʱঃɬԎɶʇɶʅᡋࡎʊɴɺ

ʲɋɗʍʧɥʊɊਭᒓႾពʍɾʠʊӑᆔͳᄟʅɣɮɲʇʱቌɸˁ˜ˊ̀̎ʇɶɾɋʗʸ˭̃̎˗ɸʪˉ˵˻ˡˇ̎ˍ˽̉ʗ‫֊ݳ‬ɉǋɉɔκᄉᏀ᰺ʍከʞᨁʌɕ

ɸʪɬʂɪɰʇʉʪ๨ʄɬʣᆌ᝾ʱৃʪˁ˜ɖᏀ᰺ɶɾɲʇɫਭᒓɴʲʍᓗ౔ʱୟ༨
ɸʪʇɬʊᦒʂʅɬɾɋᔵԔʍκᄉᏀ᰺ɫˊ̀̎ʇɶɾɋɉ
ɉǋɉɔੜ‫ۑ‬ᆔˉ˵˻ˡˇ̎ˍ˽̉ʍᆌ᝾ɕ

ᡋɪʊʉʂɾɲʇɫ‫ށ‬ɬɣʇ৲ɥɋ
ɗʉʈɖ᝾ʧɥ᝾ʝʌɷʢʂɾʨɼʍੜ‫ۑ‬ʇɸʍ˝̎˕ɪʨɊᇉᠷजᔵ᣸ɫκʇɶʅᔵइ

ʪʇɲʬʎᦒɥɶɊҳᤠʞɾɣʉʡʍʎϺŻ¡´³¡Ż

ࢡɉͬ̍ࢡɉࣉᶺᎃቛቿͼ‫ܟ‬ᇉᠷजʊʧʪᎃቛᬬ࠿ᒓʱႾពɸʪᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʍථી᝸Ꭻʇ˭̃ˑˏ

ʡପʂʅʉɣʇɲʬʆ᝾ʧɥ᝾ʝʌɶʅʡ
Ϻʡʉʨʉɣɋលᗼʎ‫׽‬ɷʆʡɊɼʍͼʎɾɋɉǌɉɔɣʃʡʍၤੳʍಂంɕ

ӂ࿷ᦒɥɰʲɋɗʉʈʍ˝̎˕ɪʨɊψʍɖ্޳ʉ០आʍ୻ʫʱ੡ɷʫʪʧɥʊɊ

ᇉᠷजʍˉ˵˻ˡˇ̎ˍ˽̉ʱʝʌʅʡਭ

ɣʃʡʍਭᒓɴʲʱᇽʂʅɩɬɾɣɋʉʲᒓʍ‫ט‬ড়ʊʎᦒɣɫɡʩɊˉ˵˻ˡˇ̎ɪ‫ݳ‬ʂʅɣɥʍʱ੡ɷʨʫʪʧɥʊɊɣʃ

ˍ˽̉ʱੜ‫ۑ‬ᆔʊᜓɥᨁ᝸৷ʊ๨ϊɮɲʇʡఖɍ᫟ʮʪɋ
ɗɊɖ᭐ɶɣʧɋ๗ఖɫɣʃ

ʱੜ‫ء‬ɸʪ඘৤ʇɶɾɋ

ʡɷʢʉɣɪʨɋɣʃʡʂʅɣɥ੡ងʂʅ

ɉǌɉɔਭᒓʍӑᆔͳᄟʗʍᇗᆾɕ

᭐ɶɣɋɗʉʈʍ˝̎˕ɪʨɊਭᒓʍɣʃ

ɖɥʀʊʇʂʅʎˊ˵ɿɰʈȾȾɴʲʡʍၤੳʇʎ्ͥ૳୴ɸʫʏͭ‫ݳ‬ʍʡʍʆᶨਭᒓᶩʊʇʂʅʎˊ˵ɷʢʉɣʲɿʉɊʎʉɣʇੜᠪɶɊɣʃʡʍၤੳɪʨΨᎲʉ‫ށ‬ԕʉʡʍʉʲɿʉɊȾȾɴʲᶨਭᒓᶩʊ

‫֊ݳ‬ʡᥢɸɲʇɫʉɣʧɥᏒɧɹີੜɶʅ

ʇʂʅʎੜ‫ء‬ɫɡʪʲɿʉʂʅɋ
ɗʉʈʍɣʪɲʇʱੜ‫ء‬ɸʪ඘৤ʇɶɾɋ

˝̎˕ɪʨɊႾព‫ۏ‬᭐ʉਭᒓʍលթʊʡɊ

ɉǍɉɔ᫟৔ʆໜɬপʩʊɴʫʪфԠ৷ɕ৕ɹɼʍκʍӑᆔͳᄟɪʨʍੜ‫ء‬ʄɰɫɖɲʍκʊ᫟৔ɫɡʪʉ̎ʇ৲ʂɾʨ

ɡʂʅលៜ֊̍ᜓթ֊ɴʫʅɣʪɲʇʊ๨

ᦒʂʅʪʧɊ‫ٹ‬ʩఄʡɋᔵԔʊʎᖐ૜ɪʉ

ʄɮɲʇʱੜ‫ء‬ɸʪ඘৤ʇɶɾɋ

ʇ৲ʂʅʡɊ᫟৔ʱପʂʅᜓʂɾʨ‫ބͩށ‬ᶲᶩᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʍථી᝸Ꭻ

ʉɲʇʂʅʧɮɡʪɋɡ̎ɲʍκᖐ૜ʂʅɉɘʸ̉˜ˠə

৲ɥɰʈɊʀʦʂʇ‫؂‬ɪɣ‫׹‬ʂʅʞɾʨӁɖɼʍͥលʊ‫ט‬ড়ɶʅᒫɣʅɡɱʨʫɾ

ʩ᥈ʠɾʩɋɗʉʈʍ˝̎˕ɪʨɊ᫟৔ʱʨɊʸ̉˜ˠ঒ʂʇʂʅɡɱʨʫɾʨʇ৲

ࡉɺʪɲʇʊʧʩɊɼʍਭᒓɫᇉᠷजʍខ

ɥɋᒫɬ໐ɶʇʂɾʨϺʆʡʉɣɲʇɪʡᇽ

ᨂʍͼʆ‫ې؝‬ɪʨໜɪʒͫɫʪʧɥʊ଻ɧ

ʫʲɰʈɊɼʍͼʆ‫ށ‬Οʉɲʇលʂʅᶨʪᶩ

ʨʫႾពɶʧɥʇɸʪੜᠪɫᱝʝʪɲʇʱ

ɪʡʞɾɣʉʇɲʬɡʪʧʌɋ
ɗɪʨɊʸ̉

ੜ‫ء‬ɸʪ඘৤ʇɶɾɋ

˜ˠʇɣɥ˃̎̅̎˟ʱৃɾɋࡩᡑᒓʍ‫ݼ‬ɮɉɘਭᒓᆾᏺʍ႘ৃə

ɫᇀ੡ʣˁ̉ʇᜟႻɶʅɣɾɾʠɊᇉᠷजɫ

ࡩᡑᒓʍʚʇʲʈɪʨɖᆾᏺɗʇɣɥ˝̎ᇀ੡ᆔʊਭᒓɪʨᆌɺʨʫʪɴʝɵʝʉˋʺ

˕ɫৃʨʫɾɲʇɪʨɖਭᒓᆾᏺɗʱ˃̎

̉̍д‫׳‬ʱᥢɴʉɣʧɥີੜʱૠʂʅɣʪɲ

̅̎˟ʇɶɊɼʍ႘ৃʍɾʠʊᇉᠷजɫᔵइ

ʇʱቌɸˁ˜ˊ̀̎ʇɶɾɋ

ʱ៬௨ɸʪˁ˜ˊ̀̎ʇɶɾɋ
ɉǋɉɔᇉᠷजʍʸ˷̎˦֊ʊʧʪ኶᫙ʍՄ᥵ɕ

ɉǋɉɔ˳ʺ̉˞ʍ୑୴ɕ
ɖ़ᒴʇɪޮ੍ʇɪɫɡʪɰʲɊρលɩɖᔵԔʱ‫ݳ‬ɧʅɣɮɋᔵԔʎʸ˷̎˦ʞɥʇ৲ʂʅ ²± ԔহʂɾʨɊɼʍ ²± Ԕাʊɾɣʊ‫ݳ‬ʮʨʉɰʫʏɣɰʉɣʇ৲ʂʅɣ

ޮ੍ʇɪԎʇʂɾʨɊɼʍκʍžρſʉɮʪʍʆɋሯ‫ۓ‬ɾʪᇉᠷд৤ʎପʂʅɣʉɰ

ʉʪɋɗʉʈʍ˝̎˕ɪʨɊਭᒓʇʍˉ˵˻

ʫʏɣɰʉɣɰʈɊɼʍࡩᡑʊʧʂʅথʎ

ˡˇ̎ˍ˽̉ʆᨁ᝸ʉ˕ʺ˵̉ˆ̍ˋʺ

‫ݳ‬ʮʂʅʡɣɣʍɪʉʇɋɗɊɖਭᒓɴʲʊ̉̍д‫׳‬ʉʈɫႻʫɾʇɬɊ᥌ᥴɪʃᆔሯ

ʇʂʅᗹʀᇗɣɾʩʇɪ់ɶʣɸɣ‫ܬ‬ʱʃʊ‫ט‬ড়ɶɼʍ˳ʺ̉˞ʱʃɪʠʪʧɥणʊ

ɮʫʫʏɊ๸ɣఄɫ๨ʱЋʮʉɣʆ‫ٹ‬ʫີੜʱૠʂʅɣʪɲʇʱੜ‫ء‬ɸʪ඘৤ʇɶ

ʪʂʅκɫɩʫʏɊɼʂʀʊʡʂʅɣʂʅŻ¡´´¡Ż

˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬ɣɣʇ৲ɥɋʃɮʪʡʲʉʲʧᶨਭᒓʇᶩ

ɉǋɉɔ഑৔ʍ૳୴ʇࡶɬɕ

ᶲκʆɋɗʉʈʍ˝̎˕ɪʨɊᇉᠷजɫᔵ

ɖਭᒓɴʲɫϺʱលɩɥʇɶʇʪɪɋល

इໂࡗʱᣐʝɧɾͫʆʸ˷̎˦ʍʧɥʊɼ

ᗼʍͼʊᬮɴʫɾɲʇʂʅɡʂɾʩɸʪʧ

ʫʱ഑ʇɶʅପʀʃʃᔵइʍ೘ʱᇁ૜ʊ‫׹‬ʌɋಢ৔ɫɋ
ɗɊɖਭᒓɴʲʡᜟႻʆɬʲʍʮɺʅ‫֊ݳ‬ɴɺɊਭᒓʇᇉᠷजʇʍˉ˵˻

ʲɷʢʉɣɪʉʇ৲ʂʅɋᜟႻʆɬʪʧɥ

ˡˇ̎ˍ˽̉኶᫙ʱՄ᥵ɶʅɣɮɲʇʱੜ

ʊɶʅɶʝʂɾʨᏃථඕɶɪʂɾʩɸʪɲ

‫ء‬ɸʪ඘৤ʇɶɾɋ

ʇɫ‫ݼ‬ɣɷʢʉɣɋɗʉʈʍ˝̎˕ɪʨɊ
ᜟԎʱ‫ۏ‬᭐ʇɸʪਭᒓʍ੡਺ʣᒑɧʉʈ

ɉǌɉɔ‫ל‬дʍ৑ेɕɖਭᒓɴʲɫ৲ʂʅʪɲʇʱ់ɼɥʇɣ

ʱɊᇉᠷजɫਭᒓʍលթɪʨୟ༨ɶɾʩល

ɥ๨ପʀʊʉʂʅʡʨɥɲʇɫ‫ށ‬Οɋঃɬៜ֊ɶɾʩɶʅɊਭᒓɫϧɧʧɥʇɶʅɣ

ԎɼɥʇɸʪʍʆʎʉɮʅɊਭᒓɴʲɪʨʪ഑৔ʱ଻ɧࡶɲɥʇɸʪɲʇʱੜ‫ء‬ɸʪ់ɺʪʧɥʊʉʪʍɫ‫ށ‬ΟɋɗɊɖᶨ់ʱɬɮ

඘৤ʇɶɾɋ

ʇɣɥʍʎᶩਭᒓɴʲɫលɣɾɣɲʇʱ

ɉǌɉɔਭᒓʇʍଢ଼࿢ʍ୛Ꭽʇଞ‫ށ‬ɕលʂʅᎡৃɸʪʝʆɋɗʉʈʍ˝̎˕ɪʨɊ

ɖਭᒓɴʲʇᔵԔʍፍ֫ʉଢ଼࿢ʱ୛ɶʅ

ਭᒓႾពʍɾʠʊਭᒓʍᜟԎʱ৑ेɶʅ‫ל‬ʪɋ˧˗̉ʇ૜ʱ૟ʃʧɥʉʍʱɶʦʂ

ɰӁʫʪɲʇʱੜ‫ء‬ɸʪ඘৤ʇɶɾɋ

ʀʤɥ୛ɶʅʪɋਭᒓɴʲʇᔵԔʍԔɪʩ

ɉǍɉɔ࿶࿢ʍ៬௨ɕ

‫׹‬ɧʪʧɥʉଢ଼࿢ʱɶʦʂʀʤɥ୛ɶʇ

ɖᅖၤʍɲʇʱ‫ל‬ɰหʠɾʩ؇࠳ɶɾʩ

ʪɋɗɊɖᇁ૜ɫᕫʲʉʇɲʬʆᏀ᰺ɫʉɣ

ᓏ࠳ɶɾʩʇɪʂʅɊʈɥɶʧɥʡʆɬ

ԔɿɰਰʞᖐɶʲʆʪʲɿʂɾʨɊᔵԔʍ

ʲɋɼɥɣʂɾ๨ପʀʆᤸɣʲɿʉʇɪɊ

Ꮐ᰺ʱɸʘʅԎɶɬʪɣɥʇɲʬʡ‫ށ‬ΟʉɼɥɣʂɾʇɲʍఄʱϺʇɪɶʅɡɱɾఄ

ʲɷʢʉɣɪʇ৲ɥɋɗʉʈʍ˝̎˕ɪʨɊ

ɫɣɣɪʉʇɣɥੜ‫ء‬ʆɊ‫ݼ‬Ԕᅖၤʇʎ

ਭᒓʇᇉᠷजɫᔵइ᫕ቌɶʅႾពɶ‫׹‬ɧʪԠɊԕʩԔɰʅʪʇ৲ɥɋɗɊɖᇁ૜ʍዒ‫ܬ‬ଢ଼࿢ʱ୛ɶɊႾពʆɬʪᧅԔʱଞ‫ށ‬ɶʅɣʊʉʂʅᒑɧʪɋʆɬʲʊɶʅʡɊͥᇫዒ

ɮɲʇʱੜ‫ء‬ɸʪ඘৤ʇɶɾɋ

ʀหʝʂʅᒑɧʇʪʇɲʬʎɡʪʇ৲ɥɋɗ

ɉɘዒʀϴᑝʍሯ៖əʉʈʍ˝̎˕ɪʨɊˉ˵˻ˡˇ̎ˍ˽̉ʆ

ɖ᫟ФɫʆɬʅɬɾʉʇɊᔵԔɫ᫟Фɫʆৃɾਭᒓᆾᏺɪʨਭᒓʍᅕᆔ̍Ѫ॓ᆔខ࿢ɬʅʪʉʇ੡ɷɾీʊሯ៖ᜓ࿣ʱʇʪɋɗʍ

ʱ᝾ඐʠɊ௨Ⴞɶʅɼʍκʍᆾᏺʱ଻ɧʪ

ʧɥʊɊᇉᠷजɫਭᒓʍលթɪʨਭᒓ̍ᇉᠷ

ɲʇʱੜ‫ء‬ɸʪ඘৤ʇɶɾɋ

जʍ᫟Ф৷ʱ៦ʞ‫כ‬ʬɥʇɶɊਭᒓʍዒ‫ܬ‬ʊɉɘਭᒓͳᄟʍ୮ӟəɾʂɾႾពɫᜓɧʅɣʪɪሯ៖ɸʪˁ˜ˊɖᆾʊ᝾ɧʪʂʅɣɥʍʎɊɼʍκʍಢಿʍߑɫ᝾ɧʅɮʪʂʅɣɥ੡ɷɋɗʍʧɥʊɊ

̀̎ʇɶɾɋ
ɉǋɉɔфκ‫׾‬ʆʍବ‫׾‬ɕ႘ৃɶɾਭᒓᆾᏺɪʨᇉᠷजɫਭᒓʍ੡਺ʣ

ɖρఖɊȾȾɴʲᶨᇉᠷजᶩχΟʉʲɷʢ৲ᒑʉʈӑᮅʍᜟԎʱୟ༨ʣលៜ֊ʆ୸Օɶ

ʌʂʅɋɼɥɣɥκɫ‫ݼ‬ɰʫʏɊɼʍκʊʅᆾʊ᝾ɧʪʧɥʊ଻ɧɊਭᒓ̍ᇉᠷजɫΣʡ‫ݩ‬ɪɰʣɸɣɶɊᅕၤʇɪʆʡಢκʡ់ɣʊᔵइ᫕ቌɸʪɲʇʆɊႾព̍Ӊಐɶ‫׹‬ɧɶʣɸɣɷʢʬɥɶɋɗʉʈʍ˝̎˕ɪʨɊ

ʪᧅԔʱ᝾Ԏɼɥʇɸʪˁ˜ˊ̀̎ʇɶɾɋ

ਭᒓɫɔᇉᠷजɴʲɕʆʎʉɮɔȾȾɴʲɕŻ¡´µ¡Ż

ࢡɉͬ̍ࢡɉࣉᶺᎃቛቿͼ‫ܟ‬ᇉᠷजʊʧʪᎃቛᬬ࠿ᒓʱႾពɸʪᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʍථી᝸Ꭻʇ˭̃ˑˏ

ʇфκ‫׾‬ʆବ‫׾‬ɸʪɲʇɪʨɊਭᒓɫɼʍ

ͼ഑ᶨˉʸˁ˜ˊ̀̎ᶩʇɶɊਭᒓɪʨʍˋʺ

ᇉᠷजʱၔԠʊфκʇɶʅ៖ᇽɶʅɣʪʇ

̉̍д‫׳‬ʱ᥌ᥴɪʃᆔሯʊ੡ᇽɶʅψʍɸʘʅʍ

៦ʞ‫כ‬ʪɲʇʱੜ‫ء‬ɸʪ඘৤ʇɶɾɋˁ˜ˊ̀̎ʊ‫ט‬రɸʪɋᇉᠷजʎʝɹɘਭᒓᆾᏺ
ʍ႘ৃəʱᜓɣɊਭᒓʍዒ‫ܬ‬ʊɾʂʅၑΟʱ଻ɧ

ɉǌɉɔਭᒓɪʨʍើМʍ៦ʞ‫כ‬ʩɕɖɡʩɫʇʌʂʅਭᒓɴʲʇɪࡂఎɪʨ

ʨʫʪʧɥɊɼʫɽʫʍਭᒓʊᔵइʱᦞড়ɴɺʅ

ͥលʆʡលʮʫɾʨρʣʂʅʪɲʇʎ᫙ᦒ

ɣɮɋตʊɘਭᒓͳᄟʍ୮ӟəʗኌʩɊਭᒓᆾᏺ

ɣɷʢʉɪʂɾʲɪʉʂʅɋጏɧɫʉɣɪ

ʍໍᄍɪʨਭᒓʍ੡਺ʣ৲ᒑʱୟ༨ɶលៜ֊ʱ୸

ʨɲɼɊɡʩɫʇɥʂʅលʮʫɾీʊʎɊ

ՕɶɊਭᒓ̍ᇉᠷजɫΣɣʊᔵइ᫕ቌɶʅႾព̍

ɲʫʆᕩɪʂɾʲɪʉ৲ɥɋɗʉʈʍ˝̎

ӉಐʆɬʪᧅԔʱ᝾ԎɶɊଞ‫ށ‬ɶʅɣɮɋ಍Ꮉᆔ

˕ɪʨɊᇉᠷजɫਭᒓɪʨʍើМʱɼʍលʊɘዒʀϴᑝʍሯ៖əʗᔷʩɊᇉᠷजɫਭᒓʍዒ

թɪʨ៦ʞ‫כ‬ʪɲʇʱੜ‫ء‬ɸʪ඘৤ʇɶɾɋ

‫ܬ‬ʊɾʂʅਭᒓʱႾពʆɬʅɣʪɪਭᒓʍលթɪ
ʨើМʱ៦ʞ‫כ‬ʩɊਭᒓႾពʊɩɰʪਭᒓʇᇉᠷ
जʍϴᑝ᫟Фʱሯ៖ɸʪɋ

ᶲᶮᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʍ˭̃ˑˏ
ਭᒓʍӑᮅʍᜟԎʱੜ‫ۑ‬ɸʪˉ˵˻ˡˇ̎ˍ˽̉ʎ᝖ᭉ‫ۏ‬᭐ʉɾʠɊɘᜟ࢜ᆔˉ˵˻ˡˇ̎ˍ˽ΨᶮᏴ‫׹‬ᆔᒑࡗ̉əɊʃʝʩਭᒓɫᜟԎʆɬʪᧅԔɪʨʣʩʇʩ
ʱʎɷʠʪᶨ‫ۑ‬ᶱᶩɋɘᜟ࢜ᆔˉ˵˻ˡˇ̎ˍ˽̉ə

ಢለኴʍᆾᆔʎᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʍ

ʎɊਭᒓʇʍˉ˵˻ˡˇ̎ˍ˽̉ʍ࠷ᣊɪʨɘঃ

ථી᝸ᎫʱనʨɪʊɸʪψʊɊᔵइ૸Ӂˉ˵˻ˡɬԎɶʍከʞͫɱəʊʧʂʅᨁ࢜֊ɶʅɣɮɋᨁ

ˇ̎ˍ˽̉ʍ˭̃ˑˏʱనʨɪʊɶʧɥʇɶʅɣ

࢜֊ʊϪɣɊᇉᠷजʎោᜓ᩺០ɶʅɣɾਭᒓʇʍ

ʪɋɶɪɶɊɲʍ˭̃ˑˏʊʎ‫ీ׽‬ʊᇉᠷजʍી

ˉ˵˻ˡˇ̎ˍ˽̉ɪʨਭᒓႾពʍɾʠʊʎӑᆔᫎ˭̃ˑˏʡ؉ʝʫʪᏃೖʇʉʂɾɋɲʫʎɊࡩ

ͳᄟʗʍʸ˭̃̎˗ɫ৕᝸ʆɡʪʇɣɥɘɬʂɪ

ᡑᒓɫਭᒓʊʧʩ༈ɮˉ˵˙˞ɸʪɾʠʍˉ˵˻

ɰəʱৃʅᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʊ‫؂‬ɪɥɋˡˇ̎ˍ˽̉ᦋ኏ʱ៥నɸʪᬫɊᔵइીᫎʊϪʂᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʎɘʸ̉˜ˠəʱʅৃʨʫɾʡʍɊʝɾʎɼʍ႘ৃᦋ኏ʱᨁខɶʅ

‫ۑ‬ᶱɉᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʍථી᝸Ꭻʇ˭̃ˑˏŻ¡´¶¡Ż

˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬ɩʩɊᇉᠷजʍીᫎ˭̃ˑˏʉɮɶʅʎᔵइ૸Ӂɩɣʅਭᒓʍၤ຤ʱᏴ‫׹‬ᆔʊ଻ɧၤ຤ʊড়ɷʅᨁ

ˉ˵˻ˡˇ̎ˍ˽̉ʍ˭̃ˑˏʱనʨɪʊɸʪɲ

᝸्ʱԟఀʆɬʪͼ‫́˯̂ܟ‬ʊᦑɸʪʊʎɊԞ৔

ʇɫ‫ۏ‬᭐ʆɡʪɾʠʇᒑɧʨʫɾɋɲʍɲʇɪ

ᒓɪʨͥκԳʝʆʍԳ์ᬤɫᮂणʊᨁ᝸ʉੜ‫ء‬ʱʨɊᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʱᔵइ૸ӁˉପʃɲʇɫᒑɧʨʫɾɋԳ์ᬤʍɸʘʅʍථી᝸

˵˻ˡˇ̎ˍ˽̉႘ৃԳʍ์ᬤʇᔵइ૸Ӂˉ˵˻Ꭻʱᣐʝɧʅɘʸ̉˜ˠəʱՄ᥵ɶɊᎃᩞ֊ɶʅ

ˡˇ̎ˍ˽̉ʇʊԔɰɊ‫ח‬ఄʍථી᝸Ꭻʇ˭̃ˑ

ɣɮɲʇɫͼ‫́˯̂ܟ‬ʗʍ᯦ᣱʍዿͥฯʆɡʩɊ

ˏɊɼʍ᫟᥸ʱ៥నɶʅɣɮɋ

ᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉႘ৃ̍ᆌ࢘ʍ᪌ʊʉ
ʪʇᒑɧʨʫʪɋ

ᶱᶮᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉႘ৃԳʍ์ᬤ
ᇉᠷजʎͼ‫́˯̂ܟ‬ʊᦑɸʪʝʆɊਭᒓʍӂϹᶲᶮᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉

҈ɫ૳୴ʆɬɹ٨ᯌʊ࿶࿢ʱɶʛʩɬʫʉɣʇɴɘʸ̉˜ˠəʊɩɣʅᎃቛቿͼ‫ܟ‬ᇉᠷजɫᄍɣ

ʫʅɣʪᶨBennerᶬ³±±¶ᶩɋˉ˵˻ˡˇ̎ˍ˽̉ᬬ

ʪᇀ੡ʇʎͭሯɪʉ੡ងʆʎʉɮɊˉ˵˻ˡˇ̎࠿ʊʧʂʅᔵइᜟԎɫ‫ۏ‬᭐ʊʉʂʅɣʪਭᒓʍល

ˍ˽̉ᬬ࠿ʍɾʠʊɴʝɵʝʉথʆᆌдɴʫʪਭៜᓗ౔ʊࡩɸʪខ࿢ʍͭᢷɫɊᜟᮅᆔʉˉ˵˻ˡᒓɪʨʍˋʺ̉̍д‫׳‬ʱ੡ᇽɸʪሯɪʉ‫ל‬дᓧՏˇ̎ˍ˽̉ʊʇʈʝʪᶱʃʍׄ‫ی‬ʇᒑɧʨʫʪɋ

ʆɡʪɋͼࢡᶨ³±±¶ᶩʎɊਭᒓʍᅕၤ‫֊ݳ‬ʱΜ༨࠽೔̍ᡅ̍μቿ̍ఖᱝ̍μቿᶨ³±±¹ᶩʎɊᎃቛቿ

ᆔʊ଻ɧʪᇉᠷजʍ࡬᫏৷ʎᡋࡎʉᎃቛቿᏀ᰺श

ᇉᠷʱᜓɥʊʎᇉᠷӂϹʍᏀ᰺ʧʩʡᎃቛቿᇉᠷ

௦ʍͼɪʨ႘ৃɴʫʪʇɶʅɣʪɋԳ์ᬤʱᣐʝ

ʍᏀ᰺ɫᨁ᝸ʆɡʪʇɶʅɣʪɫɊρ‫ۋ‬ʍᏃೖʆɧʪɲʇʆਭᒓʇʍˉ˵˻ˡˇ̎ˍ˽̉ɪʨ‫ט‬ড়ʎκᄉᏀ᰺ʍᨁ᝸৷ʡቌٖɴʫɾɋɲʫʎਭᒓʍ

ɸʘɬၔ৏ʣᨁ᝸࿢ʱ૳୴ɶɊਭᒓʍΨᎲʉលթ٨ᯌɫɼʍκʍᄉໍʊഒɵɶʅɩʩɊɴʝɵʝʉ

ʍ‫֊ݳ‬ʣ˃̎̅̎˟ʱࡗᇽɸʪᓧՏɫ᣸ʊʃɬɊ

ᓗ౔ʱପʃκ᫙ʍႾពɫ৕᝸ʇɴʫʪɾʠʇលɧɘʸ̉˜ˠəɫՄ᥵̍ᎃᩞ֊ɴʫʪʇᒑɧʨʫʪɋ

ʪɋʝɾɊᇉᠷजɫᎃቛቿᇉᠷʱႾពɶᓧՏʱᆌ

ʚʇʲʈʍࡩᡑᒓɪʨɖᆾᏺɗʇɣɥᜟႻɫৃ

୷ɸʪʊʎᶵ᷾ ²± शϒͫʍᎃቛቿᏀ᰺श௦ɫ৕

ʨʫɊਭᒓʍӑᮅʱႾពɶʧɥʇɸʪʇɬᇉᠷज

᝸ʇɴʫʅɣʪᶨೋࣉᶬ²ººµᶻ‫ށ‬᝷ψᶬ³±±·ᶻ࠽೔ɫ಍ʡີੜɶʅɣʪɲʇʎਭᒓᆾᏺʆɡʪʇᒑɧ

ψᶬ³±±¹ᶩɋɲʍಜ᫙ʎᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽ɾɋɘਭᒓᆾᏺʍ႘ৃəʎɊਭᒓʍӑᆔͳᄟʱਭ

̉ɫᜓɧʪʝʆʊ᝸ɸʪᔵइ૸Ӂˉ˵˻ˡˇ̎ᒓɫ଻ɧʪʝʝ‫ל‬ɰӁʫʪɾʠʊᇉᠷजɫᔵइʱ

ˍ˽̉႘ৃԳʍ์ᬤᶨϒͬɊԳ์ᬤᶩʍɘঃɬԎ೯ᤈʊ៬௨ɸʪཇѹ์ᬤʆɡʩɊਭᒓႾពʍɾʠ

ɶʍከʞͫɱəʊʧʪˉ˵˻ˡˇ̎ˍ˽̉ʍᨁ࢜

ʍˉ˵˻ˡˇ̎ˍ˽̉᫿࠿᝸‫ی‬ʱኹሐɶʅਭᒓʍ

֊ʱহʃಜ᫙ʇᒑɧʨʫʪɋBennerᶨ³±±¶ᶩʎɊӑᆔͳᄟʗ᥼ʟɾʠʍᨁ᝸ʉˁ˜ˊ̀̎ʆɡʪɋ

˟̂ʺ˫ʷˏ˸˝́ʱᔴॅ࠷ᣊʊᦞᄍɶʅᇉᠷज

ᇉᠷजʍ‫ࡄל‬ᆔ̍҂ᒴᆔੳ्ɫਭᒓʍᆌ់ʱХ᥼ʍᇉᠷ૮ᓧᒂৃ์ᬤʱԞ৔ᒓɊంκɊͥκԳɊͼɸʪʇɴʫʪɫᶨປᄑψᶬ³±±¶ᶻ๼ࣉψᶬ
³±±·ᶻ๮

‫ܟ‬Ɋᦑκʇɣɥᶵ์ᬤʆᜟɶʅɣʪɋԞ৔ᒓʎׄ

ᨂᶬ³±±·ᶩɊਭᒓʍ់ʱ৑ेɶʅɬɮ‫̍ࡄל‬҂ᒴʍԯᥱʩʍᜓթɶɪʆɬʉɣ์ᬤɊంκʎ˂ʺ˟˿

ߑղʇ̀˿˙˅ˏʆɬʪ኶᫙ʍՄ᥵ʊʧʂʅɊਭ

ʺ̉ʊຣʂɾˇʸʎʆɬʪɫၤ຤ԟఀɫಠဒʉ์

ᒓʎᔵԔʍӑᮅʱᔵ࿷ʊɼʍʝʝᜟԎɶʣɸɮʉ

ᬤɊͥκԳʎˏ˪̎˟ʣ೯ᤈ৷ʊʎดɰʪɫɡʪ

ʪɋʝɾɊᇉᠷजʎᔵइໂࡗʱɼʍাʍᇉᠷʊໍ

૮ᓧ̂˯́ʊᦑɶɾ์ᬤʆɡʪᶨBennerᶬ³±±¶ᶩɋɪɶʅɣɮʇɴʫʪɫᶨቬᄑᶬ³±±·ᶻࠪࢨᶬ³±±·ᶻρ‫ۋ‬ʍᏃೖɪʨɊᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʊ

ᙸׄᶬ³±±¸ᶩɊಢለኴʆʎɊᔵइໂࡗাʊʡᇉᠷजŻ¡´·¡Ż

ࢡɉͬ̍ࢡɉࣉᶺᎃቛቿͼ‫ܟ‬ᇉᠷजʊʧʪᎃቛᬬ࠿ᒓʱႾពɸʪᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʍථી᝸Ꭻʇ˭̃ˑˏ

ɫਭᒓʱႾពʆɬʪၤੳʊᔵइʱ៬௨ɶʅɣɮɲ

ᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʎɊɘʸ̉˜ˠəʱʇɫᒑɧʨʫɾɋ

΂ᤌʊ࢘᫕ɴʫʅɣʪɲʇɫቌٖɴʫɾɋɘʸ̉

ɘਭᒓͳᄟʍ୮ӟəʎɊᇉᠷजɫɘਭᒓᆾᏺʍ

˜ˠəʎɲʫʝʆᎃቛቿᇉᠷʊɩɣʅលៜ֊ɶɊ

႘ৃəʊʧʂʅৃɾਭᒓʍខ࿢ʱໍᄍɶɊˉ˵˻

Ӊಐɸʪɲʇɫ‫ۏ‬᭐ɿʂɾᧅԔʇᒑɧʨʫʪɋԳ

ˡˇ̎ˍ˽̉ᬬ࠿ʍɾʠʊ‫ۏ‬᭐ʇɶʅɣɾӑᮅʱ์ᬤʆՄ᥵ɶ຿ᐆɴʫɾɘʸ̉˜ˠəʎɊᔵइ૸

ୟ༨ʣលៜ֊ʉʈʆ୸ՕɶɊਭᒓʍӂϹ҈ʱ଻ɧӁˉ˵˻ˡˇ̎ˍ˽̉ʍψʍɸʘʅʍˁ˜ˊ̀̎ʧɥʇɸʪ์ᬤʆɡʪɋɲʍˁ˜ˊ̀̎ʆʎɊᇉ

ʊম᮰ʱͮɧʪɋɘਭᒓᆾᏺʍ႘ৃəʆʎ႘ৃɶ

ᠷजᔵ᣸ʡᏀ᰺ʣᒑɧʉʈᔵइʱ᫕ቌɶɊਭᒓ̍

ʧɥʇɸʪਭᒓʍᆾᏺʊᇉᠷजɫ‫ל‬ɰ‫כ‬ʂɾᆾᏺᇉᠷजʍ͸ᒓɫႾពɶ‫׹‬ɧʪᧅԔʱ᝾Ԏɶʅɣɮʱဆ‫׹‬ɴɺʪʇɬʊЀᄍɶɊɘਭᒓͳᄟʍ୮ӟəɲʇɫၔ৏ᆔʆɡʪɋӉ੡ʊ৕᝸ʉˏ˃́ʇɶ

ʆʎਭᒓʇᇉᠷजɫᔵइ᫕ቌɶɾӑᆔͳᄟʍ˳ʺ

ʅɊ‫࡭ט‬Ɋనሯ֊Ɋ୛೿ɫɡʪᶨJoyᶬ³±±´ᶩɋᎃ̉˞ʱᆔሯʊ୛ᎭɸʪʇɬʊЀᄍɶɊɘዒʀϴᑝቛቿͼ‫ܟ‬ᇉᠷजʎᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʱ

ʍሯ៖əʆʎਭᒓɪʨʍើМʱɼʍលթɪʨ៦ʞ

ᜓɥᦋ኏ʆɊɘʸ̉˜ˠəɪʨਭᒓʍលթʱ៦ʞ

‫כ‬ʪʇɬʊЀᄍɸʪɋʝɾɊ‫׸‬ˁ˜ˊ̀̎ʆਭᒓ

‫כ‬ʩɊᇀ੡ʊ‫ܛ‬ʄɣɾɲʫʨʍӉ੡ʍɾʠʍ૮᜖

ʍӑᆔͳᄟʍႾពʊͭӌ‫׹‬ɫᄉɷɾʇɬʡɊɘʸʱᰣЋɶʅਭᒓႾពʱ༈ʠʅɣʪʇᒑɧʪɋʝ̉˜ˠəɫЀᄍɶʅᦞԕʉˁ˜ˊ̀̎ʱ঴ಿɶʅ

ɾɊਭᒓʍˡ̎˟ʍᜟԎʱХɸੜ‫ۑ‬ʱପʂɾɪɪ

ਭᒓႾពʱ༈ʠʅɣɮɋʃʝʩɊɘʸ̉˜ˠəʱ

ʮʩʍᨁ᝸৷ɫବ஍ɴʫʅɣʪᶨ๮ᨂᶬ
³±±·ᶻ᭐

঒ʩࣿʨɺɊ᥌ᥴɪʃᆔሯʊ‫ט‬ড়ɶʉɫʨਭᒓʇ

າᶬ³±±¶ᶩɋਭᒓᆾᏺʱ႘ৃɸʪɲʇʆਭᒓɫᜟԎʍˉ˵˻ˡˇ̎ˍ˽̉ʱ༈ʠʅɣɮ˭̃ˑˏʎɊ

ʆɬʅɣʉɣ੡਺ʱୟ༨ɶɾʩɊᒑɧʱលៜ֊ɸ

ᎃቛᬬ࠿ʊʧʩˉ˵˻ˡˇ̎ˍ˽̉ᬬ࠿ʱପʃਭ

ʪ୸Օɫ‫׭‬ᓧʊʉʪʇᒑɧʪɋᎃቛቿͼ‫ܟ‬ᇉᠷजᒓʊࡩɸʪᎃቛቿᇉᠷʍ࡬᫏ᆔʆከඐᆔʉ‫ל‬дᓧʎਭᒓႾពʍɾʠʊਭᒓʍӑᮅʍᜟԎʱ୸ՕɶɊ

Տʆʎʉɣɪʇᒑɧʨʫʪɋ

ᇁΣʊᔵइ᫕ቌɶʅႾពɶৃʪӉಐ࿢ʱ୛ᎭɶɊ
ଞ‫ށ‬ɶʅɣɮʇɣɥనሯʉੜ‫ۑ‬ʱʡʂʅ᫟ʮʂʅ

ᶳᶮρাʍ៨ᯌ
ಢለኴʍᬈᄟʎɊࡩᡑᒓɫᶱʃʍᎃቛቿᅕᬎʊ

ɣʪʇᒑɧʨʫʪɋ
ɘዒʀϴᑝʍሯ៖əʎɊᇉᠷजɫਭᒓႾពʍ኏

մլɸʪᇉᠷजʊᬈ࠳ɴʫʅɣʪ࿢ʆɡʪɋɼʍ

्ʱਭᒓʍលթɪʨើМɸʪ์ᬤʆɡʪɋᇉᠷज

ᅕᬎʍၔ৷ʊं‫ױ‬ɴʫʉɣʧɥɊρাʎԠʍၔ৏

ɫឍࡗɶɾɲʇʱਭᒓʊ˫ʹ̎˟˦˙˅ɸʪɲʇ

ʱʡʃᎃቛቿᅕᬎʊʡࡩᡑᒓʱूɱʅɣɮ৕᝸ɫ

ʎᮂणʊᨁ᝸ʆɡʪᶨቬᄑᶬ³±±·ᶩɋᇉᠷजʎɘਭ

ɡʪɋʝɾɊಢለኴʎˉ˵˻ˡˇ̎ˍ˽̉ᬬ࠿ʱ

ᒓᆾᏺʍ႘ৃəʆᔵइʍᆾᏺʱ៬௨ɶɊɘਭᒓͳ

ၔ৏ʇɸʪᎃቛᅒਭʱʡʃਭᒓʱˇʸɸʪͫʆɊ

ᄟʍ୮ӟəʆӑᆔͳᄟʍဆ‫׹‬ʣӉಐʱᜓɣɊ಍Ꮉ

ਭᒓʍӑᆔͳᄟʊᥖʪɾʠʍˉ˵˻ˡˇ̎ˍ˽̉

ᆔʊʈʫɿɰਭᒓʍዒ‫ܬ‬ʊɾʅʅɣʪɪɊɲʍ์

ʊ࿶࿢ʱɡʅʅɣʪɋᎃቛቿϒ‫ݹ‬ʆʡˉ˵˻ˡᬤʆ˫ʹ̎˟˦˙˅ɶʅɣʪʇᒑɧʪɋ˝̎˕ɪˇ̎ˍ˽̉ᬬ࠿ʍɡʪਭᒓʱˇʸɸʪ෤ϥʎ‫ݼ‬ɣʨৃʨʫɾើМʍ಍ʡၔ৏ᆔʉᆾࠪʎɊᇉᠷजɫ

ɫɊɼʍ‫׹ܬ‬ʊʡড়ᄍ‫׭‬ᓧʆɡʪɪɊᎃቛቿϒ‫ݹ‬ਭᒓɪʨфκ‫׾‬ʆବ‫׾‬ɴʫɊфԠᆔʉ៖ᇽʱ‫ל‬ɰʆ҇ɮᇉᠷजʊ࿶࿢ʱɡʅɾለኴʱᜓʂʅɣɮ৕

ʪɲʇʆɡʪʇᒑɧʨʫɾɋ

᝸৷ɫɡʪʇᒑɧʪɋ

ɉಢለኴʆɊᎃቛቿͼ‫ܟ‬ᇉᠷजɫ࠷ᬫʊᜓʂʅ

M-GTA ʎ࠷ᣊᆔʉໍᄍʍɾʠʍႾ៵ᄉીʍఄ

ɣʪਭᒓႾពʍɾʠʍˉ˵˻ˡˇ̎ˍ˽̉ʆɡʪ

ຫʆɡʩɊ࠷ᣊʍ‫ܬ‬ʆড়ᄍɴʫʪɲʇʆើМʱৃŻ¡´¸¡Ż

˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬ʅɣɮʇɣɥၔ৏ɫɡʪᶨChenitz et alᶮᶬ²ºººᶻಟ

௮ɉႈ

ͬᶬ³±±¸ᶩɋಢለኴʆଇԎɴʫɾ඘৤ʣˁ˜ˊ̀̎‫׾‬ɫρা࠷ᣊʍ‫ܬ‬ʆើМ̍иฬʱ‫ל‬ɰʉɫʨɊড়
ᄍᒓʊʧʂʅʧʩ຿ᐆɴʫɾ‫׾‬ኋʊ‫֊ݳ‬ɶʅɣɮ

BennerᶬPᶮ
ᶨ²ºº³ᶩᶮ From novice to expertᶺ Excellenceand power in clinical nursing practiceᶮᶨ˯ˠ̎ᶬPᶮΥᧅШࠍᶨᆹឰᶩᶨ³±±¶ᶩᶮ¡ ˯ˠ̎ᇉᠷ៵ంឰ၅ɉԞ

ɲʇʱಜহɶɾɣɋ

৔ᒓɪʨᦑκʗɉ֚ࠜಅᬎᶩ
ChenitzᶬWᶮCᶮᶬSwansonᶬJᶮMᶮ
ᶨ²º¹·ᶩᶮ From practiceΩᶮ᠙ɉ᤺¡

to grounded theoryᶺ Qualitative research in nursingᶮᶨ˗ʽˡ˙˚ᶬWᶮCᶮᶬˏ̅̉˓̉ᶬ
JᶮMᶮළ‫̍ࠍ॓ף‬ಢለኴʍ៬೿ʊɳ֩Տɣɾɿɬʝɶɾ A ᎃቛቿᅕᬎʍᆕපɊለኴʍବࡶʇՕលʱɣɾɿɣɾूࣃ
‫۔‬ᬫ‫ܽࠜށ‬ᡅ·ࠍ௟୏Ɋͧᄑਚࠍ௟୏Ɋࡷዻׄᇽ

ኜࢨ௮వᶨᆹឰᶩ
ᶨ²ºººᶩᶮˆ˿ʼ̉˝˙˟̍ˑˀ̀̎
ɉᇉᠷʍᢑᆔለኴʍɾʠʊɉ֚ࠜಅᬎᶩ
DuxburyᶬJᶮᶨ³±±±ᶩᶮ Dif¿cult patientsᶮᶨ˖˅ˏ˯̀̎ᶬ
Jᶮᑼᆏ༒ᶨឰᶩ
ᶨ³±±´ᶩᶮ᭐ɶɣਭᒓɴʲʇʍˉ˵˻

೗௟୏ʊ༈᠙ɣɾɶʝɸɋ

ˡˇ̎ˍ˽̉̍ˏ˃́ᶭ৔ʱᥱʮɺʪ ³¸ ʍఄຫᶭɉᨅᕽ‫ܞ‬ᶩ๼ࣉቔࠍ̍ྰ֞ਚࠍ̍ࣽ໚ᑬ᎚ᶨ³±±·ᶩᶮɔึʊɾɣɕ
ʇឱɧʪਭᒓʊࡉʩ༐ɥˉ˵˻ˡˇ̎ˍ˽̉ˏ˃́
ʍ൮ឡᶭ˭̃ˑˏ̂ˉ̎˟ʊʧʪଶʩ᥏ʩᶭɉఖಢ
ᇉᠷࠜϥ៵௮ᭂᶨᇉᠷᏴ‫׹‬ᶩᶬ́¸ᶬ²²´-²²¶ᶮᙸׄ˅ˡࠍᶨ³±±¸ᶩᶮ ৵৷ಜʊɩɰʪᒐशಜਭᒓʍ‫ۋ‬৊ʗʍ୸Օɉਭᒓᶭᇉᠷज᫟ФЀʩʊ࿶࿢ʱঞʅʅ
ɉఖಢᎃቛቿᇉᠷࠜϥ៕ᶬ¶±ᶨ³ᶩᶬ³ºº-´±´ᶮቬᄑౘࠍᶨ³±±·ᶩᶮ ਭᒓʗʍ˫ʹ̎˟˦˙˅ʊࡩɸʪ
ͥᒑࡗɉᎃቛቿ৵৷ಜᇉᠷʊɩɰʪਭᒓᶭᇉᠷज
᫟Фʍථጶʊ᫟᥸ɶʅɉఖಢᎃቛቿᇉᠷࠜϥ៕ᶬµºᶨ³ᶩᶬ²²µ-²²¹ᶮළ‫̍ࠍ॓ף‬ኜࢨ௮వᶨ³±±µᶩᶮ ᇉᠷࠜ‫ח‬ಅɉᎃቛቿᇉ
ᠷɉƍዞᎃቛᇉᠷࠜʊম᮰ʱ‫ו‬ʛɸ᠈˸˝́ɉƏዞᎃቛᇉᠷʍ҇ɬɪɰɉ௮Ҵ‫ܞ‬ᯮᄑྑᑬࠍ̍᝾ᙸᬟࠍᶨ²ºº¸ᶩᶮ ˇʸʍᢑʱᱝʠʪᇉ
ᠷˁʼ̉ˑ̀̉ˆɉ֚ัᙪԎ၅๽ ་ ਚ ᑬᶨ³±±¸ᶩᶮ Ꮞ ‫ ៬ ވ ׹‬ᅖ ʍ ˉ ˵ ˻ ˡ ˇ ̎ˍ ˽ ̉ ૮ ᓧ ᶭ ̃ ̎ ́ ˭ ̂ ʺ ˜ ˏ ˞ ʱ ᥱ ɶ ʅ ᶭɉ
Schizophrenia Frontierᶬ¹ᶨ³ᶩᶬ¹´-¹¹ᶮϟᙸቔ᎚ࠍᶨ³±±´ᶩᶮ ਭᒓᶭᇉᠷᒓ᫟ФʊɩɰʪӉ੡ʍ˭̃ˑˏɉఖಢᇉᠷቿࠜϥ៕ᶬ³´ᶨ²ᶩᶬ²µ-³¶ᶮປᄑᒅ̍ᨂಳᭁᑬ̍ᄑ᥆हࠍ̍ࠨ᡼ቛ·ᑬࠍ̍ࡷ೼ࡻ
ࠍ̍ܽྙᇀᑬ̍Ϸᙸ؅ࠍ̍‫·ށ‬в˕˵ࠍᶨ³±±¶ᶩᶮဒᐆᇉᠷजʍਭᒓʇʍᇁΣ᫟Фʊɩɰʪ҂ᒴᆔੳ्ɉఖಢᇉᠷࠜϥ៵௮ᭂᶨᇉᠷጫႾᶩᶬ́·ᶬ³¹³-³¹µᶮ
KingdonᶬGᶮᶬTurkingtonᶬDᶮᶨ²ººµᶩᶮ Cognitive-Ż¡´¹¡Ż

ࢡɉͬ̍ࢡɉࣉᶺᎃቛቿͼ‫ܟ‬ᇉᠷजʊʧʪᎃቛᬬ࠿ᒓʱႾពɸʪᔵइ૸Ӂˉ˵˻ˡˇ̎ˍ˽̉ʍථી᝸Ꭻʇ˭̃ˑˏ

behavioral therapy of schizophreniaᶮᶨׄᄑ៝ͥᶨឰᶩ

ɉ֚ࠜಅᬎ

ᶨ³±±³ᶩᶮᏎ‫៬ވ׹‬ᅖʍ៖ᇽᜓթᅸຫɉఖಢើ៵቎ᶩ

ͼࢡᑬਚࠍᶨ³±±·ᶩᶮ ᎃቛቿᇉᠷजʍਭᒓʇʍɪɪʮ

ಟͬ॓μᶨ²ºººᶩᶮ ˆ˿ʼ̉˝˙˟̍ˑˀ̀̎̍ʸ˭ʩʍͼʆʍ੡਺ᜓթʇࡩԂᜓթᶭᎃቛᆔѪ॓ʱࠩʪ̃̎˗ɉᢑᆔ࠷ាለኴʍӖᄉɉআ௮‫ܞ‬ɾʠʍͥᒑࡗɉఖಢᇉᠷࠜϥ៵௮ᭂᶨᎃቛᇉᠷᶩᶬ

ಟͬ॓μᶨ³±±´ᶩᶮ ˆ˿ʼ̉˝˙˟̍ˑˀ̀̎̍ʸ˭̃̎˗ʍ࠷ᣊɉᢑᆔለኴʗʍ៚ɣɉআ௮‫ܞ‬´·ᶬµ¸-µºᶮ᭐າᄒᰖᨀᶨ³±±¶ᶩᶮ ਭᒓʱ΂ϹᆔѪ॓ᜓթʊࡶɣɾ

ಟͬ॓μᶨ³±±¸ᶩᶮ ˿ʺˬ᠘ᑵ M-GTAɉ࠷ᣊᆔᢑᆔ
ለኴຫɉиฬ၅ˆ˿ʼ̉˝˙˟̍ˑˀ̀̎̍ʸ˭̃̎˗ʍɸʘʅɉআ௮‫ܞ‬ΟАʍԔ೒ɉ˰˭̃ʼʍκ᫙᫟Ф៵ʱᄍɣʅɉ‫ޏ‬ᕩᇊዒͪ࠺ᅕᬎᇉᠷࠜᭉ៕ᶬ³²ᶬµ±-µ´ᶮ‫ݶ‬ᆾᑬᡴࠍᶨ³±±¸ᶩᶮ ᖐᅞʱϪɥ੾৷ᅒਭਭᒓʊɪɪ

Գࣽᦽᑬ̍Υᙸਚᑬࠍᶨ³±±¶ᶩᶮ ͭࠪʣ࿶ဤʍওɣਭ
ᒓʇʍ᫟ʮʩఄʱຟᅸᆔˉ˵˻ˡˇ̎ˍ˽̉૮᜖ʱ
ᄍɣʅᒑɧʪɉఖಢᎃቛቿᇉᠷࠜϥ៕ᶬµ¹ᶨ²ᶩᶬµ¹-ʮʪᇉᠷजʍӉ੡ʍ˭̃ˑˏʊ᫟ɸʪለኴɉ֚ࠜʇ
ᄉၑࠜᶬ²¶±ᶨ¸ᶩᶬ³¶¸-³··ᶮ‫ށ‬᝷ᄒᑬ̍‫ࢨ׺‬ᠵΠ̍‫ح‬ᄑ៝̍ೋᄑҥࠍ̍᝷ᨂ‫ح‬᡼ࠍ̍ࢡಢᇍႾ̍ࢨᧅρಚᑬᶨ³±±·ᶩᶮ ᎃቛቿਭᒓɫटࠧ

µºᶮೋࣉྑࠍᶨ²ººµᶩᶮ ᎃቛቿᇉᠷᒓɫᨁ᝸ខɶʅɣʪ
ᇉᠷᒓᶭਭᒓ᫟ФʍପʀఄɉᎃቛвѪᇉᠷϥ៕ᶬ́
ᶨ²ᶩᶬ¹µ-¹¹ᶮᯓಙʱឱɧʅɬɾʇɬʍ˯˜˿̉ˠ̎ˏʍ૮ɉఖಢ
ᇉᠷࠜϥ៵௮ᭂᶨᎃቛቿᇉᠷᶩᶬ́¸ᶬ²µ³-²µµᶮۭᄑͪҭ̍ᦘᙸ໺ᑬᶨ³±±±ᶩᶮ ᎃቛቿᇉᠷʇ̀˥˩̀

֪ᝃࠍᶨ³±±¹ᶩᶮ ᇉᠷʊɩɰʪለኴɉఖಢᇉᠷ֩ϥԎ၅ϥ˜̎ˍ˽̉ɉ֚ࠜಅᬎ
ᄑᄢຟᶨ²ºº¹ᶩᶮ ˅˿ʺʾ̉˞ͼ৔ᅸຫɉႻϐʍʾˏ࠽೔ᦽࠍ̍ᡅ‫ݼ‬๼ࠍ̍μቿቔࠍ̍ఖᱝᕬࠍ̍μቿह೗
ᶨ³±±¹ᶩᶮ ᎃቛቿᇉᠷʍᔴॅᓧՏʇᔴॅᏀ᰺श௦ʍ

˭̀ɉNoᶮ́¸µᶮᔷ௮‫ܞ‬འທूয়ᶨ³±±·ᶩᶮ ৔Ⴞᔴॅʍఄຫ៵ʊʃɣʅʍͥᒑ
ࡗɉಣपࠜᬎ‫ࠜށ‬κ௮ࠜϥ᎚᝸ᶬ̧ºᶬ³²-µµᶮ᫟Фɉᒨ˴̀ʸࠜᬎ᎚᝸ᶬ³³ᶬ³º-´µᶮ๮ᨂʑʬࠍᶨ³±±¶ᶩᶮ ᒴɬ૜ᶨᇉᠷजᶩʍੳ्̍ᜓթ

ࠪࢨͪ೗ᶨ³±±·ᶩᶮ ࡩκͭࠪʍɡʪᏎ‫៬ވ׹‬ᅖਭᒓʍɫ់ɶ૜ᶨ˅˿ʺʾ̉˞ᶩʍ਺թ‫ט‬ড়ʊ‫ו‬ʛɸম᮰ᥠᬎʊ‫؂‬ɰʅʍ୸Օɉਭᒓᶭᇉᠷज᫟Фʍᆌ࢘ʊʇᆌ់Х᥼՞ೖʊʃɣʅɉӉ੡ᆔႾពɔ‫ࡄל‬ᆔੳ्࿶࿢ʱɡʅʅɉఖಢᎃቛቿᇉᠷࠜϥ៕ᶬµºᶨ³ᶩᶬ³±´-ʍ૮᜖ɕʍខ࿢ɪʨɉᇉᠷ௟ᓑᶬµ¸ᶨºᶩᶬ¹³³-¹³¶ᶮ³±¸ᶮ

ͼΥ·‫ףࢡ̍ބ‬ᇀদᶨ³±±²ᶩᶮ ᇉᠷʍɾʠʍᎃቛ֚ࠜŻ¡´º¡Ż

˨˻̎˴̉̍ˇʸለኴɉዿ²´ऍɉዿᶱ‫׳‬³±²³शᶶಏɉµ±-¶³᮱

Journal of Human Care Studies Vol. ²´ No. ²
June ³±²³, pp µ±-¶³ׄɉᗾᓥᔕͼᆣᔃਭᒓʍˇʸʊɩɰʪᇉᠷजʍ‫ۏ‬᭐ᫎೋɉ॓ࠍᶱᶩ¡¡̍¡¡‫ܝ‬ӑɉીࠍᶱᶩ¡¡̍¡¡‫כ׾‬ɉᭀ‫״‬ᶲᶩ

Dif¿culties faced by nurses in caring for patients withmalignant pleural mesothelioma
Yasuko Nagamatsu ᶱᶩᶬShigeko Horiuchi ᶱᶩᶬYuji Natori ᶲᶩ

Abstract
ObjectiveᶺThis study was to explore nurses' dif¿culties in taking care of patients with malignant pleural
mesothliomaᶨMPMᶩᶮ
Methodᶺ21 nurses who cared for MPM patients were interviewedᶮData was qualitatively analyzedᶮ
The
Research Ethics Committee of StᶮLuke's College of Nursing approved the studyᶮ
ResultᶺDif¿culties faced by nurses caring for MPM patients were categorized intoᶺ ǋ groping forcareᶻǌ failure of introducing palliative careᶻǍ limitation of support for patients' decision makingᶻǎ dif¿culty in dealing with familiesᶻǏ short of communication skillᶬand ǐ painful being with MPM
patientsᶮ
ConclusionᶺEducational programs and supports are necessary because nurses faced many complex
dif¿culties in the care of the MPM patientsᶮ
Key wordsᶺasbestosᶬmalignant pleural mesotheliomaᶬnurse dif¿cultyᶮΣᶮለኴʍᓗ౔ʇᆾᆔSymanowski & Rusthovenᶬ³±±µᶩɋᖓ‫۔‬ᓥᧅࠜϥʎɊࠬຟɫඐʠʅኍʉɲʇɊ឴ఀಜਭᒓʍᶴՁɫഒຟ

ͼᆣᔃʎɊͼᆣᎲᓞʊᄉɷʪ਱৷ᔃᅮʆɊɼʍ

ᅸຫʊᦞɴʉɣɲʇɊ‫ݼ‬ɮɫ឴ఀీɪʨᐂ‫ح‬ᅸຫ‫֤ށ‬ɫʸˏ˯ˏ˞ᶨሃᏰᶩʊʧʂʅɩɲʪᶨ൛

ʱ৕᝸ʇɸʪᅖၤʱ‫ؗ‬ɸʪɲʇɪʨɊᐂ‫ˇح‬ʸࡶ

๮ᶬ³±±¹ᶩɋᓥᔕͼᆣᔃʎ݇Ւ҂‫؂‬ʊɡʩɊ³±±±Ӂʱᓥᔕͼᆣᔃˇʸʍᨁ࿢᮴ᆾʊ଱ɱɊᓓɫʲ̍शɪʨ µ± श᫙ʆᄕ৷ɿɰʆʡ ²± ͨκɫึέɸͼᆣᔃ࡬᫏ᇉᠷजɫˇʸˉ̎˝ʹˣ̎˕̎ʇɶʅʪ ʇ ʍ Μ ༨ ʡ ɡ ʪᶨMurayamaᶬTakahashiᶬNatoriʍ঱ՁʱଉɥʘɬɿʇɶʅɣʪᶨBritish Thoracic& Kurumataniᶬ³±±·ᶩɋ ᓥ ᔕ ͼ ᆣ ᔃ ʎ ɳ ɮ Ԟ ಜ ʍ

Society Standard of Care Committereᶬ³±±¸ᶩɋ ʝ ɾ‫ݹ‬ቿᅸຫϒ‫ݹ‬ʊഒຟᅸຫɫʉɮɊᶲशɩʧʒᶵ

ᡓ‫۔‬ʍ፫ɷʲᅕᝆңϥʎɊᓥᔕͼᆣᔃਭᒓʊʎʾ

शᄉࠓ႟ʎɼʫɽʫ ³º.·ᶥɊ´.¸% ʇඐʠʅΜা̉˟ˀˬ˿ʺ˫ˇʸʣɼʍাʊឭʫʪึʊʃɣʅ

ɫ਱ɣᶨͪ໘ᶬ³±±¹ᶩɋʝɾɊᓓɫʲʇ๚ʘʅʧ

АʱᄍɣɾԔɪʩʣɸɣ៥నɫ৕᝸ɿʇɶʅɊɼʩ ‫ ݼ‬ɮ ʍ ᅖ ၤ ɫ Ԏ Ⴛ ɸ ʪᶨHollenᶬGrallaᶬLiepaᶬʍ୯ЙʱᜓʂʅɣʪᶨHawley & Monkᶬ³±±µᶩɋɲᶱᶩᒨᣈՒᇉᠷ‫ࠜށ‬ᇉᠷࠜᧅᶨSt. Luke's College of Nursing,Department of Nursingᶩᶲᶩ֚ᅸຫκ቎‫ۍ‬ʑʨʍΘ૔ʑʝʮʩ឴ᅸ૗ᶨHirano Kameido Himawari Clinicᶩ‫ל‬ኢ ³±²².¸.³³ɉ‫ל‬Ⴞ ³±²².²³.³¸Ż¡µ±¡Ż

ᫎɉೋ̍‫ܝ‬ɉӑ̍‫׾‬ɉ‫כ‬ᶺᓥᔕͼᆣᔃਭᒓʍˇʸʊɩɰʪᇉᠷजʍ‫ۏ‬᭐ʍʧɥʊɊࠬຟɫඐʠʅኍʆɊ᥼ᜓɫᥴɣᓥᔕͼΤᶮለኴఄຫ

ᆣᔃʊࡩɶʅʎɊ឴ఀಜɪʨ˕̎˵ˠ́ˇʸʱੜᠪɶɾˇʸʱ୯Йɸʪ৕᝸ɫɡʪɋʮɫ‫۔‬ʆʎɲᶱᶮለኴ˝ˌʺ̉

ʫʝʆͼᆣᔃʇ឴ఀɴʫʪਭᒓɫࡸʉɪʂɾɲʇ

ᓥᔕͼᆣᔃਭᒓʍˇʸʊஉʮʪᇉᠷजʍˇʸͫɪʨɊᆌᄉᧅϴʱ٨ʮɹͼᆣᔃʊ᫟ɸʪᇉᠷԔᨂ

ʍ‫ۏ‬᭐ʱɊᇉᠷजʍៜʩʱᥱɶʅ୛Ꭽɸʪᢑᆔट

ʍለኴʣ‫ؙܫ‬ɫᮂणʊࡸʉɣɋቾࢡᶨ³±±·ᶩʎɊᎡᆔ˝ˌʺ̉ʱᄍɣɾɋ

ͼᆣᔃਭᒓʗʍឭ٨ᇉᠷʍᏀ᰺ɪʨɊ৵ᥴʊᅖ
ၤɫ᥼ʟͼʆɊQOL ʱᱝʠʉɫʨɼʍκʨɶɮᶲᶮለኴ֩Տᒓ

ɸɳɺʪʧɥ៬௨ɸʪɲʇɫᨁ᝸ɿʇɶʅɣʪɋ

ͼᆣᔃਭᒓϥʊКᯈɶɊᦋ‫א‬ᶱश᫙ʊϥ‫ى‬ɫຟᗿ᝷̍ಢᄑᶨ³±±ºᶩʎɊͼᆣᔃਭᒓʍ‫ݼ‬ɮɫ‫׽‬ҍᅸʣˇʸʱ‫ל‬ɰɾ ²µ ʍ֚ᅸ෤᫟ʍ਺‫ܫ‬ʱ୯ЙɶʍᆌᅖʱᏀ᰺ɶɊ‫ל‬឴ɶɾీ࿢ʆͭࠪʇᖐਰʊɡ

ʅʡʨɣɊɼʫɽʫʍᇉᠷᧅᫎʊಅᮅʆ៬೿֩Տ

ʪɲʇɪʨɊሯ࠳឴ఀԳɪʨʍ৔Ⴞᆔோ୸ɫ৕᝸

ʱКᯈɶɾɋ֩ՏʍᄔɶԎʍɡʂɾ ²³ ʍ֚ᅸ෤ɿʇɶʅɣʪɋᓥᔕͼᆣᔃਭᒓʱࡩᡑʇɶɾ៬೿

᫟ʍᇉᠷᧅᫎʊ᝖௦ʍᓥᔕͼᆣᔃਭᒓʍˇʸᏀ᰺ʆʎɊਭᒓʎɊ᭐ຟ৷ʍ਱৷ᅒਭɊऔࡸᅒਭɊሃ

ʱಐɸʪᇉᠷज ³² ‫׾‬ʱᎶςɶʅʡʨɣɊለኴ‫ב‬Ᏸ᜴࠿ʊʧʂʅᢰɲʪʇɣɥᓥᔕͼᆣᔃʍၔ৷ɪ

Ւʍ‫׽‬ੜʍৃʨʫɾ ³² ‫׾‬ʱࡩᡑʊʺ̉˕˩˻̎

ʨᄉɷʪපɍʉ‫ۏ‬᭐ʱϹ᰺ɶʅɣɾɋɶɪʡψʍʱᜓʂɾɋɫʲʍʧɥʊᅖၤʍᗹʀᇗɣɾీಜɫʚʇʲʈʉɮɊ឴ఀɪʨᎹಡಜʝʆͥ๨ʊ᥼ᜓɸʪɾʠɊʑᶳᶮ˝̎˕‫י‬ᭂఄຫʇʃʍ‫ۏ‬᭐ʱព຅ɸʪԳʊంɾʉ‫ۏ‬᭐ɫᆌᄉɶʅ

ʺ̉˕˩˻̎˂ʺ˟ʱᄍɣɾ֤ථ᥵֊ᮅଢ଼ʱ

‫ۏ‬᭐ʍᨁ࢜֊ɫᄉɷʅɣɾᶨᫎೋ̍‫ܝ‬ӑ̍‫כ׾‬ᶬᜓʂɾɋለኴ֩Տᒓʍ࢙৷ʊʃɣʅʎʸ̉ˇ̎˞

ִԨͼᶩɋɲʫʨʍҳᜓለኴʎɊᓥᔕͼᆣᔃʍၔᄍᎧʱᄍɣʅ਺‫יܫ‬ᭂʱᜓʂɾɋ

৷ʱʧɮႾពɶʅɊ٨ᯌʱΜಜɶɾˇʸʱᦞฬʉీಜʊ୯ЙɸʪɊၔʊᅖၤˉ̉˞̃̎́ʱ؉ʠɾ

ᶱᶩʺ̉˕˩˻̎˂ʺ˟ʍЀી˕̎˵ˠ́ˇʸʱచಜɪʨཇѹɸʪ৕᝸ɫɡʪɲ

ᓥᔕͼᆣᔃʊʎɊɫʲᇉᠷɊၔʊ˕̎˵ˠ́ˇ

ʇʱቌɶʅɣʪɋɶɪɶɊᓥᔕͼᆣᔃʊ᫟ɸʪ៍ʸɫ৕᮶ʆɡʪʇᒑɧʨʫɾɲʇɪʨɊᎹಡಜɫ

ɶɣᇉᠷ௟ಲʣˇʸʍ˂ʺ˟˿ʺ̉ʎʉɮɊ‫֚׸‬ʲਭᒓʍˇʸʊɩɰʪᇉᠷजʍ‫ۏ‬᭐ᶨSasaharaᶬᅸఆឮʊɩɰʪᓥᔕͼᆣᔃᅖАɫࡸʉɣુɫ‫۔‬ʆMiyashitaᶬKawa & Kazumaᶬ³±±´ᶻ Ւ ᙸᶬ³±±¹ᶩ ʱʎɊᇉᠷजʍᓥᔕͼᆣᔃʊ᫟ɸʪᇽᠪʣᏀ᰺ɫͭ

‫ב‬ᒑʊጅᒓʨɫʺ̉˕˩˻̎˂ʺ˟ʱЀીɶɊᓥᢷɶɊˇʸʊ‫ۏ‬᭐ʱɬɾɶʅɣʪ‫׭‬ᓧ৷ɫɡʪɋ

ᔕͼᆣᔃਭᒓʍˇʸᏀ᰺ʍɡʪᇉᠷजᶲ‫׾‬ʇ‫؎ئ‬ɼɲʆಢለኴʎɊᓥᔕͼᆣᔃਭᒓʍˇʸʊɩɰʪ‫ګ‬ӑቿ֚जʊੜ᝾ʱ๳ʠɊ޸ঞ৷ʇ៬೿࠷Ⴛ‫׭‬ᓧᇉᠷजʍ‫ۏ‬᭐ʱనʨɪʊɸʪɲʇʱᆾᆔʇɶɊɼ

৷ʍሯ៖ʱᜓʂɾɋᢑ٨ӑࡄʎɊᓥᔕͼᆣᔃਭᒓʫʱᓥᔕͼᆣᔃਭᒓʍˇʸʱᜓɥᇉᠷजʊࡩɸʪ

ʍ඘᝸Ɋለኴ֩Տᒓɫ᫟ʮʂɾీʍਭᒓʍපࠍʇ

ோ୸ጐʊ঱ዒʅɊʑɣʅʎᓥᔕͼᆣᔃਭᒓʗʍˇ

ᜓʂɾˇʸ‫ו‬ʒˇʸͫʍ‫ۏ‬᭐ʇɼʍႾᄒʆɡʂɾɋʸʍ‫ͫ؂‬ʊᢁɸʪɲʇʱੜ‫ۑ‬ʇɸʪʡʍʆɡʪɋ
ᶲᶩᮅଢ଼ʍ࠷ఆఄຫ
ለኴ֩ՏᒓɫɊঞీʍၤ຤ʱ৲ɣԎɶʣɸɣʧ
ɥɊԞʠʊǋ‫ל‬ɰପʂɾਭᒓʍᅕ๨ʣຟᅸʍᏀᦋ

Ż¡µ²¡Ż

˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬

ʇǌਭᒓɫ৔᣸ᮅʆʈʲʉ٨ᯌʱଂɧʅɣɾɪʊ

ʱ៥నɶɊ‫׽‬ੜʱৃʨʫɾᒓʍʞʱࡩᡑʇɶɾɋ

ʃɣʅɊӁᬎɪʨᥠᬎʇɣɥʧɥʊᏀీᆔʊ់ɶ

ʉɩɊಢለኴʎᒨᣈՒᇉᠷ‫ࠜށ‬ለኴјႾ࡟೿߆‫ى‬ʅʡʨɣɊɼʍͫʆɊǍᇉᠷजʇɶʅʈʍʧɥʉ

ϥʍ࡟೿ʱ‫ל‬ɰɊ૭៖ɴʫɾᶨ૭៖ᄰ‫ ׳‬²±-±´¹ᶩɋɲʇɫ‫ۏ‬᭐ʆɡʂɾɪʱៜʂʅʡʨʂɾɋለኴ֩
ՏᒓɫᔵᄒʊៜʫʪʧɥɊɔʈʲʉɲʇɫ‫ݳށ‬ʆΥᶮᏃೖɶɾɪᶿɕʇ‫ށ‬೘ʉᢑ٨ʱɶɊϺʱ಍Ԟʊៜʪɪ
ʊʧʂʅለኴ֩ՏᒓɫϺʱ಍ʡᨁ᝸ʉ٨ᯌʇɸʪ

ᶱᶩለኴ֩Տᒓʍ࢙৷ᶨᜟᶱᶩ

ɪʱႾពɸʪʧɥʊɶɾɋ಍াʊɊʺ̉˕˩˻̎

ለኴ֩ՏᒓʎɊ᝖௦ʍᓥᔕͼᆣᔃਭᒓʍˇʸᏀ˂ʺ˟ӑࡄʍɥʀᮅଢ଼ͼʊԎʅɲʉɪʂɾ᮴ᆾʊ

᰺ʍɡʪާ৷ ³± ‫׾‬Ɋᄕ৷ᶱ‫׾‬Ɋឞ ³² ‫׾‬ʍᇉᠷजᬈʂʅᢑ٨ɶɾɋᮅଢ଼ీ᫙ʎ ·± Ԕɪʨ ²¶± Ԕʆवʆɡʂɾɋ૗࢙֚ᅸ෤᫟ʎɊ᫟೅ɪʨͼ‫ۨ۔‬ఄʍ‫ ۮ‬¹¸.µ Ԕʆɡʂɾɋʺ̉˕˩˻ʸ̎ʎጅᒓʆɊ៬

ͼ഑ᅕᬎʇ‫ࠜށ‬ᅕᬎʍ‫ګ؎ئ‬ӑቿɊ‫ݹګ؎ئ‬ቿɊ೿ʎ˭˿ʺ˦ˍ̎ɫвʅʪ‫ܬ‬૗ʆ࠷ఆɶɾɋ˝̎ᐂ‫ˇح‬ʸ‫ו‬ʒឭ٨ᇉᠷˏ˜̎ˍ˽̉ʆɊᔴॅᏀ᰺

˕‫י‬ᭂಜ᫙ʎ ³±²± श ²± ಏɪʨ ²³ ಏʆɡʂɾɋ

ʎᶲशɪʨ ´· शʆव‫ ۮ‬²².º शă ·.± शʆɡʂɾɋˇʸᏀ᰺ʍɡʪᓥᔕͼᆣᔃਭᒓ௦ʎɊᶲ‫׾‬ɪʨᶴᶮԔ೒ఄຫ

²±± ‫׾‬ϒͫʆɡʂɾᶨᜟᶲᶩɋ

Ԕ೒ʎɊˆ̂˙ˆᶨ³±±¸ᶩʊʧʪᢑᆔឧᥙᆔԔ
೒ຫʱ‫ב‬ᒑʊᜓʂɾɋ

ᶲᶩᓥᔕͼᆣᔃਭᒓʍˇʸʊɩɰʪᇉᠷजʍ‫ۏ‬᭐ʝɹለኴ֩Տᒓʍៜʂɾӑࡄʱᥩៜឧ᩻ʊɩɲ

ᶨᜟᶳᶩɶɊለኴ֩Տᒓಢκʊʧʪሯ៖ʱᏀɾɥɧʆฬॾ

Ԕ೒ʍᏃೖɊᶶʃʍˁ˜ˊ̀̎ʇ ²º ʍˋˬˁʉᥩៜ᩻ʇɶɾɋตʊɊᥩៜ᩻ʱᐴʩ᥏ɶ៦ʞɊ

˜ˊ̀̎ɫଇԎɴʫɾɋˁ˜ˊ̀̎ʎɊ
ɐಠᏀ᰺ᓥᔕͼᆣᔃਭᒓʍˇʸʊɩɰʪ‫ۏ‬᭐ʱቌɸᬗᥙʱ

ʥɧʍ૜୛ʩʍˇʸɑɊɐࡶӁʆɬʉɣᐂ‫ˇح‬ʸɑɊለኴ֩ՏᒓʍលᗼʍʝʝଇԎɶʅɊੜ‫ء‬ʱ୽ʉʮɐੜ৲຅࠳ோ୸ʊɩɰʪᬈᄟɑɊɐࡂఎʗʍࡩড়ʊ

ʉɣ኏्ʊనᇬʊᜟႻɶʅˉ̎˟֊ʱᜓʂɾɋต

ɩɰʪᖐ઄ɑɊ
ɐˉ˵˻ˡˇ̎ˍ˽̉ˏ˃́ͭᢷɑɊ

ʊឧᥙӑࡄɫ‫׽‬ᯕʍʡʍʱʑʇʝʇʠʊɶʅӉᥱɐᇉᠷजᔵ᣸ʍᤸɣ๨ପʀɑɪʨʉʪɋϒͬʊˁɸʪੜ‫ء‬ʱᜟʮɸʧɥᜟႻɶɊˋˬˁ˜ˊ̀̎ʇ˜ˊ̀̎ʊʃɣʅˋˬˁ˜ˊ̀̎ʱɡɱʉɫʨ៥

ɶɊ‫׽‬පʊˋˬˁ˜ˊ̀̎ɪʨˁ˜ˊ̀̎ʱЀીనɸʪɋɐɉɑʎˁ˜ˊ̀̎ʱɊɒɉɓʎˋˬˁ˜ɶɾɋˊ̀̎ʱቌɸɋ

ʉɩɊԔ೒ʊɡɾʂʅʎᢑᆔለኴʍ࡬᫏ࡂɪʨ

ɉɐಠᏀ᰺ʥɧʍ૜୛ʩʍˇʸɑˏ̎˧̎˩ˎ˽̉ʱ‫ל‬ɰʉɫʨᜓʂɾɋ

ɒᓥᔕͼᆣᔃʍᇽᠪͭᢷɓɊɒ٨ᯌʱΜ༨ɶɾˇʸɫʆɬʉɣɓɊɒᓥᔕᓓӂ஍᜖াʍጫႾɫ᭐ɶ

ᶵᶮјႾᆔ᧖઄

ɣɓɊɒˉ̉˞̃̎́ʆɬʉɣᨁɣᅖၤɓʍˋˬˁ

៬೿ʊҳዒʀɊ֩Տᒓʍ૗࢙ɸʪ֚ᅸ෤᫟ʍᇉ

˜ˊ̀̎ɪʨીʪɋϒͬʊɊɼʫɽʫʍˋˬˁ˜ᠷᧅᫎʊΛ૭ʱৃɾɋКᯈ௮ಅʇ‫ף‬ᯃʆɊለኴ֩

ˊ̀̎ʊʃɣʅᥙʘʪɋʝɾɊ
ɔɉɕӑʊˊˍ˙ՏʎϙੜʆɡʩɊ֩ՏɶʉɣɲʇʆͭԢᆯʱ᜴ʪ

˅Ϲʆ֩Տᒓʍៜʩʱ଺ӁɶɊʮɪʩʊɮɣʇɲ

ɲʇɫʉɮɊɣʃʆʡ֩ՏʱͼఀʆɬɊ˝̎˕ʎʬʊʎᶨɉᶩʍͼʊលᗼʱᝆʂɾɋ

ለኴᆾᆔʍʞʊЋᄍɶɊфκʱ‫࠳׽‬ɶʉɣথʆ‫ܫ‬ɒᓥᔕͼᆣᔃʍᇽᠪͭᢷɓ

‫ؙ‬ಅɊࠜϥɊ៵௮ጇʆᆌᜟɸʪ‫׭‬ᓧ৷ɫɡʪɲʇ

ᓥᔕͼᆣᔃʊ᫟ɸʪᇽᠪɫͭᢷɶʅɣʪɾʠɊ

Ż¡µ³¡Ż

ᫎɉೋ̍‫ܝ‬ɉӑ̍‫׾‬ɉ‫כ‬ᶺᓥᔕͼᆣᔃਭᒓʍˇʸʊɩɰʪᇉᠷजʍ‫ۏ‬᭐ᜟᶱɉմլᧅᑟ

ᜟᶲɉˇʸᏀ᰺ʍɡʪᓥᔕͼᆣᔃਭᒓ௦

ᜟᶳɉᓥᔕͼᆣᔃʍˇʸʊɩɰʪᇉᠷजʍ‫ۏ‬᭐ᇉᠷजʎɊᯕϯɸʪʇ৲ʮʫʪᓓɫʲʗʍˇʸʱʅɊੜ‫ء‬ɫ࿵ɣʇ৲ʂɾɋሃᏰɊᅉࠜɊΜাͭᕩ‫ב‬ᒑʊɶʅɊᅖၤʊড়ɷɾˇʸʱᜓʂʅɣɾɋ

ʍᶳʃɿɰʆɊɡʇʎ঱ʊዒɾʉɣɋຟᅸຫɊ֊

ɔͼᆣᔃʊʃɣʅʎʮɪʨʉɣʍʆɊᓓɫʲʇࠜᅸຫʍᙪԺɊ൮೿Ɋ᜖াʊᥠᬎɶʅᔵࠧʊࢍʨ

‫ݳ‬ʮʨʉɣʍʆʎʉɣɪʇɊᅞʞɊਘᖐɶɴɊᓥ

ʫʪಜ᫙ɫᇽʩɾɣɋɼɥɸʫʏ‫ࠧۦ‬ᶨˇʸ˗̎๬ʇɣɥᅖၤʊࡩɶʅϺʇɪ૜୛ʩʆʣʂʅɬ

˶ᶩʊКᯈɸʪీʊɊʈɲʊີੜɶʅʚɶɣɪϧɾɋͼᆣᔃʆɡʂʅᓓɫʲʆʎʉɣʍʆɊɲʫʆ

ɧʨʫʪɶɊᥠᬎɸʪਭᒓɴʲʊɊɼʍাʍ൮೿

ɣɣʍɪʇɣɥ๨ପʀʡɡʩʉɫʨʣʂʅɣɾɋɕ

ʣຟᅸʍ᝾ᥱɶʱ௟ɧʨʫʪɪʨɊਭᒓɴʲʎᥠᶨ֩Տᒓ ÂɊ‫ګ؎ئ‬ӑቿᶩᬎͼʊϺʱɸʘɬɪᒑɧʨʫʪɋ
ɕᶨ֩Տᒓ ÃɊ‫ئ‬ᇉᠷजʎɊͼᆣᔃʊ᫟ɸʪᇽᠪʱৃʧɥʇោʞ

؎‫ݹګ‬ቿᶩ

ʪʡʍʍɊ৕᝸ʇɸʪ਺‫ܫ‬ɫৃʨʫʉɣɾʠʊɊ

ɒ٨ᯌʱΜ༨ɶɾˇʸɫʆɬʉɣɓ

ਭᒓʊ֝Ԕʉˇʸʱ୯Йʆɬʅɣʉɣʇ੡ɷʅɣ

ɉᇉᠷजʎɊᓥᔕͼᆣᔃਭᒓʍᏀᦋʣీಜɳʇ

ɾɋʍˇʸˡ̎ːɫʮɪʨʉɣɾʠɊ٨ᯌʱΜ༨ɶɾɔͼᆣᔃʎ਺‫ܫ‬ɫࡸʉɣɋ௟ቿಅʍᶨͼᆣᔃʍˇʸʱᜓɥΟɫ᭐ɶɣʇ੡ɷʅɣɾɋ

ᧅԔʍᶩ֤ԔʊሃᏰʍӟᇍɫᤓʂʅɣʪʍʱ᝾Ż¡µ´¡Ż

ɔͼᆣᔃʍਭᒓɴʲʊʡˏ˜̎ˎɫɡʪʧɥʊ

˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬੡ɷɾɋɼʫʱႾពɸʪʍɫ‫ݳށ‬ɋɕᶨ֩Տᒓ ÄɊʅɣʅʡʈʲʈʲԎʅɬʅɊᅽᇗ᜖ʡʆɬʉɮ

‫ګ؎ئ‬ӑቿᶩʅɊҳᄉʡɖʈɥɸʪɪɋɗʇʉʂɾɋɕ
ᶨ֩Տᒓ ÈɊɔᓓɫʲɿʇɊɼʍাʍᏀᦋɫԔɪʪɪʨɊԳ

‫ݹګ؎ئ‬ቿᶩʡʂʅ٨ᯌʱ᝾ᢳɶɾˇʸʱɸʪɋͼᆣᔃʎɊᅕ

ɔͼᆣᔃɫᔈʱ‫כ‬ʩऍɣʅɊɩᔉɫ˧̉˧̉ʊ

๨ʍᏀᦋʡɼʍাʍຟᅸʡʮɪʨʉɣʍʆɊϺʱʉʪɋᖐɶɮʅਭᒓɴʲʎɖɩᥱɷɫԎʉɣɋɗɖ๬ɸʫʏɣɣʍɪ᝾ɧʉɣɋ
ɕᶨ֩Տᒓ ÅɊ‫ګ؎ئ‬ӑʱ૽ɣʅɮʫɋɗʇɣɥɫɊ˂˗˙ʇʉʂʅɊᨌ

ቿᶩʱԫɸˏ˰̎ˏʡʉɣɋɕ
ᶨ֩Տᒓ ÉɊ‫ګ؎ئ‬ӑቿᶩɔʉɻɪͼᆣᔃʍκʎɊ৔ɫ‫ݘ‬ʫʪɲʇɫɡʪ

ɒᓥᔕᓓӂ஍᜖াʍጫႾɫ᭐ɶɣɓ
ᓥᔕͼᆣᔃʊၔಐʉ૜᜖ʆɡʪᓥᔕᓓӂ஍᜖াʇ৲ɥɋႾᄒʎʮɪʨʉɣɫɊκഓɫ‫ݳ‬ʮʂʅɊʎɊᅞʞɫওɮɊ৔૖Ꮂթጇʍ‫׹‬ЇᅖɫԎʣɸɣɺʲޮɫႻʫɾʩɊ౭ՏᆔʊʉʪɋɼɲɫᓓɫʲʍʆɊᇉᠷजʎ᜖াʍጫႾɫ‫ۏ‬᭐ɿʇ੡ɷʅɣɾɋ

ʇᦒɥɋɕᶨ֩Տᒓ ÊɊ‫ګ؎ئ‬ӑቿᶩͥఄʆɊᐂ‫ˇح‬ʸʍˏ˃́ʱପʃᇉᠷजʎᅖၤ

ɔ᜖াᅐᅞʍˉ̉˞̃̎́ɫ᭐ɶɣɋᓓɫʲʍఄʎɖթɣɾʇɬʊኹʂ঒ʪɋɗʇɩʂɶʢʪɫɊ

ʍᐂ‫ح‬ʊ٨ᯌʱ੡ɷʅɣʉɪʂɾɋ
ɔͼᆣᔃɿɪʨၔԠʇʎ৲ʮʉɣɋᓓɫʲʊ๚ͼᆣᔃʍఄʎթɰʉɣɋɖ᣸ʍᑝɬ૗ɫʉɣɋɗʇ

ʘʅᨁɣʇɣɥɲʇʡ੡ɷʉɣɋɕᶨ֩Տᒓ ËɊᐂɣɥɮʨɣᅞɣɋɕᶨ֩Տᒓ ÆɊ‫ݹګ؎ئ‬ቿᶩɔ᜖াʍԎᎡ˦˿̉ˏɫʈɥвɾʫʅɣʪɪʱ

‫ˇح‬ʸᶩ

᝾ʪɲʇɫ‫ށ‬Οɋˋ̎˟ˏ˰̎ˏʊʇʨʫʅɣʪ

ɔͼᆣᔃʍᅞʞɫᐂ‫ح‬ʆɬʪʍʎɊၔԠᶨʉ‫ܬ‬ʍɪɊোშʊӁʂʅɣʪʍɪɊ˟̂̎̉ʊɬʅɣ

‫׹‬ɿɰᶩɿʬɥʇលʮʫʪɫɊɼʲʉɲʇʎʉɣɋ

ʪʍɪɋˋ̎˟ˏ˰̎ˏʡɊСᝳʱ‫ל‬ɰʣɸɣᓓ

చɮᐂ‫ˇح‬ʸʱӁʫʫʏ‫ބͩށ‬ɋɕᶨ֩Տᒓ ÌɊឭɿɰʊᄤʂʅɣʪʍɪɊӂ᣸ʊ‫כ‬ʨʫʅɣʪʍɪ

٨ᇉᠷᶩʱ᝾ʉɰʫʏʉʨʉɣɋɼʫɫ᭐ɶɣɋɕᶨ֩Տᒓ

ɉɐࡶӁʆɬʉɣᐂ‫ˇح‬ʸɑÆɊ‫ݹګ؎ئ‬ቿᶩɒ៬௨ɫᥟɣϊɪʉɣɓʇɒ‫ؙ‬ᇽɶʅɣʉɣʍ

ɒˉ̉˞̃̎́ʆɬʉɣᨁɣᅖၤɓ

ʆ˱ˏ˪ˏʱնʠʨʫʉɣɓʍˋˬˁ˜ˊ̀̎ɪᇉᠷजʎɊႾពʱᢲɧʅᨁᅖʉᓥᔕͼᆣᔃਭᒓʨીʪɋʍᅖၤʊࡩԂʆɬɹɊᓥᔕͼᆣᔃʍᅖၤʎ‫כ‬ʪɲɒ៬௨ɫᥟɣϊɪʉɣɓʇɫʆɬʉɣʇɣɥ‫࠳ۓ‬ឍ৤ʱପʃᒓʡɡʂɾɋ

ᐂ‫ˇح‬ʸࡶӁʣ˱ˏ˪ˏӁ૗ʍ៬௨ʱ߂ʠʅ

ɔᅞʞʍˉ̉˞̃̎́ɫ‫ۏ‬ʪɋͼᆣᔃʍᅞʞʎ

ʡɊ࠷ႻʍԳʊᅖၤɫ᥼ʲʆɊɼʍ෤ϥʱ‫ވ‬ʂɾ‫כ‬ʩɬʫʉɣɋᨁɣᅞʞɊ᣸ʍᑝɬ૗ʍʉɣᅞʞ

ʩɊᮂणʊ᥼ᜓɶɾၤੳʆʍ࠷Ⴛʊʉʂʅɣɾɋ

ɫɹʂʇᏙɮɋɕᶨ֩Տᒓ ÅɊ‫ګ؎ئ‬ӑቿᶩɔຟᅸɫᎹʮʂʅɪʨᐂ‫ح‬ʊˇʸʱᐥɱʪʍɫ

ɔ‫ۏ؎ئ‬᭐ʍɾʀɫ਱ɣɋɫʲ৷̀̉˧ጫᔃʆ

᭐ɶɣɋᶨᅕ๨ʍ᥼ᜓɫᶩᥴɣɋᐂ‫ˇح‬ʸɫ৕᝸ᓥ๬ɫ৵ʊᓓʊ໐ʫ᥈ʲʆɮʪၤੳɫɹʂʇᏙɮ

ɿʇ৲ʂɾీʎʈʲʈʲᅖၤɫ᥼ʲʆɊᇉᠷɫᥟ

੡ɷɋɼʫɫ৵ྟʊɩɲʪɋಚҮ๨ʆɖʀʦʂʇ

ɣʃɪʉɣɋɕᶨ֩Տᒓ ÄɊ‫ګ؎ئ‬ӑቿᶩᅞɣɰʈɋɗʇលʂʅɣɾκɫɊ‫ݸ‬ఄ‫ۏ؎ئ‬᭐ʊʉʂʅ᧦Ꭻʇ˸́˨ˣɫ߂ʝʪɋᇉᠷजʎ৵ྟʉ

៬௨ɫ᭐ᕑɸʪͥ‫ی‬ʇɶʅɊ֚जɫᐂ‫ˇح‬ʸʣ˱ˏ˪ˏʍࡶӁʱɾʠʨʂɾАʡ଱ɱʨʫɾɋ

˥̎˟ʉ‫ۏ؎ئ‬᭐ʗʍࡩԂఄຫʱ᣸ʊʃɰʅɩɣ

ɔᥠᬎʆɬʪ˕ʺ˵̉ˆʡɡʂɾɫɊ‫ݹ‬ቿʍҳɾఄɫᕩɣʇ৲ɥɋɕᶨ֩Տᒓ ÄɊ‫ګ؎ئ‬ӑቿᶩᄉɫଂɧ᥈ʲʆɶʝɣɊᥠᬎோ୸ˑ̉˕̎ʊᄔ៰

ɔ‫ށ‬ᨃᓥ๬ʍఄɫ‫ݳށ‬ɿʂɾɋ˗˻̎ˬɫӁʂɶʉɪʂɾɋɼɥʆʉɰʫʏɊᐂ‫ˇح‬ʸʣ˱ˏ˪Ż¡µµ¡Ż

ᫎɉೋ̍‫ܝ‬ɉӑ̍‫׾‬ɉ‫כ‬ᶺᓥᔕͼᆣᔃਭᒓʍˇʸʊɩɰʪᇉᠷजʍ‫ۏ‬᭐ˏʊᜓɰɾʇ৲ɥɋɕᶨ֩Տᒓ ÍɊ‫ګ؎ئ‬ӑቿᶩɋၤʊɼɯʮʉɣ֊ࠜຟᅸᏘᏙʊᔷʂɾАɫɡʂɾɋ

ͥఄɊឭ٨ᇉᠷˏ˜̎ˍ˽̉ʍᇉᠷजʎɊᐂ‫ح‬ɔ֊ࠜᅸຫɫʆɬʪၤੳʆʎʉɣʍʊɊਭᒓɴˇʸʣ‫ˇࠧۦ‬ʸʍࡶӁɫᦅʫʪɲʇʆਭᒓʍ৔᣸

ʲʎɖʡʂʇຟᅸɶʅธɶɣɋɗʇɣɥɋҳᄉʡɊʍࠪ࡝ɫ޹ɱʨʫʅɣʪʇ੡ɷʅɣɾɋ

ɖ‫ބͩށ‬ɪʉɋɗʇɣɣʉɫʨᜓʂʅɣɾɋɕᶨ֩

ɔ૜᜖ʍাʍᅞʞʣɊͼᆣᔃɫ᥼ᜓɶɾᅞʞʊՏᒓ ÏɊ‫ݹګ؎ئ‬ቿᶩʎɸɯʊᐂ‫ح‬ʣ‫ࠧۦ‬ɫӁʂʅɣɮʘɬʉʍʊɊɼ

ɒಢκʍੜ‫؂‬ʱࡂఎɫ޹ɱʪɓ

ʫɫ᥼ʝɹɊ݇਱ɶʅᅞʞɫওɮɊϹՏ๨Տʇʡ

ਭᒓʇᄴʉʪࡂఎʍੜ‫؂‬ɫɊਭᒓʍੜʊ‫ט‬ɶɾʊᗹʀɾၤੳʆಿʪɋɼʫʝʆਭᒓʎͭࠪɫও

ຟᅸᏘᏙʣຟᅸͫʍ֚ᅸᒓʇਭᒓʍ᫟Фʍ਱֊ʱɮɊࡕɾɬʩʆᦋɳɴʉɰʫʏʉʨʉɣɋɕ
ᶨ֩Տঃɬᢰɲɶʅɣɾɋᒓ ÌɊឭ٨ᇉᠷˏ˜̎ˍ˽̉ᶩ

ɔಢκɫɖᶨ֊ࠜᅸຫʎᶩʡɥɣɣɋɗʇɣʂʅ

ɒ‫ؙ‬ᇽɶʅɣʉɣʍʆ˱ˏ˪ˏʱնʠʨʫʉɣɓ

ʡɊࡂఎɫɖʣʂɾʚɥɫᕩɣɋɗʇɣɥɋɕᶨ֩

ᇉᠷजɫɊ˱ˏ˪ˏʱնʠʅʡɊಡಜʆɡʪɲՏᒓ ÐɊ‫ګ؎ئ‬ӑቿᶩʇʱ‫ؙ‬ᇽɴʫʅɣʉɣ‫׹ܬ‬ʎɊኌᜓʊʎᔷʨʉ
ɪʂɾɋɔɖ֊ࠜᅸຫɫʆɬʉɣɲʇʱಢκʊលʮʉɣ
ʆธɶɣɋɗʇɣɥࡂఎʍ‫׹ܬ‬Ɋਭᒓɴʲʎɖɣɔ˱ˏ˪ˏʊᜓʂʅʚɶɣɫɊɼʫʊʎਭᒓɴ

ʃ֊ࠜᅸຫʱɶʅɮʫʪʍɿʬɥᶿɗʇহʂʅɣ

ʲʊಡಜʆɡʪɲʇʱ‫ؙ‬ᇽɶʉɮʅʎʉʨʉɣɋ

ʪɋҳᄉʡাʊʉʫʏʉʪ኏ᶨʆɬʉɣʇʎᶩល

ਭᒓɴʲɫ˱ˏ˪ˏʊପʂʅɣʪʺ˷̎ˎʎಡಜ

ɣʊɮɮʉʩɊਭᒓʇʍ᫟Фʊᵮᵶɫʆɬʅɶʝ

ʍκɫึʋɾʠʊᜓɮʇɲʬʉʍʆʉɪʉɪɥʝ

ɥɋਭᒓɴʲʇҳᄉɿɰʍీʊʡʠʪɲʇʎʚʇ

ɮɣɪʉɣɋɕᶨ֩Տᒓ ÎɊ‫ګ؎ئ‬ӑቿᶩʲʈʉɣɋࡂఎɫӁʂʅɮʪɪʨʡʠʪɋɕᶨ֩Տ

ɉɐੜ৲຅࠳ோ୸ʊɩɰʪᬈᄟɑ

ᒓ ÉɊ‫ګ؎ئ‬ӑቿᶩɒੜ৲຅࠳ோ୸ʍ෤ϥɫʉɣɓɊɒ՞ೖʍʉɣຟ

ɉɐࡂఎʗʍࡩড়ʊɩɰʪᖐ઄ɑ

ᅸʍᏘᏙɓɊɒಢκʍੜ‫؂‬ʱࡂఎɫ޹ɱʪɓʍˋˬˁ˜ˊ̀̎ɪʨીʪɋ

ɒࡂఎʡˇʸʱ৕᝸ʇɶʅɣʪɓʇɒࡂఎ᫙ʆ
ੜ᝾ɫᦒɥɓʍˋˬˁ˜ˊ̀̎ɪʨીʪɋ

ɒੜ৲຅࠳ோ୸ʍ෤ϥɫʉɣɓɒࡂఎʡˇʸʱ৕᝸ʇɶʅɣʪɓ

ຟᅸᦦ૾ʍ‫ݼ‬ɮɫ‫ݹ‬ಿʆᜓʮʫʪɾʠɊᇉᠷோ

ᇉᠷजʎɊਭᒓʍɾʠʊࡂఎʍ֩Տʱಜহɸʪ

୸ɫͭ֝Ԕʆʧɣੜ৲຅࠳ʊᔷʨʉɣʇᅕൖᇉᠷ

ʡʍʍɊࡂఎʡʝɾ‫ۏ‬᭐ʊɡʪɾʠɊಜহɸʪோ

जʎ੡ɷʅɣɾɋ

୸ɫৃʨʫʉɣၤ຤ʊᬑʂʅɣɾɋ

ɔˑˁ̉˟ˀ˪ˡˀ̉ʱ‫ל‬ɰʅɣʉɣͫɊдᯈɔਭᒓɴʲɫ᣸᥆௨ႾʱऔಙɶʅɣʪɫɊࡂఎ

৷ɫᅃʮɶɣʺ̉˕̎ˣ˙˞਺‫ܫ‬ʱʡʇʊੜ৲຅

ʍ๨ପʀɫʃɣʅɣɪʉɣɋᇉᠷजʎɊ
ɖρटʨ࠳ʱɶʅɩʩɊᦞԕʉੜ৲຅࠳ɫʆɬʅɣʪʇʎ

ʉɣʇटʫʉɣɋɗʇ৲ɥɫɊᶨࡂఎʎᶩɖᅞɣʍ

ɣɧʉɣɋᇉᠷजɫਭᒓɴʲʊ߂ʠɪʨςӁɶʅʊटʪʍʎ࿵Ⴞɋ
ɗʇɣɥɋɕᶨ֩Տᒓ ÏɊ‫ګ؎ئ‬ੜ৲຅࠳ʱோɧʅɣɪʉɣʇɣɰʉɣɫɊӁᬎɶ‫ݹ‬ቿᶩʅಿʪਭᒓɴʲʎకʊຟᅸᦦ૾ʱɶɾাʆɊᇉᠷ

ɔࡂఎʍႾពՏɫ਱ɣɲʇɫɡʪɋ֊ࠜᅸຫʱ

जɫςӁɸʪϽۨɫʉɣɋ
ɕᶨ֩Տᒓ ÈɊ‫ݹګ؎ئ‬ɶʅʡᶱᶬᶲɪಏ८‫ا‬ɸʪɿɰɿʇɣɥɲʇʱ់

ቿᶩɶʅʡɊɣɵ਱ɮʉʪʇࡂఎɫ‫ל‬ɰӁʫʨʫʉɒ՞ೖʍʉɣຟᅸʍᏘᏙɓ

ɣɋಢκɫ˧ˡ˙˅ʊʉʪʇࡂఎʡͥ᏶ʊ˧ˡ˙ਭᒓʍຟʩɾɣʇɣɥ๨ପʀɫওɣɾʠʊɊᅕ

˅ʊʉʪɲʇɫ‫ݼ‬ɣɋɕᶨ֩Տᒓ ÉɊ‫ګ؎ئ‬ӑቿᶩŻ¡µ¶¡Ż

˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬ɒࡂఎʍ᫙ʆੜ᝾ɫᦒɥɓ

පʍࡩড়ʆʎਭᒓʍ๨ପʀʊ༐ɧʉɣʇ੡ɷʅɣ

ࡂఎ᫙ʆੜ᝾ɫԔɪʫɾʩɊɼʫɽʫʊ‫ݼ‬පʉɾɋ৲ɣɫɡʪɾʠɊᇉᠷजʎɼʫʨʱᒫɬɊ៬௨ɸ
ʪʍɫᮂणʊ᭐ɶɣʇ੡ɷʅɣɾɋ

ɔɖਭᒓϥɫɡʪʍʎᇽʂʅɣʪɫɊͼᆣᔃʍਭᒓɴʲʇ់ʎɶɾɮʉɣɋ
ɗʇលɥκɫɣɾɋ

ɔᶨ˕̎˵ˠ́ʆᶩ҂ᇎ҂‫؂‬ʍਭᒓɴʲʆɊࡂɼɲʊʎᅕ๨ʍׄ‫ی‬ʆɡʪሃᏰɫɡʪʍɿʇ৲

ఎʍͼʆʡɖχఄɫʉɣɋɗʇɣɥఄʇɖከඐᆔ

ɥɋκʊᇽʨʫɾɮʉɣʇɣɥɪɊɼɥʂʇɶʅ

ʉຟᅸʱɶʅɮʫɋɗʇɣɥఄʆੜ᝾ɫԔɪʫʅɊ

ɩɣʅธɶɣʇɣɥ੡ɷʆɊ᭐ɶɣʇ৲ʂɾɋ
ɕᇉᠷजʡʈɥɶʅɣɣɪʮɪʨɹɊᐂ‫ˇح‬ʸᶨʍᶨ֩Տᒓ CɊ‫ګ؎ئ‬ӑቿᶩˏ˕˙˫ʊ៬௨ᶩʊӁʂʅʡʨʂɾɋɕ
ᶨ֩Տᒓ ÑɊɒˡ̎ːɫঃɬԎɺʉɣࡘᵎʉਭᒓɓ

‫ګ؎ئ‬ӑቿᶩᇉᠷजʎɊ٨ᯌʱପʂʅɣʪʇ੡ɷʉɫʨʡɊ

ɔɾʝʊಿʪញ૆ɫɖɲʍᅕᬎʆ‫ބͩށ‬ɪᶿɗɖɲɥɣɥຟᅸʡɡʪʨɶɣɋɗʇ޾ʊលɥʍʆɊ

ˡ̎ːʱঃɬԎɸʍɫ᭐ɶɣࡘᵎʉਭᒓʱᏀ᰺ɶ
ʅɣɾɋ֚जʇʡʠʅɊɼʍ᫙ʊӁʪʍɫ‫ݳށ‬ɿʂɾɋɕᶨ֩Տᒓ ÅɊ‫ګ؎ئ‬ӑቿᶩɔਭᒓɴʲɫϺʇʉɮͭࠪʱପʂʅɣʪʧɥʊ
੡ɷʪీɫɡʪɋ់ʱᒫɣʅɡɱʨʫɾʨᕩɣ

ɉɐˉ˵˻ˡˇ̎ˍ˽̉ˏ˃́ͭᢷɑ

ɫɊͼᆣᔃʍఄʎᒶκɴʲʆુ੾ওɣɪʨɊຳɬ

ɒ‫ݩ‬ʍɪɰఄɫʮɪʨʉɣɓɊɒ᝖ᭉʉᓥᔕͼᆣលɫលɧʉɣɋɕᶨ֩Տᒓ ÅɊ‫ګ؎ئ‬ӑቿᶩᔃਭᒓʍ๨ପʀɓɊɒˡ̎ːʱঃɬԎɺʉɣࡘᵎʉ

ɉɐᇉᠷजᔵ᣸ʍᤸɣ๨ପʀɑ

ਭᒓɓʍˋˬˁ˜ˊ̀̎ɪʨીʪɋ

ɒᖐᅞʊɡʪਭᒓʱ᝾ʪᤸɴɓɊɒຟʨʉɣਭᒓ

ɒ‫ݩ‬ʍɪɰఄɫʮɪʨʉɣɓʱˇʸɸʪᤸɴɓɊɒඋլʇͭࠪʗʍˇʸɫ͸ዒʆᇉᠷजʎɊΜাɫ਱ɣʥɧʊɊᓥᔕͼᆣᔃਭᒓɬʉɣɓɊɒ಍ಜʝʆᇉ‫כ‬ʫʉɣ˫˿ˏ˞̂̎ˍ˽

ʍͭࠪʊࡩɶʅᇍ࠷ʱϧɧʪɲʇɫʆɬɹɊ᥏ጏ

̉ɓɊɒ᝾ពʍᦒɥຟᅸఄᨌʊূʮɵʪʱৃʉɣ࿵

ʊ‫ۏ‬ʂʅɣɾɋ

Տ੡ɓʍˋˬˁ˜ˊ̀̎ɪʨીʪɋ
ɒᖐᅞʊɡʪਭᒓʱ᝾ʪᤸɴɓ

ɔਭᒓɴʲɫʮ̎ʂʇʉʪʇɊʈɥɶʧɥʡʉ

ਭᒓʍឱɧʪᖐᅞʎɊᇉᠷजʊթ୻ʇˏ˞̂ˏ

ɣɋɖɼɥʆɸʌɊɼɥʆɸʌɋɗʇɾɿᒫɣʅɣ
ʪɶɪʆɬʉɣɋᕩɮʉʪʇលɧʉɣɲʇɫᤸ

ʱᄉɷʅɣɾɋ

ɣɋᇉᠷजʡᤸɣɪʨᶨਭᒓʍ૗ʗᶩᜓɪʉɣɋɕ
ᶨ֩Տᒓ ÆɊ‫ګ؎ئ‬ӑቿᶩɔɖᅞɣɊᅞɣɋɗʇɣʮʫʪʍɫᤸɣɋਭᒓɴ
ʲɫɖᅞɣɊᅞɣɋɗʇលɥʇɊᔵԔʡɖʈɥɶ

ɔ᜖াʍਘᖐɶɴʊɊɖɣʃɪᶨᅕ๨ɫ᥼ʲɿ
ʨᶩɲʲʉʊᖐɶɮʉʪʍɪɋɗʇɣɥਭᒓɴʲʧɥɊʈɥɶʧɥɋɗʇ৲ʂʅɣɾɋɕ
ᶨ֩Տᒓ ÃɊ‫ݹګ؎ئ‬ቿᶩɫɣʪɋ‫ݩ‬ɪɰʆɬɹʊᒫɮɲʇʊ৑ɸʪɲʇɫ

ᖐᅞʱ‫כ‬ʂʅธɶɣʇɣɥਭᒓʍˡ̎ːʊড়ɧ

‫ݼ‬ɣɋ‫ݩ‬ʱɪɰʅɡɱʪʇɶɾʨɖɲʫϒͫᤸʈʨʫʉɣɾʠɊᇉᠷजʎᔵԔʱᡭʠʪɲʇʡɡʂ

ɮʉʨʉɣʇɣɣʌɋɗʇɣɥʍɫᬈᄟɋɖ಍ಜʡ

ɾɋᖐɶɮʉɣɋ
ɗʇʎលɧʉɣɋ
ɕᶨ֩Տᒓ ÒɊ‫؎ئ‬‫ݹګ‬ቿᶩ

ɔ‫ۏ؎ئ‬᭐ʎ‫כ‬ʩɬʫʉɣɋ᝾ʅɣʪʍʎʇʅ
ʡᤸɣɋϺʡʆɬʉɣʍʊɊɼʏʊɣʉɰʫʏʉ

ɒ᝖ᭉʉᓥᔕͼᆣᔃਭᒓʍ๨ପʀɓ

ʨʉɣɋϺʡʆɬʉɣᔵԔʱᡭʠʅɶʝɥɋɕᶨ֩

ሃᏰʆᆌᅖɶɾɲʇʊࡩɸʪ๨ପʀʎਭᒓʊՏᒓ ÄɊ‫ګ؎ئ‬ӑቿᶩʧʂʅපɍʆɊ˝̀ˇ̎˞ʉ٨ᯌʆɡʪɾʠɊͥ

Ż¡µ·¡Ż

ɼʍᏃೖɊਭᒓʍᖐᅞʱ᝾ʪʊৗʒʉɣɾʠɊ

ᫎɉೋ̍‫ܝ‬ɉӑ̍‫׾‬ɉ‫כ‬ᶺᓥᔕͼᆣᔃਭᒓʍˇʸʊɩɰʪᇉᠷजʍ‫ۏ‬᭐ɒ᝾ពʍᦒɥຟᅸఄᨌʊূʮɵʪʱৃʉɣ࿵Տ

ᇉᠷजʊɊਭᒓʍʇɲʬʗᜓɬɾɮʉɣʇɣɥ๨

੡ɓପʀʱᄉɷʅɣɾɋ
ɔɡʝʩʊʡᅞɫʪɪʨɊɲʀʨɫᜓɬɾɮʉ

֚जʍԟఀʣຟᅸɫਭᒓʊಐᆯʆʉɣʇᒑɧɾ

ɮʉʪీɫɡʪɋ
ɖɡʍκɊʝɾᤸʈɣʇʏɪʩ

ʡʍʍɊຟᅸɫᦄᜓɴʫɊɼʫɫਭᒓʍ QOL ʱលʂʅɣʪɋ
ɗʇɊᖐ૜ʉᧅᯕʍκʊʉʪɋɕᶨ֩୽ʌɾ‫ܬ‬ᮅʊᦟᦆɶɾᇉᠷजʎɊᇉᠷजʇɣɥᒶՏᒓ ÒɊ‫ݹګ؎ئ‬ቿᶩඋʍᏘᏙʱֵʕʟʚʈʍওɣ࿵Տ੡ʱ੡ɷʅɣɾɋ
ɔ૜᜖ʣ๨ጫԕ᫕ʆ ÒÐÍ ɫʈʲʈʲ਱ɮʉʂɒຟʨʉɣਭᒓʱˇʸɸʪᤸɴɓ
ᓥᔕͼᆣᔃʎࠬຟɶʉɣɾʠɊ૜᜖ʍࠬΛʱ૜ɾɋɼʍ्ʊหʠɾɫɊҳᄉʎɖಢκʍ‫׽‬ੜɫʇ௓ɶʆ‫ٽ‬ʘʉɣɲʇʊ‫ݹ‬ቿᇉᠷजʎˏ˞̂ˏʱ੡

ʫɾɪʨɋɗʇɣʂʅʣʂʅɶʝʂɾɋɲʍκʍɷʅɣɾɋहɺʎʉʲɿʬɥᶿቼɾʀʍϺɫɣɰʉɪʂɾʍ

ɔᶨਭᒓɴʲʎᶩΜাɫ਱ɣʇᇽʂʅɣʪɋᶨ૜

ɿʬɥʇ৲ɥʇɊʣʩɬʫʉɣɋᇉᠷजʍͼʆʎɊ᜖ɫᎹʮʂʅʡᶩ૜௓ɶʆɖˀ˰ɶʅᕩɪʂɾɊ

ҳᄉʍɣʉɣీʊɼɥɣɥ់ʱɶʅɣʪɋɖʣʂ

ͨาɋɗʇʎɊɲʀʨʡਭᒓɴʲʡ‫ٽ‬ʘʉɣɋᏃ

ʐʩ᫙ᦒɣɿʧʌɋ
ɗʇɪɖʆʡหʠʨʫʉɪʂ

ࢋɊᓥᔕᓓӂ஍᜖ʱɶɾκʍʚʇʲʈɫέɮʉʂɾʧʌɊቼɾʀɋ
ɗʇɪɋʡɶɊ‫؝‬ʩʍˏ˕˙˫ʅɣʪႻ࠷ʱ᝾ʅɣʪɿɰʊᨁɴʱ੡ɷʪɋɕᶨ֩

ʡʮɪʂʅɮʫʉɣɊਭᒓɴʲʡߵɿʇɣɥɊҳՏᒓ ÒɊ‫ݹګ؎ئ‬ቿᶩᄉʡᒫɣʅɮʫʉɣʇʉʂɾʨɊᇉᠷजʱʣʂʅ
ɣʨʫʉɮʉʪɋɕᶨ֩Տᒓ ÈɊ‫ݹګ؎ئ‬ቿᶩɒඋլʇͭࠪʗʍˇʸɫ͸ዒʆɬʉɣɓ
ͥᕓᅕൖʍᇉᠷजʎɊᓥᔕͼᆣᔃਭᒓʍͭࠪʊ
ࡩɸʪˇʸʍ৕᝸৷ʱ੡ɷʃʃʡɊඋլʊᥟʮʫ

Φᶮᒑɉࡗʅɷʂɮʩ់ʱᒫɮϽᝃɫʉɣɾʠɊ৔Ⴞᆔʉᡥ
ଉʱ੡ɷʅɣɾɋ

ಢለኴᏃೖʎɊᓥᔕͼᆣᔃਭᒓʍˇʸᏀ᰺ʍɡɔ‫ݾ‬մʆ ³± κϴᇉʉɮʅʎɣɰʉɣʍʊɊᶨᓥ

ʪᇉᠷज ³² κʊʺ̉˕˩˻̎ʱᜓɣɊˇʸʊɩᔕͼᆣᔃਭᒓʍ់ʱᶩᶱీ᫙ϴᒫɪʉɮʅʎʉʨ

ɰʪ‫ۏ‬᭐ʱᢑᆔʊԔ೒ɶɾɋɼʍᏃೖɊᇉᠷजɫ

ʉɣɋᒫɣʅɡɱɾɣɫɊψʍඋլʡɡʪʍʆɊ

ͼᆣᔃਭᒓʍˇʸʊɩɣʅපɍʉ‫ۏ‬᭐ʱϹ᰺ɶʅ๨ɫ࿶ʪɋɕᶨ֩Տᒓ ÆɊ‫ݹګ؎ئ‬ቿᶩɣʪɲʇɫనʨɪʊʉʂɾɋ

ɒ಍ಜʝʆᇉ‫כ‬ʫʉɣ˫˿ˏ˞̂̎ˍ˽̉ɓ
಍ಜʝʆᇉ‫כ‬ʂʅɡɱɾɣʇɣɥ๨ପʀʱɊᅕ

ᶱᶮᓥᔕͼᆣᔃʍၔ৷ʊʧʪᇉᠷजʍ‫ۏ‬᭐ᬎʍԧ᎜ɪʨೖɾɺʉɪʂɾᇉᠷजʎɊႾ੍ʍᇉ

ᓥᔕͼᆣᔃʎɊऔࡸʆɊ᭐ຟ৷ʍ਱৷ᅒਭʆɊ

ᠷʇႻ࠷ʍ˄˹˙˭ʊ˫˿ˏ˞̂̎ˍ˽̉ʱ੡ɷ

ሃᏰ᜴࠿ʊʧʂʅᢰɲʪɋ‫׽‬ɷɮऔࡸʆຟᅸຫʍ

ʅɣɾɋʉɣቛᏀ৷᭐ᅕʍˇʸʊɩɰʪᇉᠷजʍ‫ۏ‬᭐ʇ๚ɔ‫ࠜށ‬ᅕᬎʇɣɥၔ฽৷ɪʨɊࡷ॓ၤੳʊʉʂ

ᤑɸʪʇɊ֚जʇʍ᝾ពʍᦒɣɪʨ৲ɥʧɥʉˇ

ɾਭᒓɴʲʎࢍʨʫʉɣɋᤉᬎʍԳʊၤੳɫ਱ɮʸʱԎಿɹʊᤸɣʇ੡ɷɊ᥼ᜓʱਆʫʪਭᒓʗʍ

ʉʂɾɫɊɼʫʱᥢɸʇᤉᬎʆɬʉɣʍʆɊ໪ʉ

‫ݩ‬ɪɰʊਰʟʇɣɥ࿢ʆͥᔸɶʅɣɾɋͥఄʆɊ

ɫʨʊԎᆌɶʅɊตʍᅕᬎʆᶳఖাʊέɮʉʂ᣸Ϲ෤ᓧϵͬʊϪɥˉ˵˻ˡˇ̎ˍ˽̉ʍ᭐ɶ

ɾɋᶳఖ᫙ʉʨɲɲʊɣʨʫɾʍʊʇ৲ɥʇਲɶ

ɴɊϹʍϴᑝ‫ݳ‬ɧʣ؎ঃʉʈʊ᝸ɸʪీ᫙ʇৗ

ɪʂɾɋᇉ‫כ‬ʂʅɡɱɾɪʂɾɋ໤֊ʆɬʉɣɋɕᒗɊળ‫ا‬ʍˇʸʊʡɪɪʮʨɹព໤ʆɬʉɣਭᒓ

ᶨ֩Տᒓ ÇɊ‫ݹګ؎ئ‬ቿᶩʣࡂఎʍͭགɊিɍʊ᥼ᜓɶʅɣɮਭᒓʊɡʅʡŻ¡µ¸¡Ż

˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬ʉɮ‫׽‬ɷˇʸʱᜓʮʌʏʉʨʉɣ࿵Տ੡ᶨࠪ೅̍

ɴʫʅɣʪᶨᫎೋʨᶬִԨͼᶩɋಢለኴ֩ՏᒓʊɊ

၄ࢨ̍ࡷ೔̍ࢨಳᶬ
³±±·ᶻࢡᄑ̍๽ᄑ̍၄ࢡ̍ᙸ

᜴࠿ʣɼʫʊϪɥਭᒓʍ๨ପʀʱᒫɮɲʇʊ᫟ɸ

ׄ̍۟Υ̍ಟͬᶬ
³±²±ᶻϟᙸ̍ᱝ෡̍Ϸᙸ̍ͼᨂ̍ʪ‫ۏ‬᭐ɫឍࡗɴʫʉɪʂɾʍʎɊᓥᔕͼᆣᔃຟᅸచࣽ̍ ሃͫ̍ͼвᶬ³±±¹ᶩʎᓥᔕͼᆣᔃਭᒓʍ

ʱ΂ᆾᆔʇɸʪຟᅸʍ‫ܬ‬ʆʎɊਭᒓɫ᜴࠿ʊ᫟ɸˇʸʆʎᏀ᰺ɴʫʉɪʂɾɋɲʫʎɊቛᏀ৷᭐ᅕ

ʪᤸɣ๨ପʱᜟԎɸʪ෤ϥɫࡸʉɣɲʇʊʧʪʡ

ɫᫎಜ᫙ʊʮɾʂʅিɍʊ᥼ᜓɶɊADL ʣˉ˵˻ʍʇୟࡗɴʫɾɋ

ˡˇ̎ˍ˽̉ᓧՏɫϵͬɶʣɸɣʍʊࡩɶɊᓥᔕ

ϒͫʍᏃೖɪʨɊᓥᔕͼᆣᔃʍˇʸʊɩɰʪ‫ۏ‬ͼᆣᔃʎ᥼ᜓɫᥴɮɊᯨΟɊ୔ɺʃ‫ו‬ʒˉ˵˻ˡ᭐ʎɊ᥼ᜓɫᥴɣ਱৷ᅒਭɊ᜴࠿ʊʧʂʅɩɲʪ

ˇ̎ˍ˽̉ɫ಍াʝʆвʅʪɲʇʊʧʪᦒɣʇᒑ

‫ו‬ʒᅒਭʣຟᅸʊ᫟ɸʪ਺‫ܫ‬ɫࡸʉɣʇɣɥၔ৷

ɧʨʫɾɋᓥᔕͼᆣᔃʊɩɣʅʎɊʟɶʬɐࡶӁʱЇɺପʃɲʇɫనʨɪʊʉʂɾɋ

ʆɬʉɣᐂ‫ˇح‬ʸɑɊɐੜ৲຅࠳ோ୸ʊɩɰʪᬈ
ᄟɑɊɐࡂఎʗʍࡩড়ʊɩɰʪᖐ઄ɑʉʈɊɫʲਭᶲᶮᓥᔕͼᆣᔃਭᒓʊ৕᝸ʉˇʸɉᒓʍˇʸʊɩɣʅᇉᠷजɫᏀ᰺ɸʪ‫ۏ‬᭐ᶨSasaharaᶱᶩ˕ʺ˵̉ˆʱᥢɴʉɣˇʸ

et alᶮ
ᶬ³±±´ᶻͼಳ̍ͼಳ̍༒๬ᶬ³±²±ᶩɫᏀ᰺ɴʫ

ɐੜ৲຅࠳ோ୸ʊɩɰʪᬈᄟɑʇɐࡶӁʆɬʉɾɋʝɾɊಢለኴᏃೖʆ಍ʡ‫ۋ‬ጏɫ‫ݼ‬ɪʂɾɐಠ

ɣᐂ‫ˇح‬ʸɑʎɊᇉᠷजɫɊੜ৲຅࠳ோ୸ʣ᫟᥸

Ꮐ᰺ʥɧʍ૜୛ʩʍˇʸɑʎɊᇽᠪͭᢷʆඋլʱ

෤᫟ʇʍ᥸உʱោʞʪʡʍʍɊᓥᔕͼᆣᔃʍ᥼ᜓ

ᜓɥɲʇʊʧʪᔵдͭᢷʇਭᒓʍͭࠪʣᅃ٨ʗʍ

ɫᥴɣɾʠɊీ᫙ԕʫʊʉʪႻၤʱቌɶɾɋɼʍ

ࡩড়‫ۏ‬᭐ʱᏀ᰺ɸʪ࿢ʆɊຟ᰺උլʱᜓɥᇉᠷज

ᓗ౔ʊʎɊɒ៬௨ɫᥟɣϊɪʉɣɓɫቌɸ֚ᅸূ

ʍ‫ۏ‬᭐ᶨᨅྙ̍ࡷࢡ̍ͼᨂ̍ࡷ᝷̍‫ޏ‬ᕩᶬ
³±±·ᶩ

ΟᒓѮʍ҇ɬɪɰʍᦅʫɊ֊ࠜᅸຫɫ՞ɪʉɣʚ

ʇͥᔸɶʅɣɾɋɲʫʨʎɊᇉᠷजɫˇʸʱᜓɥʈ᥼ᜓɶɾᅕၤʊ๨ପʀɫᥟɣʃɪɹʊɒ՞ೖʍ

ʊɡɾʂʅɊᅒਭʣຟᅸʊʃɣʅʍ࡬᫏ᆔᇽᠪɫ

ʉɣຟᅸʍᏘᏙɓʱᦦ૾ɸʪਭᒓѮʍ᝸‫ی‬Ɋɴʨͭ‫׭‬ดʆɡʪɲʇʱቌɶʅɣʪɋᓥᔕͼᆣᔃʎɊʊɐࡂఎʗʍࡩড়ɫ᭐ɶɣɑɫቌɸɊ৵ྟʊึʊ

ɲʫʝʆਭᒓ௦ɫࡸʉɪʂɾɾʠʊᇉᠷज‫؂‬ɰ௟᥎ʄɮਭᒓʍึʱ‫ל‬ɰӁʫʨʫʉɣࡂఎѮʍ᝸‫ی‬ಲʣ௟ᓑʍ෤ϥɫͭᢷɶʅɣʪɲʇɫɼʍׄ‫ی‬ʆɫ᫟᥸ɶʅɣɾɋɲʫʎቾࢡᶨ³±±·ᶩɫɊͼᆣᔃɡʪʇᒑɧʨʫʪɲʇɪʨɊచ৵ʉ௑‫ٴ‬ɫ৕᝸ʆʎਭᒓʇࡂఎʍΜ੍ϒͫʊᅖၤɫ᥼ʟɾʠɊੜ৲

ɡʪɋɴʨʊɊಢለኴ֩ՏᒓʍᇉᠷजʎɊਭᒓɫ

຅࠳ʣ៬௨ʊ֝Ԕʉీ᫙ʱʇʫɹɊਭᒓʣࡂఎ

ਭᒓϥʗʍ‫ב‬ՒʱऔಙɸʪᒓɫɣʪͥఄɊ‫ב‬Ւɶʍऔಙʱ࠷Ⴛɸʪɲʇɫ᭐ɶɣʇɶɊHawley ʨɾɮʉɣʇ੡ɷʪਭᒓʍ๨ପʀʱɊሃᏰ᜴࠿ʊᄒ

ᶨ³±±µᶩɫɊᔵࠧʆʍᇉ‫כ‬ʩʱಙʟਭᒓʍ‫ݼ‬ɮಿɸʪɒ᝖ᭉʉᓥᔕਭᒓʍ๨ପʀɓʇɶʅɊႾព

ɫɊ᥼ᜓʍᥴɴɊᨁɣᅖၤɩʧʒࡂఎʍᡥଉɪ

ɫ᭐ɶɣʇ੡ɷʅɣɾɋࡷ᝷ᶨ³±±·ᶩʊʧʪʇɊ

ʨɊᅕᬎʆέɮʉʪʇɶʅɣʪʍʊͥᔸɸʪɋɲ

᜴࠿ᒓʎɊ᜴࠿ʊʧʂʅϹ᰺ɸʪ਑ɊᔵᡭɊՒ࠿

ʍʧɥʉ٨ᯌʊࡩɶʅɊHawley ʨᶨ³±±µᶩʎɊᒓʗʍᅕᆔʉઑ਱ɊᔵԔɫ๸ɴʫɾ੡ɷጇʍ᝖ᭉ

ࡂఎʊᥴɣ᥼ᜓʱ‫ؙ‬ɱɊʣʩ฾ɶʍʉɣీ᫙ʍᦋ

ʉ੡਺ʣɊ᜴࠿ᒓʍ๨ପʀʱႾពɶʉɣψᒓʊʧɳɶఄʱᒑɧʪీ᫙ʱͮɧʪɲʇʱɊቾࢡᶨ³±±·ᶩʪΠต᜴࠿ɪʨɊψᒓʊࡩɶʅ৔ʱ᫓ɵɶʣɸ

ʎɊਭᒓɫࠬຟʊ‫ܙۓ‬ɶʅၤੳʍᕩɣీಜʱ໤ᡸ

ɣɋᓥᔕͼᆣᔃਭᒓʎɊ
ɔሃᏰʱЋʂʅɬɾ቎ϥɶɸɭʉɣʧɥʊՕលɸʪɲʇɫ৕᝸ɿʇ‫ؙܫ‬ɶʗʍ৬ʩɕɊɔᔵԔʍɺɣʆʎʉɣႾᄒʆึʱ᥍ɧ

ʅɣʪɋɲʍʧɥʊɊ᥼ᜓɫᥴɣɾʠ٨ᯌព຅ʊ

ʪ࿵৤ɴɕʉʈʍ᜴࠿੡਺ʱʡʃɲʇɫనʨɪʊ

ɪɰʨʫʪీ᫙ɫࡸʉɮɊਭᒓʇࡂఎɫ٨ᯌʊ‫؂‬Ż¡µ¹¡Ż

ᫎɉೋ̍‫ܝ‬ɉӑ̍‫׾‬ɉ‫כ‬ᶺᓥᔕͼᆣᔃਭᒓʍˇʸʊɩɰʪᇉᠷजʍ‫ۏ‬᭐ɬ‫׹‬ɥϽᝃɫʉɣᓥᔕͼᆣᔃʊɩɣʅʎɊ٨ᯌɫ

ʡʍʇᒑɧʨʫɾɋɲʫʨʍᏃೖɪʨɊᓥᔕͼᆣಠព຅ʍʝʝᨁከɶʣɸɣʍʆɊ˕ʺ˵̉ˆʱ᝾

ᔃਭᒓʍˇʸʊɩɣʅʎ֚जɊᇉᠷजɊឭ٨ᇉᠷ

ឞʨʂʅͥʃͥʃʍ٨ᯌʱሯ࠷ʊព຅ɸʪɲʇɫ

˗̎˶Ɋᐂ‫ˇح‬ʸ˗̎˶Ɋˁʼ̉ˑ˿̎Ɋ֚ᅸ

ᨁ᝸ʇᒑɧʨʫɾɋɲʫʎɊᖓ‫۔‬ʍᓥᔕͼᆣᔃˇ˓̎ˍ˹́̅̎ˁ̎ʉʈʍ˗̎˶ϹԧʱᎻʲʆɊʸ˂ʺ˟ʍͼʆ Darlisonᶨ³±²±ᶩɫͼᆣᔃਭᒓʍ

ᐂ‫ˇح‬ʸɊ˱ˏ˪ˏɊ‫ˇࠧۦ‬ʸʊᐥɱʨʫʪʧɥ

QOL ʱͫɱʪʊʎ˕ʺ˶̀̎ʉோ୸Ɋ਺‫ܫ‬Ɋᇉ᥸உɸʪɲʇɫᨁ᝸ʆɡʪʇᒑɧʨʫɾɋᖓ‫۔‬ʆᠷʸˑˏ˷̉˞ɫ৕᝸ʆɡʪʇɶʅɣʪӑࡄʇͥʎɊӂκᆔˇʸʱ୯ЙɸʪɾʠʊɊᓓɫʲ̍ͼᆣᔸɸʪɋˇʸʍ˕ʺ˵̉ˆʱᥢɴʉɣɾʠʊʎɊ

ᔃ࡬᫏ᇉᠷजɫͼ৔ʇʉʂʅɊຟᅸɊᐂ‫ح‬Ɋ˱ˏᓥᔕͼᆣᔃʍᏀᦋʇˇʸˡ̎ːʱႾពɶʅ٨ᯌʱ

˪ˏɊឭ٨ᇉᠷʉʈʍˉ̎˝ʹˣ̎ˍ˽̉ʱᜓʂ

Μ༨ɶɊҳ૜ʱ૟ʃˇʸɫᨁ᝸ɿɫɊ
ɐಠᏀ᰺ʥɾᏃೖɊ‫ݼ‬ɮʍਭᒓɫ QOL ʱᏢପɶɾʝʝᫎɣ

ɧʍ૜୛ʩʍˇʸɑʎɊᇉᠷजʍᓥᔕͼᆣᔃʊ᫟ీ᫙ʱ‫ࠧۦ‬ʆᦋɳɶʅɣʪᶨAhmedzai & WalshᶬɸʪᇽᠪͭᢷʱቌɶʅɩʩɊచ৵ʉ௑‫ٴ‬ጐɫ৕᝸³±±±ᶻBolg-BortoloᶬSimmonds & Ahmedzaiᶬ³±±±ᶻʆɡʪɋ

Ahmedzai & Claysonᶬ³±±·ᶩɋᶲᶩᐂ‫ˇح‬ʸʇ‫ݼ‬ᒶኚ˗̎˶Ϲԧᶳᶩࡂఎʗʍோ୸

Hollen ʨᶨ³±±µᶩ ʣ ClaysonᶬSeymour & Nobleɐࡂఎʗʍࡩড়ʊɩɰʪᖐ઄ɑʎɊࡂఎɫ৵ྟ

ᶨ³±±¶ᶩʊʧʫʏɊᓥᔕͼᆣᔃʎᓓɫʲʧʩᅐʊึʊ‫؂‬ɪɥਭᒓʱᆾʍԳʊթ୻ɶɊɼʫɫࡂఎ

ᅞʣ‫ۏ؎ئ‬᭐ʍᨁᅖ्ɫᱝɣɋLübbe & Ahmedzaiӑʍᗿᙸʱ៚ᆌɶʅ༌Εʇ‫ۏ‬᭐ʱᄉɷɊࡂఎʗʍ

ᶨ³±±µᶩʣ Clayson ʨᶨ³±±¶ᶩʎɊ˸́˨ˣʱ؉ˇʸˡ̎ːɫᄉɷʅɣʪɲʇʱቌɶɾɋʝɾɊ

ʠɾᙪԺ૸ͮɊቛᏀˬ̃˙˅Ɋˑ˝̎ˍ˽̉Ɋ̀

ɐੜ৲຅࠳ோ୸ʊɩɰʪᬈᄟɑɫቌɸʧɥʊɊࡂ˥˩̀˜̎ˍ˽̉ጇʍ᣸ϹᆔˇʸɿɰʆʉɮɊ

ఎʍੜ‫؂‬ɫɶʏɶʏਭᒓʍɼʫʇᄴʉʩɊਭᒓʍ

ADL ʍᏢପʣͭࠪʗʍ҇ɬɪɰʉʈɊ৔Ⴞᆔோ

ੜ‫؂‬ʱ࠷Ⴛɸʪͫʆʍᬬ࠿ʊʉʂʅɣɾɋᓥᔕͼ୸ʱ؉ʠɾӂκᆔʉᅖၤˉ̉˞̃̎́ɫᨁ᝸ɿʇ

ᆣᔃਭᒓʍࡂఎʍˡ̎ːʊʃɣʅʍᇉᠷለኴʎʉ

ɶʅɣʪɋಢለኴᏃೖʍɒˉ̉˞̃̎́ʆɬʉɣ

ɣɫɊͼᆣᔃਭᒓʍࡂఎʱࡩᡑʊɶɾ៬೿ᶨͼᆣᨁɣᅖၤɓʆʡɊᐂ‫ˇح‬ʸʍˏ˃́ʱಐɸʪᇉᠷᔃ̍ʸˏ˯ˏ˞ᅒਭ̍ਭᒓʇࡂఎʍϥᶬ³±±¶ᶩʎɊजʎɊᓥᔕͼᆣᔃʍᅖၤᐂ‫ح‬ʊ٨ᯌʱ੡ɷʅɣʉ

ࡂఎʡʝɾ༌ΕɊᖐਰɊᥛɣʍͼʊɡʪɲʇʱቌ

ɪʂɾɋɲʫʎɊᐂ‫ح‬ᅕൖʣ‫ࠧۦ‬ʇɣɥӂκᆔˇɶʅɣʪɋ֚ᅸূΟᒓʊʇʂʅɊˇʸʍ֩Տʱৃʸʊᦞɶɾ‫ܬ‬ʍԢʇɊᅖၤᐂ‫ح‬ʣˉ˵˻ˡˇ̎ʪᨁ᝸ʉ˧̎˞ˠ̎ʆɡʪࡂఎʍˡ̎ːʎɊʇʡ

ˍ˽̉ʍˏ˃́ɫᓥᔕͼᆣᔃਭᒓʍˡ̎ːʇ‫׹‬ᔸɸʪʇ᝾ᗹʇɴʫʪɲʇɫɡʪɋᓥᔕͼᆣᔃʊɩɶɾɾʠʇୟࡗɴʫɾɋͥఄʆɊͥᕓᅕൖʆʎᅖ

ɣʅʎɊࡂఎʡʝɾɊਭᒓʍᏒಙᆔʉΜাʇᥴɣၤˉ̉˞̃̎́ɫ‫ۏ‬᭐ʆɡʂɾɫɊɲʫʎ৵৷

᥼ᜓʊˍ˽˙˅ʱ‫ל‬ɰɊ֝Ԕʉీ᫙ɫͮɧʨʫʉ

ಜɊ੾৷ಜɩʧʒ˕̎˵ˠ́ಜʍਭᒓʱ‫ీ׽‬ʊˇɣʝʝੜ৲຅࠳ʱᥖʨʫʪ‫ۏ‬᭐ʉၤ຤ʊɡʪɲʇʸɶʉɮʅʎʉʨʉɣͼʆɊӂκᆔˇʸʱ୯ЙɸʱႾពɶɊˇʸɫ৕᝸ʉࡩᡑᒓʇɶʅோ୸ʱᜓɥ

ʪᬈᄟʱቌɶɾʡʍʇᒑࡗɴʫɾɋɐࡶӁʆɬʉɲʇɫᨁ᝸ʆɡʪʇᒑɧʨʫɾɋ

ɣᐂ‫ˇح‬ʸɑɫቌɶɾʧɥʊɊຟᅸᥬͼʆʡᅕၤɫ᥼ᜓɸʪᓥᔕͼᆣᔃʎɊᐂ‫ˇح‬ʸʍࡶӁɫᦅʫɫʀʆɡʪɲʇʡᅖၤˉ̉˞̃̎́ʱ‫ۏ‬᭐ʊɶɾŻ¡µº¡Ż

˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬ఎʍᎃቛᆔோ୸Ɋੜ৲຅࠳ோ୸ʍɾʠʍ਺‫ܫ‬୯Йᶳᶮᇉᠷजʍᤸɣ੡਺ʗʍோ୸
ึʊʥɮਭᒓʍˇʸʊɩɣʅʎɊᇉᠷजʊ੡਺

ʣᇁ៯Ɋψʍ࡬᫏ᒶʣ֚ᅸ෤᫟ʇʍ᥸உɊˡ̎ː՜҇ɫᄉɷʪɲʇɫᇽʨʫʅɣʪᶨͪᖒ̍‫ͼ̍ܝ‬ʱঃɬԎɸˉ˵˻ˡˇ̎ˍ˽̉ᶨ᥎ᙸ̍‫̍ᧂפ‬๽۞̍ᙸׄ̍ࢨ̍‫ށ‬ಳ̍ቬಢ̍ᖲᨂᶬ
³±±¹ᶻ‫ށ‬඿̍ᄑ̍ᡋᄑ̍࠽Υ̍ᙸᄑᶬ³±²²ᶻᇉᠷ֩ϥࠍ௮ႈᶩࡷ೔̍ٙທᶬ³±²±ᶩɋᓥᔕͼᆣᔃʍˇʸʊɩɣʅʡɊ

ʍᒂৃʱᆾᆔʇɸʪ˭̃ˆ˿˶ӑࡄɫ৕᝸ʇᒑɧ

ɐᇉᠷजᔵ᣸ʍᤸɣ๨ପʀɑɫቌɴʫɾɋɲʍɥ

ʨʫɾɋɴʨʊɊၡᑛ᜴࠿ᒓˇʸ௟ᓑ˭̃ˆ˿˶

ʀɊɒᖐᅞʊɡʪਭᒓʱʞʪᤸɴɓʎɊᅖၤˉ̉

ʆɊᠯࡗʣ‫״‬ຫʊʧʪோ୸ɊຟᅸఄຫɊ᜴࠿ᒓᔵ

˞̃̎́ʍᇽᠪʇ૮᜖ʍ‫ͫ؂‬ʊʧʂʅ௑‫ٴ‬ɴʫʪ᣸ʍៜʩɊˇʸˏ˃́ʍ̃̎́˭̂ʺɫ࠷ఆɴʫ

‫׭‬ᓧ৷ɫɡʪɋɒຟʨʉɣਭᒓʱˇʸɸʪᤸɴɓ

ʅɣʪᶨ‫۔‬ዒᎃቛвѪለኴ૗ᶬ³±²²ᶩʧɥʊɊͼʇɒඋլʇͭࠪʗʍˇʸʍ͸ዒɫʆɬʉɣɓʎɊ

ᆣᔃਭᒓʊࡩɸʪ՜࿔̍௚༔ʉʈʍ቎ϥвᬬோ୸ʚʇʲʈʍਭᒓɫࠬຟɸʪ‫ݹ‬ቿᅕൖʣ৵৷ಜ̍੾

ጐʊ᫟ɸʪᇽᠪʇਭᒓʍ᝖ᭉʉ৔ႾʱႾពɸʪɾ

৷ಜɫ༌‫ۦ‬ɸʪ‫ݼ‬௦ʍਭᒓʱˇʸɶʉɮʅʎʉʨ

ʠʍਭᒓᔵ᣸ʍៜʩɫಙʝʫɾɋ಍াʊɊᇉᠷज

ʉɣშ݄ʍͼʆɊᨁᅖʆˇʸˡ̎ːʍ‫ݼ‬ɣᓥᔕͼᔵ᣸ʍᤸɣ๨ପʱᐂ‫ح‬ɸʪɾʠʍˏ˞̂ˏ˴ˣˎᆣᔃਭᒓʱˇʸɸʪɲʇʊᢰ‫ی‬ɶʅɣʪʍʆɊᐂ

˷̉˞ɫ৕᝸ʇᒑɧʨʫɾɋ

‫ˇح‬ʸʱచಜʊࡶӁɸʪɲʇʆɊᤏ༜ɸʪɲʇɫ
‫׭‬ᓧʆɡʪʇᒑɧʨʫɾɋͥఄʆɊ
ɒ಍ಜʝʆᇉ

ᶵᶮಢለኴʍᬈᄟʇρাʗʍቌٖ

‫כ‬ʫʉɣ˫˿ˏ˞̂̎ˍ˽̉ɓʣɒ᝾ពʍᦒɥຟ

ಢለኴʎɊҳᜓለኴɫ΋ɶɣᓥᔕͼᆣᔃਭᒓʍ

ᅸఄᨌʊূʮɵʪʱৃʉɣ࿵Տ੡ɓʍׄ‫ی‬ʇʉʪˇʸʊɩɰʪᇉᠷजʍ‫ۏ‬᭐ʱనʨɪʊɸʪɾʠʊ

ၤ຤ʎɊᇉᠷजɿɰʆ௑‫ٴ‬ɸʪɲʇʎ᭐ɶɣʍ

ᜓʂɾ୛Ꭽᆔለኴʆɡʪɋಢለኴ֩ՏᒓʎɊͥᧅ

ʆɊᤸɣ๨ପʗʍோ୸ɫ৕᝸ʆɡʪɋ˕̎˵ˠ́

ʍ֚ᅸ෤᫟ʊ૗࢙ɸʪᇉᠷजʆɡʪɲʇɊʝɾɊˇʸʊϪɥᇉᠷजʍ੡਺՜҇ʱᤏ༜ɸʪோ୸ጐʇ

ᐂ‫ˇح‬ʸᅕൖʣឭ٨ᇉᠷˏ˜̎ˍ˽̉ʊմլɸʪ

ɶʅɊ˗̎˶ˁ̉˫ʷ̂̉ˏʍ࠷ఆᶨᆯܺ̍๽ᄑ̍

ᇉᠷजʍՁ‫׹‬ɫࡸʉɪʂɾɲʇɪʨɊለኴᏃೖɫ

‫פ‬ᡅᶬ³±±ºᶩɊ̀ʾ˔̉ˠ̎ˏʍໍᄍᶨടᄑ̍൛ᶬ

ુɫ‫۔‬ʍᇉᠷजʍ‫ۏ‬᭐ʱϐᜟɸʪʇʎᒑɧʊɮ

³±±ºᶩɊɫʲᇉᠷʍ࠷ᣊᆔᇽᠪʇˇʸ૮᜖ʍ႘ৃ

ɣɋᇉᠷजʍ‫ۏ‬᭐ʱనʨɪʊɸʪɾʠʊʎɊӂ‫۔‬෤ϥʍ୯Йᶨࠨࡅ̍Գᄑᶬ³±²±ᶩʉʈɫ‫ؙܫ‬ɴʫʍ֚ᅸ෤᫟ʆᓥᔕͼᆣᔃਭᒓʍˇʸʊূΟɸʪᇉʅɣʪɋᠷजʱࡩᡑʇɶɾ‫ށ‬᝿ාʉ៬೿ɫ৕᝸ʆɡʪɋ
ಢለኴᏃೖʎɊᓥᔕͼᆣᔃʍˇʸʎᱝ्ʊ࡬᫏

ᶴᶮᓥᔕͼᆣᔃʊ᫟ɸʪᇉᠷज‫؂‬ɰ௟ᓑ௟ಲʣ˭

ᆔʉᇽᠪʇ૮᜖ʱ᝸ɶʅɣʪʊʡɪɪʮʨɹɊ֝

̃ˆ˿˶ʗʍቌٖ

Ԕʉᇽᠪʱৃʪɲʇɫ᭐ɶɣɾʠɊˇʸʱᜓɥᇉɉಢ៬೿ʆቌɴʫɾɊᓥᔕͼᆣᔃਭᒓʍˇʸʊᠷजʍ৔᣸ʍᡥଉɫ‫ށ‬ɬɣɲʇʱቌɶɾɋρাʍɩɰʪᇉᠷजʍ‫ۏ‬᭐ʧʩɊᇉᠷज‫؂‬ɰʍ௟ᓑ˭̃

௟ᓑ௟ಲʍ᫕ᆌʣ௟ᓑ˭̃ˆ˿˶ʍ᫕ᆌʇ࠷ఆɫ

ˆ˿˶ʣ˭̃ˆ˿˶ʊಙʝʫʪᶴʃʍӑࡄʊʃɣಙʝʫʪɋʅឧɸɋ‫ۏ‬᭐ʇɶʅɐಠᏀ᰺ʥɧʍ૜୛ʩʍˇʸɑɫʡʂʇʡ‫ۋ‬ጏɫ‫ݼ‬ɪʂɾɲʇɪʨɊʝɹᅒਭʇ

ΧᶮᏃɉៜຟᅸʊ᫟ɸʪᇽᠪɫͭ‫׭‬ดʆɡʪʇᒑɧʨʫɾɋ
ตʊɊɫʲᇉᠷʍᏘᏙ௟ᓑʆ࠷ఆɴʫʅɣʪʧɥ

ᓥᔕͼᆣᔃਭᒓʍˇʸʊஉʮʪᇉᠷज ³² κʊʊɊᅖၤʸˑˏ˷̉˞ʇˉ̉˞̃̎́Ɋਭᒓʇࡂ

ࡩɶʅʺ̉˕˩˻̎ʱᜓʂɾᏃೖɊɐಠᏀ᰺ʥɧ

Ż¡¶±¡Ż

ᫎɉೋ̍‫ܝ‬ɉӑ̍‫׾‬ɉ‫כ‬ᶺᓥᔕͼᆣᔃਭᒓʍˇʸʊɩɰʪᇉᠷजʍ‫ۏ‬᭐ʍ૜୛ʩʍˇʸɑɊɐࡶӁʆɬʉɣᐂ‫ˇح‬ʸɑɊɐੜ௮ɉႈ৲຅࠳ோ୸ʊɩɰʪᬈᄟɑɊɐࡂఎʗʍࡩড়ʊɩɰ
ʪᖐ઄ɑɊɐˉ˵˻ˡˇ̎ˍ˽̉ˏ˃́ͭᢷɑɊɐᇉ
ᠷजᔵ᣸ʍᤸɣ๨ପʀɑʉʈʍ‫ۏ‬᭐ʱᏀ᰺ɶʅɣ

AhmedzaiᶬSHᶮ
ᶬ& WalshᶬDᶮᶨ³±±±ᶩᶮ Palliative medicine
and modern cancer careᶮ Semin oncologyᶬ³¸ᶬ²-·ᶮ
AhmedzaiᶬSHᶮᶬ& ClaysonᶬHᶮ
ᶨ³±±·ᶩᶮ Supportive andɾɋpalliative care in mesotheliomaᶮO'ByrneᶬKᶮ& Ruschᶬ
Vᶮ
ᶨEdsᶮᶩMalignant pleural mesotheliomaᶮOxford

᠙ɉ᤺ɉ

University Pressᶬµ±´-µ´µᶮቾࢡฬࠍᶨ³±±·ᶩᶮ ਭᒓʇࡂఎʍˇʸʊʃɣʅɉ֚ᅸ

ಢ៬೿ʎɊ௮ᧅቿࠜᇄቿࠜለኴᡸᶨवી ²º-³³श्‫ܛ‬ᆺᶨCᶩ៨ᯌᄰ‫׳‬ᶺ²º¶º³·²±ᶩʍՕીʱ‫ל‬᫟Фᒓʍɾʠʍʸˏ˯ˏ˞᠘ॎɔሃᏰ᫟᥸ᅒਭŻ឴ఀ̍ˇʸ̍Μ᫾Żɕᶬ̧¹-º²ᶮɰʅᜓʂɾɔʸˏ˯ˏ˞ᇁ៯ΟඋʊࡩɸʪвѪजࠪ೅ᄒІࠍ̍၄ࢨɉѪ̍ࡷ೔௙ᄉ̍ࢨಳɉμᶨ³±±·ᶩᶮʍࡩড়̍ବࡶ˂ʺ˟˿ʺ̉ʍථጶʇើМɕʍͥᧅቛᏀ᭐ᅕਭᒓʱˇʸɸʪᇉᠷजʍχΟˏ˞̂˙ˋ̎ʆɡʩɊዿ ²· ‫ۋ‬ఖಢᐂ‫֚ح‬ᅸࠜϥࠜ᜖‫ށ‬ϥʊɩʍనሯ֊ɉᔴॅᇉᠷᶬ́³ᶬµ²³-µ²ºᶮBorg-BortoloᶬPᶮᶬSimmondsᶬ& AhmedzaiᶬSHᶮᶨ³±±±ᶩᶮ

ɣʅͥᧅʱᆌᜟɶɾɋ

Conflicting advice in the care of dying patientsᶮለኴʊɳ֩Տɣɾɿɬʝɶɾᇉᠷजʍᆕපʊ༈
ɮ੡᠙ᄔɶͫɱʝɸɋ

Practitionerᶬ³µµᶬ·¸³-·¸¸ᶮBritish Thoracic Society Standard of Care Committere
ᶨ³±²²ᶩᶮ BTS statement on malignant mesothelioma
in the UKᶬ³±±¸ɜElectronic versionɝᶮThoraxᶬ·³ᶬ
²-²ºᶮͼᆣᔃ̍ʸˏ˯ˏ˞ᅒਭ̍ਭᒓʇࡂఎʍϥᶨ³±±¶ᶩᶮͼᆣᔃ̍ʸˏ˯ˏ˞ᓓɫʲʊ᫟ɸʪʸ̉ˇ̎˞‫ؙܫ‬ಅᶮɉɐhttp://www.chuuhishu-family.net/survey³±±¶±·.pdfɑ
ɉᶨ³±²².²².²²ᶩ
C l a y s o n ᶬH ᶮ
ᶬS e y m o u r ᶬJ ᶮ
ᶬ& N o b l e ᶬB ᶮ
ᶨ ³ ± ± ¶ ᶩᶮ
M e s o t h e l i o m a f r o m t h e p a t i e n t ' s p e r s p e c t i v eᶮHematology/Oncology Clinics of North Americaᶬ²ºᶬ²²¸¶-²²º±ᶮDarlisonᶬLᶮ
ᶨ³±²±ᶩᶮ Role of Clinical Nurse Specialist
ᶨCNSᶩin Malignant Pleural Mesotheliomaᶮ
Mesothelioma UKᶬMesothelioma-Good Practice guideᶬ³³ᶮˆ̂˙ˆᑬᨦᶨ³±±¸ᶩᶮ ᢑᆔឧᥙᆔለኴᶮˆ̂˙ˆᑬ
ᨦ̍ᵀׄɬʧʞ̍ීࢡᑬ๼ᐁᶮʧɮʮɪʪᢑᆔለኴ
ʍ᥼ʠఄ̍ʝʇʠఄŻᇉᠷለኴʍʾ˃ˏ˧̎˞ʱʠ
ɵɶʅɉ֚ัᙪԎ၅ᶬ¶µ-¸³ᶮ
Hawley RᶬMonk Aᶮ
ᶨ³±±µᶩᶮ Malignant mesotheliomaᶺ
current practice and research directionsᶮCollegianᶬ²²ᶬ
³³-³·ᶮ
ᶬGrallaᶬRJᶮᶬLiepaᶬAMᶮᶬSymanowskiᶬJTᶮᶬ
HollenᶬPJᶮŻ¡¶²¡Ż

˨˻̎˴̉̍ˇʸለኴ ³±²³ श¡ዿ ²´ ऍ¡ዿᶱ‫׳‬& RusthovenᶬJJᶮᶨ³±±µᶩᶮ Adapting the lung cancer
symptom scaleᶨLCSSᶩto mesotheliomaᶮCancerᶬ²±²ᶬ
¶¹¸-¶º¶ᶮ¸³-¸µᶮ
ͪ໘ཌྷ‫ᦿރ‬ᶨ³±±¹ᶩᶮ ͼᆣᔃŻᔴॅᶮ൛๮᠖Πᐁᶮᒶඋ৷ሃᏰʏɮ᭭ʇሃᏰ᫟᥸ᅒਭɉ‫ܛ‬ቃᇽᠪʇ՜࿔ᝆ

ϟ೅ᑬᄒ᎚̍ᱝ෡ᬟਚ̍Ϸᙸɶʍʕ̍ͼᨂআ೗̍చࣽ

ңɉ݇ᝆంᝀ၅ᶬͪд‫ۑ‬ಅᶬ²´´-²·²ᶮᬝࠍ̍ሃͫጱࠍ̍ͼвԢᥱᶨ³±±¹ᶩᶮ ˱ˏ˪ˏ̍ᐂ

൛๮᠖Πᶨ³±±¹ᶩᶮͼᆣᔃᶬ൛๮᠖ΠᐁᶬሃᏰʏɮ᭭ʇ

‫ˇح‬ʸᅕൖʍᇉᠷजɫ᪘ᮀʊ᫟ʮʪႻၤʇଂɧʪ٨

ሃᏰ᫟᥸ᅒਭɉ‫ܛ‬ቃᇽᠪʇᝆң̍௚༔ᶨ݇ᝆంᝀ

ᯌʣˏ˞̂ˏɉ೅֋‫ᧅ֚ࠜࠜށ‬вѪࠜቿ᎚᝸ᶬ
²¸ᶬ၅ᶩᶬͪд‫ۑ‬ಅᶬ²²³-²³¸¶º-¸±ᶮ

MurayamaᶬTᶮᶬTakahashiᶬKᶮᶬNatoriᶬYᶮᶬ& Kurumataniᶬᨅྙɴɩʩ̍ࡷࢡቔࠍ̍ͼᨂᏓࠍ̍ࡷ᝷௙ࠍ̍‫ޏ‬ᕩన

Nᶮ
ᶨ³±±·ᶩᶮ Estimation of future mortality from pleuralࠍᶨ³±±·ᶩᶮ ᇉᠷᒶᒓʍຟ᰺ʊ᫟ɸʪ࠷ੳ៬೿ᶨᶱᶩ

malignant mesothelioma in Japan based on an age-cohortᇉᠷᒶᒓʍຟ᰺ʊ᫟ɸʪඋլ‫ו‬ʒ៖ᠪʍ࠷ੳɉఖಢ

modelᶮAmerican Journal of Industrial Medicineᶬµºᶬᇉᠷࠜϥ៵௮ᭂᶺᇉᠷጫႾᶬ́·ᶬ²´±-²´³ᶮ

²-¸ᶮᗿ᝷ުᑬ̍ಢᄑভࠍᶨ³±±ºᶩᶮ ʸˏ˯ˏ˞̍ͼᆣᔃʍᫎೋ॓ࠍ̍‫ܝ‬ӑીࠍ̍‫כ׾‬ᭀ‫״‬ᶨִԨͼᶩᶮ ਱৷ᓥᔕ឴ఀ̍ຟᅸಜʊɩɰʪਭᒓʍᖐਰɉɩᖭʍ๬ᇉᠷࠜ

ͼᆣᔃʍᏀᦋʇਭᒓɫᇀᮅɸʪ‫ۏ‬᭐ɉ˨˻̎˴̉̍

ᭉ៕ᶬµᶬ́µ-µµᶮˇʸለኴ୚૾

Ւᙸᖓࠍᶨ³±±¹ᶩᶮ ‫˵̎˕ࠧۦ‬ˠ́ʊɩɰʪឭ٨ᇉᠷ
जʍ‫ۏ‬᭐੡ɉఖಢᇉᠷࠜϥ៵௮ᭂᶺۨ‫ܕ‬ᇉᠷᶬ́¹ᶬ
²²³-²²µᶮఖಢɫʲᇉᠷࠜϥɉ
ᶨ³±²±ᶩᶮ ɫʲᇉᠷˉʸˁ̀˃˻˿˶ɉɐhttp://jscn.umin.jp/core/img/panf_³±²±.pdfɑ

‫۔‬ዒᎃቛвѪለኴ૗ᶨ³±²²ᶩᶮ ዿᶶ‫ۋ‬ၡᑛ᜴࠿ᒓ˷̉˕́ˇʸለиᶮ

ᶨ³±²².²².²¹ᶩ
ͼಳਮࠍ̍ͼಳۧࠍ̍༒๬Ⴞਚᶨ³±²±ᶩᶮ ᐂ‫ˇح‬ʸʊɐhttp://www.ncnp.go.jp/nimh/kenshu/h³´/h³´_hanzai±·.

᫟ʮʪͥᕓᅕൖᇉᠷजʍ৔᣸ʍᡥଉ्ʇɼʍ᝸‫ی‬ɉhtmlɑᶨ³±²².²².²¹ᶩ

ంྃ᭽ᬘࠜϥ៕ᶬ́ᶬ²-ºᶮ᥎ᙸਚࠍ̍‫̍ࠍݶᧂפ‬๽ᄑ·Ά̍ᡋᄑᦶ๼̍࠽Υ֞ਚ̍‫ށ‬඿ᝃ๼̍ࡷ೔‫ح‬ᑬ̍ٙທδࠍᶨ³±²±ᶩᶮ ˭˿ʺ˴̀̎

ᙸᄑϷ‫ح‬ᶨ³±²²ᶩᶮ ᱝᇽᇊʊɩɰʪ࡬᫏Ԕᨂɔɫʲˠ̎ˏʍᇉᠷजʇɶʅʍᖐਰʇˏ˞̂ˏɉ੾৷ಜᅒ

ʊɩɰʪᢑʍᱝɣᇉᠷजᓑીΟඋɕીೖʇρাʍ࢘ਭʆӁᥠᬎʱᐴʩ᥏ɸਭᒓʱ‫׽‬ɷᇉᠷजɫ‫ל‬ɰପʃಙɉᔴॅᇉᠷᶬ́¸ᶬ³¶´-³·±Οʊ࿶࿢ʱɡʅʅɉఖಢᇉᠷࠜϥ៵௮ᭂᶺીκᇉᠷࡷ᝷ᒨࠍᶨ³±±·ᶩᶮ ၡᑛ৔Ⴞࠜᒓʍ৔ʍҁɉᆏ๬቎ᶮ

IIᶬµ±ᶬ³··-³·¹ᶮ
SasaharaᶬTᶮᶬMiyashitaᶬMᶮᶬKawaᶬMᶮ
ᶬ& KazumaᶬKᶮ

²º´-³²·ᶮടᄑ᮰̍൛నࠍᶨ³±±ºᶩᶮ ɫʲᅕᬎʊմլɸʪᇉᠷज

ᶨ³±±´ᶩᶮ Dif¿culties encountered by nurses in the care

ʍ SOC ʇˏ˞̂ˏʍ᫟᥸ʊʃɣʅɉᇉᠷጫႾᶬµ±ᶬ

of terminally ill cancer patients in general hospitals in´²¶-´²¸ᶮJapanᶬPalliative Medicineᶬ²¸ᶬ¶³±-¶³·ᶮ

LübbeᶬASᶮ
ᶬ& AhmedzaiᶬSHᶮᶨ³±±µᶩᶮ A new approachࠨࡅ௮ࠍᶬԳᄑʑʇʞᶨ³±²±ᶩᶮ Ꮉಡಜɫʲᇉᠷˇʸfor cancer pain management-the pyramid modelᶮʊࡩɸʪͥᕓᅕൖᇉᠷजʍ‫ۏ‬᭐̍ˏ˞̂ˏʊ᫟ɸʪ

Progpalliat careᶬ²³ᶬ³¹¸-³º³௮ႈ൮ឡɉဍಢ‫ᧅ֚ࠜࠜށ‬вѪࠜቿ᎚᝸ᶬ·ᶬºº-²±¹ᶮᆯܺӍࠍ̍๽ᄑฬࠍ̍‫׺‬ᡅɲɹɧᶨ³±±¹ᶩ
ᶮ Ꮉಡಜɫ

ࢡᄑીՑ̍๽ᄑ᎚ࠍ̍၄ࢡਚࠍ̍ᙸׄచঊᰖ̍۟Υ‫ح‬ʲਭᒓʍᇉᠷʊɩɣʅ‫ۏ‬᭐ʱϹ᰺ɶʅɣʪᇉᠷजʗ

ਚ̍ಟͬʝʩࠍᶨ³±²±ᶩᶮ ͼ‫۔֙ۨ۔ۊ۔‬ዒᅕᬎ෤ʍˋ˳̎˞ɉᇉᠷጫႾᶬ́ºᶬ́¶µ-´¶·ථ̍‫۔‬ዒᅸ᯷ᒓᇉᠷለኴࠜᭉ៕ᶬ·ᶬ²¸¸-²¹²ᶮͪᖒᨀᑬ̍‫ܝ‬ɉᑬв̍ͼ۞ᵀ᜞ࠍ̍ᙸׄҥࠍ̍ࢨΩऔࠍ̍‫ށ‬ಳ·ᑬࠍ̍ቬಢຼᑬ̍ᖲᨂʑʇʞᶨ³±±¹ᶩᶮ৵৷ಜᅕᬎʊɩɰʪᇉᠷजʍˏ˞̂˙ˋ̎ɩʧʒ੡
਺՜҇ʍ࠷ੳɉఖಢᇉᠷࠜϥ៵௮ᭂᶺᇉᠷᏴ‫׹‬ᶬ́ºᶬŻ¡¶³¡Ż

ϥɉ‫ܫ‬
ዿᶵಜणϙႾΟϥ¡ᶴᶮ‫ؙܫ‬Ο᮴ɉᶱᶩࠜ᜖ᶨಟಳႾΟᶩዿᶱ‫ۋ‬णϙႾΟϥᠳΟ᩻ɉɉ

ɉዿ²´‫ࠜۋ‬᜖ᭂϥ‫ؙܫ‬ఖɉɉీᶺ³±²²श²±ಏ³³ఖᶨۣᶩ²±ᶺ´±᷾²³ᶺ±±ɉɉɉɉࠜ᜖ᭂϥ‫ב‬Ւᒓ௦ʎ²±·‫׾‬Ɋለиϥ‫ב‬Ւ‫ܬ‬ɉɉ૗ᶺതᑬ೔‫ۊࠜށ‬ᡅ˃˹̉˧ˏ

ᒓ௦ʎ¶µ‫׾‬ʆɡʂɾɋለኴᆌᜟʎ‫ף‬ᯃᆌᜟԎ झ ᒓᶺࡷႠฬ֬Ɋಟಳᆍ᎚ࠍɊᦘᙸӆ·Ɋɫ²¶‫׾‬Ɋ˳ˏ˕̎ᆌᜟɫµ²‫׾‬ʆɡʩɊɣɹ

ɉɉɉɉɉ०࿇༒κᶨಅឧᶩɊ༒๬ᝃࠍᶨ᥼ᜓᶩ

ʫʡໍᆌʉੜ᝾ί୳ɫɡʂɾʇʍ‫ؙܫ‬ɫด झ ᒓᶺᫎᄑ·ᭀɊࢫࣉ቟ͥ

ɡʂɾɋ᧖ऑᢁ௶ᶺᇄᄬ

ɉɉ

ɉዿ²µ‫ࠜۋ‬᜖ᭂϥᶨΜ࠳ᶩʍϗɉɉɉɉዿ²µ‫ࠜۋ‬᜖ᭂϥʎ³±²³शᶷಏ²¶ఖᶨఖᶩɊ
ᶱᶮᠳΟ᩻ഛʍ૭៖

²·ఖᶨಏᶩ
ɉግາ‫ࠜށ‬೅δ˃˹̉˧ˏ௮δɉตʍᠳΟ᩻ഛʎͥᧅ௮លиฬʍͫɊ૭៖ɴʫɾɋ

ഊᕆʊɩɣʅɊ‫ށ‬ϥᫎʱࡷႠฬ֬๤ᶨግາ

ɉᶱᶩዿ²·‫ۋ‬णϙႾΟϥᠳΟ᩻ഛ‫ࠜށ‬ᶩɊ‫ށ‬ϥԾ߆‫ى‬ᫎʱϟᙸʝʥʞ๤ᶨӉɉᶲᶩዿᶴಜዿᶵ‫ۋ‬ႾΟϥɊዿᶵಜዿᶱ‫ۋ‬ႾΟϥዒާࠍሀ‫ށ‬ᶩɫլʠʪʇʍ‫ؙܫ‬ɫɡʂɾɋ
‫ށ‬ϥ˜̎˴ʎɔˇʸɸʪκʍžˇʸſʱᒑᠳΟ᩻ഛɉᶳᶩዿ²´‫ۋ‬ᏴϥᠳΟ᩻ഛɧʪɕʊ຅࠳ɶɾɲʇʡɊЇɺʅ‫ؙܫ‬ɴʫᶲᶮϥ‫ى‬ʍᄴթɾɋ᠘ཱϥʎऐ๥ӆ᫕ʇɶʅϜᄘɴʫʅɣ

ɉᶱᶩӁϥɉం᝿Ӂϥᒓ௦ᶶ‫׾‬ʪഛʡᎶςɴʫɾɋለиϥʎ‫ܝ‬ᢳծᶨ‫۔‬ዒɉᶲᶩᥠϥɉᶰ‫׾‬ᶨश्ಡʆᥠϥΜ࠳ᶱ‫׾‬ᶩᎃቛ̍ቛᏀ֚ᅸለኴˑ̉˕̎ለиବࡶᧅᫎᶩ

ɉɉɉ²±ಏ³³ఖႻ‫ۦ‬Ɋϥ‫ى‬௦ʎ³¹¸‫׾‬ʆɡʂɾɋ

ʊʧʪɔ֚ᅸᒶʍɾʠʍɥʃɊͭࠪʊࡩɸ

ᶳᶮ࡟ᠳΟ᮴

ʪ៖ᇽᜓթᅸຫɕᶨഛᶩɫ‫ؙܫ‬ɴʫɾɋɉᶱᶩᦦ଱᝿኏௑ฬഛʍ൮ឡ

ɉᶲᶩࠜϥWebଉঞᶨࢫࣉႾΟᶻϐႾɉ༒๬ႾΟᶩɉɉɉᢁ௶ᶴᶨᇄᄬᶩʍɔఖಢ˨˻̎˴̉̍ˇʸɉɉ৔Ⴞࠜϥᦦ଱᝿኏ɕɩʧʒɔఖಢ˨˻̎˴̉̍

ɉ˨˻̎˴̉̍ˇʸለኴɉɉɉɉɉዿ²³ऍᶱ‫׳‬ɫʸ˙˭̃̎˟ɴʫɾʇʍ‫ܫ‬ˇʸ৔Ⴞࠜϥϥԯɕᶨዿ²²಻ᶩʊʃɣʅɊ࡟
ᠳʍᏃೖɊׄഛᥱʩ૭៖ɴʫɾɋ

‫ؙ‬ɫɡʂɾɋɉ
ɉࠜ᜖ᭂϥዿ²´‫ށۋ‬ϥʍӟᇍɫʸ˙˭̃̎ɉɉ˟ɴʫɾʇʍ‫ؙܫ‬ɫɡʂɾɋ

ɉᶲᶩᯗ٨̍‫׾‬។ϥ‫ى‬ʍϗɉɉɉɉɉዿᶵಜʍᯗ٨ʍ߆‫ڠ‬ʊʃɣʅʎɊΟլࢋɉᶳᶩለиଉঞᶨᫎᄑႾΟᶻϐႾɉ༒๬Οլࢋᫎᶩᫎ᮹ɪʩʇʉʂɾɋ

ɉɉɉዿ²µ‫ۋ‬ʍࠜ᜖ᭂϥʊɩɰʪለиϥʱɊρাɊோ୸ɶʅɣɮʇʍ‫ؙܫ‬ɫɡʂɾɋᯗ ٨̍ ‫ ׾‬។ ϥ ‫ ى‬ʊ ʎɊɔࠜ᜖ᭂϥ૱᩻
ᶨ˭̃ˆ˿˶ᭂᶩɕɔ˨˻̎˴̉̍ˇʸለኴɕɉᶴᶩᐁᭂଉঞᶨᦘᙸႾΟᶩɔˡ˻̎ː̂˕̎ɕʱᥡϊɸʪɲʇʇɶɾɋ

ɉɉɉᶳᶩ߆‫ى‬ϥ᝿኏ׄഛʍ൮ឡ

ɉ˨˻̎˴̉̍ˇʸለኴɉɉɉɉɉዿ²³ऍᶲ‫׳‬ʎ²³ಏ²¶ఖʍᆌԗΜ࠳ʆɡʪɉɉɉఖಢ˨˻̎˴̉̍ˇʸ৔ႾࠜϥႾΟϥ߆‫ى‬ϥ᝿኏ᶨׄഛᶩʱ൮ឡɶɾɋɲɲʆʍੜ᝾ʱ

ɲʇɫ‫ؙܫ‬ɴʫɾɋɉɉˁ˜ˊ̀̎ʊ·,±±±௮ࠒ኏्ʍ೘ӑʍሀ‫ט‬రɴɺɊ‫ى߆׸‬ϥʆᏘᏙ൮ឡʱᜓɥɲʇʆ

‫ܫ‬ᶨshort reportᶩʱЀʩɊρাɊࠜ᜖ᭂϥΛ૭ɴʫɾɋ

ʍ‫ށ‬ϥᆌᜟᢋ‫ל‬ᢋᒓʊׄኢʍ‫ܙ‬ጅʱКᯈɸŻ¡¶´¡Ż

ϥɉ‫ܫ‬

ʪɲʇɫ‫ؙܫ‬ɴʫɾɋɉׄഛᥱʩɊ૭៖ɴʫɾɋ

ɉᶵᶩू‫ܫ‬ଉঞᶨ०࿇ႾΟᶩᶲᶮϥ‫ى‬ʍᄴթᶨᢁ௶Ձ੠ᶩ

ɉɉɉӁϥᒓʉɶɊᥠϥᒓᶱ‫׾‬ʆɊ³±²²श²³ಏ²¶ఖႻˡ˻̎ː̂˕̎No.²´ʍՁϊʇ᥼ୁၤ຤
ʍ‫ؙܫ‬ɫɡʂɾɋ

‫ۦ‬ʆɊϥ‫ى‬௦³¹·‫׾‬ʇʍ‫ؙܫ‬ɫɡʂɾɋ

ɉᶶᶩΟլࢋᶨ༒๬Οլࢋᫎᶩᶳᶮ࡟ᠳΟ᮴ɉɉ ɉႾΟ̍ᆹΟʍ߆‫ڠ‬ၤʍϗɉɉᶱᶩᯗ٨ʍ߆‫ڠ‬ʊʃɣʅɉɉɉɉႾΟ̍ᆹΟӂ‫ى‬ɪʨࢂϙɸʪఙʍ᥏ᥡɫ

ɉɉɉᫎᡅࣽ໙๤ʧʩዿᶵಜ঱‫ى‬ᶨᯗ٨ᶩʍࢂϙɡʂɾʇʍ‫ؙܫ‬ɫɡʂɾɋᯗ٨ʍࢂϙʊʃ᤺ᥠʍ‫ۋ‬ጏɫɡʩɊ૭៖ɴʫɾɋ
ɉᶲᶩ߆‫ى‬ϥ᝿኏ʍׄഛʊʃɣʅ

ɾɋ

ɉɉ

ɉJSTᢁ௶ᥡϊၤ຤ɉɉɉɉ߆‫ى‬ϥ᝿኏ʍ௮លʊʃɣʅ൮ឡɶɊиฬɉɉɣʅʎɊͥీɊ༒๬Οլࢋᫎ᮹ɪʩʇʉʂ

ɉɉɉɉɔ˨˻̎˴̉̍ˇʸለኴዿ²³ऍᶱ‫׳‬ɕɔࠜɉࠜ᜖߆‫ى‬ϥʍͫʆɊ૭៖ɴʫɾɋ
ɉɉ‫ؙܫ‬ɫɡʂɾɋ

ɉɉɉɉ߆‫ى‬ϥ᝿኏ʍ௮លʊʃɣʅ൮ឡɶиฬʍɉɉ᜖ᭂϥዿ²´‫ށۋ‬ϥʍ૱᩻ɕʱᆌᥡɶɾʇʍ

ɉᐁᭂ߆‫ى‬ϥɥɧʆɊ૭៖ɴʫɾɋ

ɉJSTˡ˻̎ː̂˕̎˷̎́ʍϗɉɉɉɉࠜϥΟլࢋ෤ᓧɫ˭˿ʺ˶ʸ˓ˍʾʺ˚

ɉɉ

ɉɼʍψ

ɪʨᰖࣽ‫ᧅ֚ࠜࠜށ‬ʊኌᤉɶɾɲʇʊࡩড়

ɉɉɉɉɸʘʅʍ߆‫ى‬ϥ᝿኏ʍʉɪʊᆴʩ᥈ʝʫ

ɶɊJSTˡ˻̎ː̂˕̎˷̎́ɫᰖࣽ‫ࠜށ‬ʅɣɾɔႾΟϥʗʍ‫ؙܫ‬ɕʎɊ԰ᬐɸʪɲ

ɪʨणϙႾΟʊᥡϊɴʫʪʧɥʊʉʂɾʇ

ʇʊʉʂɾɋ
ɉᶳᶩࠜ᜖߆‫ى‬ʊʧʪ൮ឡΟ᮴ʍ࡟ᠳᶨᢁ௶Ձ੠ᶩ

ɉᐁᭂΟլࢋʗʍ৕᝸Ꮐᡸʍ᧖Ԕʍϗɉɉɉࠜ᜖ᭂϥʍᆌᜟᒓʍɥʀʆɊҥቻʉᆌᜟʊ

ɉɉʍ‫ؙܫ‬ɫɡʂɾɋ

ɉɉɉɉΟլࢋɪʨᦘᙸႾΟᶨᐁᭂଉঞᶩʊ˨˻̎

ࡩɶ᝚ᢋԧ्ʊʃɣʅɊࠜ᜖߆‫ى‬ϥɪʨɣɮ˴̉̍ˇʸለኴʍᆌᥡ௶ᨅʇɶʅ²±,±±±Ӓʃɪʍ៨ᯌɫ୯ᢰɴʫɾɋɼʫʊʃɣʅणϙʱ᮹ɰɾఙʍ‫ؙܫ‬ɫɡʂɾɋ

ႾΟϥʆ൮ឡɶɾʇɲʬɊ᝚ᢋԧ्ʊʃɣʅ

ɉ֚ࠜಅᬎू‫ܫ‬Ɋࠜϥश᫙਺‫ܫ‬୯ЙʍϗʎɊࡸʉɮʇʡตಜࠜ᜖ᭂϥʆʎɊҳʍࠜ᜖ɉɉɉɉɉɉᆍ᩻༔ʞʆɡʪɲʇɫ‫ؙܫ‬ɴʫɾɋᭂϥʍ࠷ఆʱᣐᝳɶɾɣʇɣɥตಜ‫ށ‬ϥཇѹ߆‫ى‬ϥʍੜ‫؂‬ɫɡʂɾɋɲʫʱ‫ל‬ɰɊणϙႾΟϥʇɶʅʎɊɲʍϗʊʃɣʅɊࠜ᜖߆‫ى‬ϥዿᶲ‫ۋ‬णϙႾΟϥᠳΟ᩻ʆʍᏘᏙ࡟ᠳʱɩᯓɣɸʪʇʍᏃ៵ʊᔷʂ

ಜɉɉఖᶺ³±²²श²³ಏ²¸ఖᶨۣᶩ²µᶺ±±ᶭ²·ᶺ´±ɾɋ‫ܬ‬ɉɉ૗ᶺതᑬ೔‫ࠜށࠜށ‬ᬎ‫ۊ‬ᡅ˃˹̉˧ˏ

ɉɉɉʝɾɊตಜࠜ᜖ᭂϥʊɩɣʅɊϔʊɊɼʍԎ झ ᒓᶺࡷႠฬ֬Ɋಟಳᆍ᎚ࠍɊᫎᄑ·ᭀɊ᝚ᢋԧ्ʍ࠷ఆɫ຅࠳ɶɾ‫׹ܬ‬ʊʎɊǋ࠷ఆɉɉɉɉɉࢫࣉ቟ͥɊᦘᙸӆ·Ɋ०࿇༒κᶨಅឧᶩɊ

΂Ϲʎ‫ށ‬ϥᫎʆɡʪɲʇɊǌࠜ᜖߆‫ى‬ϥʎ‫ށ‬ɉɉɉɉɉ༒๬ᝃࠍᶨ᥼ᜓᶩ

ϥᫎʱˋ˳̎˞ɸʪ঱ՁʆɡʪɲʇɊǍˋ˳̎˞ʍ኏्ʊʃɣʅʎɊρাʍᏘᏙ࡟ᠳɫ

ᠳɉΟ৕᝸ʆɡʪɲʇɊǎρাɊ᫕ѻɴʫʪࠜ᜖ᭂ

ᶱᶮዿᶱ‫ۋ‬णϙႾΟϥᠳΟ᩻ϥʊɩɣʅɊˀ̎˭ˡ̉ˆ̍ˑ̂˸ˡ̎ʇ˅Ż¡¶µ¡Ż

ϥɉ‫ܫ‬

̃̎ˎ̉ˆ̍ˑ̂˸ˡ̎ʱ࠷ఆɸʪʧɥʊ˭

ɉɉɉ‫ܙ‬ጅ᝸ᮾʍ௮លʍиฬɫ૭៖ɴʫɾɋ

̃ˆ˿˶ʱɾʅʪɲʇɫಙʝɶɣʉʈʍੜ᝾

ɉɉɉ˨˻̎˴̉̍ˇʸʍឍ࿢ɪʨʞɾ࿔࠿ʍ

ɫԎɴʫɾɋ

৔Ⴞʊ᫟ɸʪ៵௮ʱКᯈɶɾʇʍ‫ؙܫ‬ɫɉᶴᶩᐁᭂ߆‫ى‬ʊʧʪ൮ឡΟ᮴ʍ࡟ᠳɡʂɾɋɉɉɉ೿៦ᒓʱࠜϥ‫ى‬ϒ‫ݹ‬ʊКᯈɸʪ‫׹ܬ‬Ɋᶱ៵ɉɉ௮ɡɾʩ´,±±±Ӓʍ᠙ቍʱோૠɥʇʍ୯ഛɫ
ɡʩɊΛ૭ɴʫɾɋ

ɉ೿៦ᒓ๤‫׾‬ጇʍ̀ˏ˞ʍӆ᫕ʊʃɣʅཇ
ѹʱɶʅɣʪఙʍ‫ؙܫ‬ɫɡʂɾɋ

ɉᶵᶩू‫ܫ‬ᶨ०࿇ᶩɉᶵᶩू‫ى߆ܫ‬ʊʧʪ൮ឡΟ᮴ʍ࡟ᠳ

ɉɉɉNLNo²´ʍ᥼ୁၤ຤ʍ‫ؙܫ‬ɫɡʂɾɋ

ɉɉɉू‫ى߆ܫ‬ϥɪʨႻᜓʍNLʍ૜์ʊՒɧɊ

ɉᶶᶩΟլࢋ

E-mailʊʧʪϥ‫ى‬ᇁΣʍί໐૜์ʊʃɣʅ൮

ɉɉɉᶸ/²±ʊ‫׾‬។ϥ‫ى‬ʗࠜϥ៕ɊNLɊ‫ށ‬ϥ૱᩻ឡɶɾӑࡄʊʃɣʅʍ࡟ᠳɫɡʂɾɋɼʍᏃ

ᭂʱᥡϊɶɾɋ

ೖɊዿᶲʍू‫ܫ‬૜์ʊʃɣʅʎ٦ᄍˋ̎˦̎

ɉɉɉ²²/²±ᯗ٨Кᯈ௮ಅʱᫎᡅࣽ๤ʊᥡϊɶɾɋ

ᶨSpee VerᶩʍԢᄍʱ៖ʠʪɲʇɫ຅ʝʂɾɋ

ɉɉɉӁϥᄔ᥈ಅʍ࡬᫏Ԕᨂʱ˝̎˕֊ͼʆɡ

ɾɿɶɊǋ٦ᄍˋ̎˦̎ʍ‫ޔ‬᎜ಜ᫙ʎɊ੶ᨁ

ʪɋʱಜɶʅɊρ‫ۋ‬ʎᶱश‫ޔ‬᎜ʇɸʪɲʇɊǌϥɉɉɉϥ‫ى‬௦Ɋ‫ށ‬ϥ‫ב‬Ւᒓ௦Ɋᆌᜟ௦Ɋለиϥ‫ב‬‫ى‬ʊɲʍू‫ܫ‬૜์ʱ‫ל‬дɸʪɪ؇ɪʱ಍Ԟʍ

Ւᒓ௦ʉʈɲʫʝʆʍ˝̎˕ʱ‫׭‬ខ֊ɶಢఖ

˷̎́ʆሯ៖ɸʪɲʇʇɣɥɲʇʊʉʂɾɋ

᧖ऑɶɾɋɉᶶᶩΟլࢋᶨ༒๬ႾΟᶩɉɉɉश्ಡʊϥ‫࠴ى‬ϥᡸ៰๳ಅʱཇѹͼʆɡɉɉɉᯮᄑྑࠍϥ‫ى‬ʍ‫׾‬។ϥ‫ى‬ୟ଱ʍ୯ഛɫ༒๬

ʪɋू‫ܫ‬ʗ‫׾‬Գϊɬ࡫ಅɊϥᡸ៰๳ಅʱᶱಏ

ႾΟʧʩɡʂɾɋणϙႾΟϥʇɶʅʎɊɼʍ
ഛʊᢉ‫׽‬ɸʪੜ᝾ɫᭂ᎜ɴʫɊႾΟϥʊ᠃ʪಡᥡϊɸʪɋ
ᶵᶮɼʍψɲʇɫሯ៖ɴʫɾɋต ‫ ۋ‬ʍ Μ ࠳ ʎ³±²³श ᶲ ಏ²¹ఖᶨ ۣ ᶩ²¶ᶺ±±᷾ᶴᶮ‫ؙܫ‬Ο᮴²¸ᶺ±±ᶨ௮δഊᕆᶩʇɸʪɋ

ɉᶱᶩࠜ᜖ᶨಟಳႾΟᶩ
ɉɉɉዿ²µ‫ށۋ‬ϥཇѹ߆‫ى‬ϥʍ᥼ୁၤ຤ɫ‫ؙܫ‬ɴʫɾɋ˭̃ˆ˿˶ʎNLNo²´ʊ୤ᤓɶᶬᶱ‫׳‬ዿᶳ‫ۋ‬णϙႾΟϥᠳΟ᩻ᥱдጇʱ‫࡫׽‬ɸʪɲʇʱКᯈɸʪʇʍ‫ؙܫ‬ɫ᫕ѻఖీᶺ³±²³शᶲಏ²¹ఖᶨۣᶩ²¶ᶺ±±᷾²¸ᶺ³±ɡʂɾɋ᫕ѻ‫ܬ‬૗ᶺግາ‫ˏ˧̉˹˃ܺށࠜށ‬ɉᶲᶩࠜϥWebᶨࢫࣉႾΟᶩԎ झ ᒓᶺࡷႠฬ֬Ɋಟಳᆍ᎚ࠍɊࢫࣉ቟ͥɊ

ɉɉɉዿ²´‫ࠜۋ‬᜖ᭂϥ᫟᥸Ɋ‫ܙ‬ጅ᝸ᮾʍ௑វ၅ɩ

ɉɉɉɉɉᦘᙸӆ·Ɋ०࿇༒κᶨಅឧᶩɊ

ʧʒΟլࢋʍ϶૗ʍˉ̉˜̉˚ʍʸ˙˭̃̎ɉɉɉɉɉ༒๬ᝃࠍᶨ᥼ᜓᶩɊ

˟ʱᜓʂɾɋด झ ᒓᶺᫎᄑ·ᭀɉᶳᶩለиᶨᫎᄑႾΟᶩɉɉɉɉ‫ؙܫ‬Ο᮴ʉɶᶱᶮԳ‫ۋ‬ʍᠳΟ᩻ʍሯ៖ɉᶴᶩᐁᭂᶨᦘᙸႾΟᶩᶨᢁ௶Ձ੠ᶩ

ɉɉׄഛʍᥱʩɊ૭៖ɴʫɾɋ

ɉɉɉ˨˻̎˴̉̍ˇʸለኴʍ૸ኢ៵௮ʍ೿៦

ᶲᶮϥ‫ى‬ʍᄴթʍ᥼ୁၤ຤ʊʃɣʅ‫ؙܫ‬ɫɡʂɾɋ

ɉᶱᶩం᝿Ӂϥᒓɉᶶ‫׾‬Ż¡¶¶¡Ż

ϥɉ‫ܫ‬

ɉᶲᶩᥠϥᒓɉɉɉᶳ‫׾‬ɉɉɉɉɉ˳ˏ˕̎ᆌᜟɩʧʒ‫ף‬ᯃᆌᜟʊɩɰʪ

ɉᶳᶩɼʍψɉɉɉҥቻᒓʊࡩɶɊ᝚ᢋʱዿ²µ‫ށۋ‬ϥཇѹ߆ɉɉɉం᝿Ӂϥᒓɩʧʒᥠϥᒓϒ‫ݹ‬ʊɊᶱ‫׾‬ʍᬐ‫ى‬ϥʆ࠷ఆɸʪɲʇɫ‫ؙܫ‬ɴʫɾɋʉɩɊ

ፚ૨ɣ༔ʞʍҮϥ‫ى‬ɪʨϥᡸɫଶʩ᥈ʝʫɾ

ӌϹᆔʊʎɊᆌᜟᒓᔵ᣸ʍʾ̉˞̀̎ఄ

ϗʊʃɣʅɊᬐፚʍ‫כ‬ʩ໤ɶʱ᠃ʩɊ૭៖ɴ

ॾʇɶɊ‫ށ‬ϥഛӑʊ୤ᤓɸʪΜ࠳ʆɡʪʫɾɋɲʇɫ‫ؙܫ‬ɴʫɾɋᶳᶮ࡟ᠳΟ᮴

ɉɉɉǍɉથញϥʍ࠷ఆɉᶱᶩ‫׾‬។ϥ‫ى‬ʍୟ଱ɉɉɉɉɉ¶,±±±Ӓ኏्ᶨᬎᄉʎ´,±±±Ӓ኏्ᶩʍɉɉɉಢࠜϥʍឮዒᆌᢰκʆʡɡʩɊዿᶱಜɪʨ

ϥᡸʇɶʅɊϥ‫ܬ‬ഊɪʨᔷ᥎ʍ‫ܬ‬૗ʱюዿᶴಜʝʆႾΟ̍ᆹΟʇɶʅໍᣱɴʫɾᯮᄑ

ʩʪΜ࠳ʆɡʪɋ

ྑᑬࠍ๤ɫ‫׾‬។ϥ‫ى‬ʊୟ଱ɴʫɊඋᐠʉʈ࡟

ɉɉɉǎɉᶲ‫׳‬ᥱдʍᆌᜓʊʃɣʅ

ᠳʍᏃೖɊ૭៖ɴʫɾɋ

ɉɉɉɉɉᶲ‫׳‬ᥱдʍᆌᜓʊʃɣʅʎ‫ށ‬ϥཇѹ߆ɉᶲᶩ‫ى߆׸‬ϥʍ᝿኏ᶨഛᶩ

‫ى‬ϥʆ൮ឡͼɋᏀᡸጇʍᮅʱիഛɸʪʇɊ

ɉɉɉఖಢ˨˻̎˴̉̍ˇʸ৔Ⴞࠜϥ߆‫ى‬ϥ᝿኏

webʆʍϥ‫ى‬ʗʍ‫؝‬ᇽʇʉʪ‫׭‬ᓧ৷ɫᥙഛɫ୯ԎɴʫɊͥᧅ௮លʍиฬʍͫɊ૭៖ɴ

ʘʨʫɾɋ

ʫɾɋ

ɉɉɉǏɉϥ‫ى‬ʗʍ˭̃ˆ˿˶ʍᆌᥡʊʃɣʅ

ᶴᶮ‫ؙܫ‬Ο᮴ɉɉɉɉɉ‫ށ‬ϥʍಜఖɪʨᥤጣɸʪʇɊׄኢʍ୯

ɉᶱᶩࠜ᜖߆‫ى‬ϥᶨಟಳႾΟᶩԎʍ୚ᭂ᏾ʠԕʩʍಏఖʎᶶಏᶹఖᶨۣᶩ

ɉɉ

ɉዿ²µ‫ށۋ‬ϥᶨግາ‫ࠜށ‬௮δഊᕆᶩʊ᫟᥸

ʉʍʆɊɲʍಜఖʱʊʨʞʉɫʨɊϥ‫ى‬ɸʪ‫ؙܫ‬

ɪʨʍ୯Ԏၤ຤ʱիഛɶʅ˭̃ˆ˿˶ʍ

ɉɉɉǋɉዿ²µ‫ށۋ‬ϥʍӌϹᆔʉӑࡄʎϒͬʍᥱʩʇʍ‫ؙܫ‬ɫɡʂɾɋ

ᆌᥡʱ຅࠳ɸʪɋ
ɉዿ²¶‫ށۋ‬ϥϒᬆɉɉɉɉɉɉ̍ለиϥɉ‫ל‬᠘ʍᬫʊ௶ᨅʱ৏‫י‬ɸʪለ

ɉɉɉǋɉঃɬᏙɬ൮ឡɴʫʪɲʇʇʉʂɾɋ

иϥʇɸʪɋ‫ב‬Ւʎಢࠜϥʍϥ‫ى‬ʍ‫ל‬

ɉɉɉǌɉዿ²·‫ۋ‬ʎɊዿ²¶‫ۋ‬ʆыᝆʊ଱ɫʂʅɣ

ϊʱҥҳɸʪɋ࠷ఆʎ಍‫ށ‬º´‫׾‬ɫ‫ࡄי‬ʪ‫ࠜށ‬ʍɥʀʆɊዿ²¶‫ۋ‬ʊ᫕ѻɴʫʉʆɬʪ௟࠺ʱᄍɣʪɋ

ɪʂɾࠜഊʱыᝆʊᒑɧʅɣʪɫɊɲʍ

ɉɉɉɉ̍‫ށ‬ϥ᠘ཱɉͥᕓӆ᫕ʊɸʪɋ

ీ࿢ʆӑ᠊ɫৃʨʫʅɣʪʮɰʆʎʉɣ

ɉɉɉɉ̍ˍ̉˳ˎʼ˶ɉˍ̉˳ˎˏ˞ʎϟᙸࡻʇʍɲʇʆɡʂɾɋ

ࠍ๤ᶨ‫۔‬ᬫ֚ᅸቬቓ‫ࠜށ‬ᶩɊ৙᡼ϑనɉᶲᶩࠜ᜖WebᶨࢫࣉႾΟᶩ๤ᶨቬࣃᇊዒ֚ቿ‫ࠜށ‬ᶩɊᱝᄑɪɩʪɉɉዿ²µ‫ށۋ‬ϥʍഛӑʱʸ˙˭̃̎˟ɶɾɋ

๤ᶨϥ‫ى‬ᶩʍΜ࠳ɋବ࠳ឡ៵ᒓʎೋΥʝɾɊࠜϥʍHPɪʨዿ²µ‫ށۋ‬ϥʍHPʊ̀

ᡋ๤ᶨግາ‫ࠜށ‬ᶩʍΜ࠳ᶨ௥ኋᄬᶩɋ

̉˅ʱʎʂɾɋ

ʉɩɊ៍Ꮂʎᶱ‫׳‬ᥱдʆቌɸɲʇʇɶɊɉɉ

ዿ²´‫ࠜۋ‬᜖ᭂϥʍපࠍᶨӟᇍᶩʍʸ˙˭ᶳಏԞఛʊϥ‫ى‬ʊᧇᥡɸʪˡ˻̎ː̍̃̎˟ɫᦅʫʅɣʪɾʠɊʉʪʘɮచɮࡩ

̂˕̎ʊᶱ‫׳‬ᥱдʱ‫࡫׽‬ɸʪɲʇɫ‫ܫ‬ড়ɸʪʇʍ‫ؙܫ‬ɫɡʂɾɋ

‫ؙ‬ɴʫɾɋ

ɉᶳᶩለиϥᶨᫎᄑႾΟดझʍɾʠɊ༒๬ΟլࢋᫎɫϐႾ‫ؙܫ‬ᶩ

ɉɉɉǌɉࠜ᜖ᭂϥʊɩɰʪ᝚ᢋԧ्

Ż¡¶·¡Ż

ϥɉ‫ܫ‬‫ؙ‬ɫɡʩɊ௮លʱͥᧅиฬɶɾᶨᢁ௶Ձ੠ᶩ

ɉɉɉዿ²µ‫ށۋ‬ϥʇ᥸թɶɊ‫ב‬Ւᄔɶ᥈ʞʎWebʱᄍɣʪɲʇʱΜ࠳ɶʅɣʪɋ‫ב‬Ւκ௦ʎ·±ɉɉ‫׾‬኏्ʱ᝾᥈ʲʆɣʪɋʊʧʪू‫ܫ‬ʍ᥼ୁၤ຤ʊʃɣʅ‫ؙܫ‬ɫɡʂɉᶴᶩᐁᭂᶨᦘᙸႾΟᶩɉɉɾɋ˨˻̎˴̉̍ˇʸለኴʍᐁᭂʍ᥼ୁၤ຤
ʊʃɣʅ‫ؙܫ‬ɫɡʂɾɋ

ɉɉɉɉɉᶶᶩΟլࢋᶨ༒๬Οլࢋᫎᶩɉɉᆌԗɫᦅʫ๨‫ء‬ʆɡʂɾ²³‫׳‬ᶲऍɫಿ᥻

ҳʊʃɣʅ‫ؙܫ‬ɫɡʂɾɋ
ɉɉɾɋɉɉɉɉᇽᠪ‫ܛ‬ᆺ਺‫ܛᧅܫ‬ᆺˉ̉˜̉˚ଉঞʊ࢐‫ܙ‬ጅ᝸ᮾʍ௮លʍͥᧅиฬʊʃɣʅ‫ؙܫ‬ɉɉᐁᭂ᝿኏ʍ௮លʍͥᧅʊʃɣʅ‫ؙܫ‬ɫ¡ ࠜϥश᪽ɩʧʒఖᏀ˷˝ʹˁ́ˀ̉˿ʺ
̉ʆࠜϥʍू‫ܫ‬ʱᜓʂɾɲʇʍ‫ؙܫ‬ɫɡʂɾɋ˨˻̎˴̉̍ˇʸለኴʍ૸ኢᄍᎧʍӑࡄɉɉʍͥᧅ‫ݳ‬ಂʊʃɣʅ‫ؙܫ‬ɫɡʂɾɋɉɉ¡ ࠜϥ៕˝̎˕̎˯̎ˏቿࠜ૮᜖ଶᕁ෤ථ

ɰʪɲʇʍ‫ؙܫ‬ɫɡʂɾɋ

ɡʂɾɋ
ɉɉ

¡ ࠜϥ៕ʍᡪ‫ݫ‬ʊʃɣʅ΀‫ٴ‬ʱᏀᄒʍᡪ‫ݫ‬ͼʊʎϥ‫ى‬ʊ࢐ɰʨʫʪʇɣɥ‫ؙܫ‬ɫɡʂ

ɫɡʂɾɋ
ɉɉ

ంɶɣϥ‫؂ى‬ɰʍू‫ܫ‬૜์ʆɡʪ˷̎́¡ ࠜϥ‫ܛ‬ቃ਺‫ܫ‬ʱࠜϥश᪽ɩʧʒఖಢࠜ᜖
ϥᠳࠜ᜖֩Տϥᠳʊ୯Йɶɾʇʍ‫ؙܫ‬ɫᖓ௮᝸᎜ʍഊ᫦ʍាనಅʱࠜϥʆЀીɸʪʇɣɥఙʍ‫ؙܫ‬ɫɡʩɊഛɫ‫ؙܫ‬ɴʫɾɋ

ɡʂɾɋ
ɉɉ

ࠜϥ‫ى‬ʧʩࠜϥᄰ‫׳‬ʍ٨ɣ‫׹‬ʮɺɫɡʂ

ɉᶵᶩू‫ܫ‬ᶨ०࿇ᶩɾʍʆɊϥ‫ܫ਺ى‬ʊ᫟ɸʪႻᜓʍɡʩఄʊ

ɉɉʃɣʅ‫ؙܫ‬ɶɊ਺‫ܫ‬ʱӉಐɶɾɋˡ˻̎ː̍̂˕̎No²´ʍˈ˿ׄኢʍ‫ܫ‬Ż¡¶¸¡Ż

ϥɉ‫ܫ‬

Ż¡¶¹¡Ż

ఖಢ˨˻̎˴̉̍ˇʸ৔Ⴞࠜϥϥԯԧ࠳ɉ²ºººशᶵಏᶱఖ
௑ฬɉ²ºººश²±ಏ´±ఖ
௑ฬɉ³±±³शᶶಏᶲఖ
௑ฬɉ³±±·शᶹಏᶶఖ
௑ฬɉ³±±¸शᶹಏᶸఖ
௑ฬɉ³±±ºशᶷಏ²ºఖ
௑ฬɉ³±²±शᶷಏ²ºఖ
௑ฬɉ³±²±श²³ಏ²²ఖᶨ‫׾‬ɉኋᶩ

௑ฬɉ³±²²शᶷಏ³µఖዿɉᶱɉ಻ɉಢϥʎɊఖಢ˨˻̎˴̉̍ˇʸ৔Ⴞࠜϥʇኋɸʪɋ

ᶨΟլࢋᶩዿɉᶲɉ಻ɉಢϥʍΟլࢋʎɊঞᮅɊ¸·²-±¸±²ɉᰖࣽᇊಟᄑᧂͪಟᄗ‫ࠒށ‬๽૔²¸¶±-ᶱɊᰖࣽ‫ᧅ֚ࠜࠜށ‬ᇉᠷࠜቿ༒๬ᝃࠍለኴ࠺ʊᑝɮɋ

ᶨᆾɉᆔᶩዿɉᶳɉ಻ɉಢϥʎɊᇉᠷ̍ςᠷ̍ͳ់ʉʈʍ˨˻̎˴̉̍ˇʸʊɪɪʮʪᮾ‫ܕ‬ʍ৔Ⴞࠜᆔለኴʱୟ᥼ɶɊ
ɼʍ᥼ฯ̍ᆌ࢘̍౓‫ו‬ʊᡧႈɸʪɲʇʱᆾᆔʇɸʪɋ

ᶨΟɉඋᶩዿɉᶴɉ಻ɉಢϥʎɊԳ಻ʍᆾᆔʱᦑીɸʪɾʠʊɊ෤᫟៕ʍᆌᜓɊ˨˻̎˴̉̍ˇʸ৔Ⴞࠜʊ᫟ɸʪለ
ኴᆌᜟ̍ለиʍɾʠʍᭂϥɊ᫟᥸Ԕᨂʇʍࠜᬫᆔʉ᥸உጇʍΟඋʱᜓɥɋ

ᶨϥɉ‫ى‬ᶩዿɉᶵɉ಻ɉಢϥʎɊฬϥ‫ى‬Ɋ‫׾‬។ϥ‫וى‬ʒᢉՕϥ‫ى‬Ɋᢗ៦ϥ‫ى‬ʱʡʂʅථીɴʫʪɋ
ɉɉɉɉɉɉฬϥ‫ى‬ʎɊตʍɣɹʫɪʍ಻ϗʱགɾɸᒓʆɊ˨˻̎˴̉̍ˇʸ৔Ⴞࠜʊ᫟৔ʍɡʪᒓʇɸ
ʪɋɉɉɉɉɉǋɉ‫ࠜށ‬ʆ৔Ⴞࠜ‫ו‬ʒɼʍᬯଢ଼ᮾ‫ܕ‬ʱ࡬௒ɶɊࠜ‫ݥ‬ʍࠜϴʱಐɸʪᒓ
ɉɉɉɉɉǌɉࠜ‫ݥ‬ʍࠜϴʱಐɶɊᇉᠷजɊвѪजɊՕᄊजɊ቎ϥቬቓ‫ݥ‬ɊᎃቛвѪቬቓ‫ݥ‬Ɋςᠷቬቓ‫ݥ‬ɊႾࠜᅸຫ‫ݥ‬ɊЀඋᅸຫ‫ݥ‬Ɋលៜᒴង‫ݥ‬Ɋвᓑ‫ݥ‬ʉʈʇɶʅᆍ᩻ɴʫʅɣʪᒓ
ɉɉɉɉɉǍɉͫឧʍǋʉɣɶǌʇ‫׽‬ጇϒͫʍᏀำʱಐɸʪʇ៖ʠʨʫʪᒓ
ɉɉɉɉɉɉ‫׾‬។ϥ‫ى‬ʎɊฬϥ‫ى‬ʍɥʀಢϥʍᦉ‫ࠜ̍ډ‬᜖ለኴໍթʊɩɣʅᗾɶɣՑᐠʍɡʂɾᒓʆɊႾ
ΟϥʍᆌᠳʊʧʩᏴϥʍ૭៖ʱৃɾᒓʇɸʪɋ
ɉɉɉɉɉɉᢉՕϥ‫ى‬ʎɊಢϥʍΟඋʊᡦ௔ᆔʉ୸ՕʱʉɸᒓʆɊႾΟϥʍ૭៖ʱৃɾᒓʇɸʪɋ
ɉɉɉɉɉɉᢗ៦ϥ‫ى‬ʎɊࠜϥ៕˨˻̎˴̉̍ˇʸለኴʍᢗ៦ɫʆɬʪфκʇ෤᫟ʆɡʪɋ

ᶨӁɉϥᶩዿɉᶶɉ಻ɉಢϥʊฬϥ‫ى‬ʇɶʅӁϥɶʧɥʇɸʪᒓʎɊฬϥ‫ى‬ᶱ‫׾‬ϒͫʍୟᙥʊʧʩɊणϙႾΟϥʍ૭៖ʱৃʉɰʫʏʉʨʉɣɋ

Ż¡¶º¡Ż

ᶨϥ‫ى‬ʍිԢᶩዿɉᶷɉ಻ɉಢϥʍϥ‫ى‬ʎɊಢϥʍ᠈Οඋʊ‫ב‬ՒɶɊಢϥʍᐁᭂԎ၅ၑጇʊʃɣʅҥҳ᧖ϊʱ‫ל‬ɰʪɲʇɫʆɬʪɋɉɉɉɉɉɉฬϥ‫ى‬ʎɊಢϥɫᜓɥለኴʍɾʠʍᭂϥɊ͹ʒʊ෤᫟៕ʊለኴᆌᜟʱᜓɥɲʇɫʆɬʪɋ

ᶨᥠɉϥᶩዿɉᶸɉ಻ɉϥ‫ى‬ɫᥠϥɶʧɥʇɸʪʇɬʊʎɊ௮ಅʱʡʂʅɼʍఙಢϥʊᥱᇽɶɊणϙႾΟϥʍ૭៖ʱৃʉɰʫʏʉʨʉɣɋ

ᶨᬐɉፚᶩዿɉᶹɉ಻ɉ૗࠳ʍϥᡸʱᶲशϒͫཡᎡɶɾᒓʊࡩɶʅʎɊႾΟϥʍᠳ຅ʱᏀʅɊɲʫʱᬐፚɸʪɲʇɫ
ʆɬʪɋᶨ঱ɉ‫ى‬ᶩ
ዿɉ²±ɉ಻ɉಢϥʍΟඋʱᦉ‫ډ‬ɸʪɾʠʊɊฬϥ‫ى‬ʎตʍ঱‫ى‬ʱΣᦦɸʪɋ঱‫ى‬ʍϙಜʎᶳशʇɸʪɋɾ
ɿɶɊӖϙʱ޹ɱʉɣɋ
ɉɉɉɉɉɉϥᫎᶱ‫׾‬ɉϥᫎʎႾΟʍΣᦦʊʧʩ຅࠳ɶɊಢϥʱϐᜟɶɊϥլʱᏎଟɸʪɋϥᫎʎणϙႾΟʍӑᶱ‫׾‬ʱԾϥᫎʊବ‫׾‬ʆɬʪɋɉɉɉɉɉɉणϙႾΟᖏऴ‫׾‬ɉႾΟʍΣᦦʊʧʩ຅࠳ɶɊᥱणϥլʱ‫ᜓܙ‬ɸʪɋӑᶱ‫׾‬ʎΟլࢋᫎʇɸʪɋ
ɉɉɉɉɉɉႾΟᖏऴ‫׾‬ɉฬϥ‫ى‬ʍΣᦦʊʧʩ຅࠳ɶɊಢϥʱᦉ‫ډ‬ɸʪɋɉɉɉɉɉɉᆹΟᶲ‫׾‬ɉฬϥ‫ى‬ʍΣᦦʊʧʩ຅࠳ɶɊಢϥʍϥឞ‫ו‬ʒϥլ‫ᜓܙ‬ʱᆹ೿ɸʪɋ
ɉɉɉɉᶲɉᯗ٨ʱᑝɮɲʇɫʆɬʪɋᯗ٨ʎႾΟϥʍ૭៖ʱৃʅϥᫎɫ߆‫ڠ‬ɸʪɋᯗ٨ʍϙಜʎᶳशʇ
ɸʪɋɾɿɶɊӖϙʱ޹ɱʉɣɋ

ᶨᦉɉ‫ډ‬ᶩዿɉ²²ɉ಻ɉᏴϥʎɊฬϥ‫ى‬ʱʡʂʅථીɶɊಢϥʍ಍ᱝ෤᫟ʇɶʅϥʍੜ৲ʇఄᨌʱ຅࠳ɸʪɋ຅ᠳʎɊ
Ԏझᒓʍᦋ֤௦ʍ‫׽‬ੜʊʧʪɋ
ɉɉɉɉɉɉႾΟϥʎɊಢϥʍΟඋʍᦉ‫ډ‬ʇ‫ᜓܙ‬ʍᡭϙʱᡥɥɋɼʍΟඋʱ࠷ఆɸʪʊɡɾʩɊ߆‫ى‬ϥʱɩɮɲʇɫʆɬʪɋ߆‫ى‬ϥʍᦉ‫ډ‬ʎɊԠʊ࠳ʠʪɋ
ɉɉɉɉɉɉणϙႾΟϥʎɊႾΟϥʍ߆ឦʱ‫ל‬ɰʅɊಢϥʍᥱणϥլʍ‫ᜓܙ‬ʊɡɾʪɋ

ᶨϥɉឞᶩዿɉ²³ɉ಻ɉಢϥʍᏀᡸʎɊϥᡸɊࡉϊᨅ‫ו‬ʒᝆՕᨅʉʈʆʝɪʉɥɋ
ɉɉɉɉɉɉϥឞश्ʎɊ๗शᶴಏᶱఖʊ߂ʝʩɊᒁशᶳಏ´²ఖʝʆʇɸʪɋ
ɉɉɉɉɉɉϥᡸʎɊӁϥᨅ‫ו‬ʒशϥᡸʇɸʪɋ
ɉɉɉɉɉɉӁϥᨅʎɊ´,±±±Ӓʇɸʪɋɉɉɉɉɉɉฬϥ‫ى‬ʍशϥᡸʎɊ¸,±±±ӒʇɸʪɋŻ¡·±¡Ż

ɉɉɉɉɉɉᢉՕϥ‫ى‬ʍशϥᡸʎɊᶱ‫ף‬³±,±±±Ӓʇɸʪɋɉɉɉɉɉɉ‫׾‬។ϥ‫ى‬ɪʨशϥᡸʎ৏‫י‬ɶʉɣɋɉɉɉɉɉɉᢗ៦ϥ‫ى‬ʍशϥᡸʎɊश᫙ʊᆌᜓɴʫɾ෤᫟៕࠷ᡸʇɸʪɋ
ɉɉɉɉɉɉश्ϥᡸʎɊԳश्ಡᶨᶳಏ´²ఖᶩʝʆʊᎡʠʪʡʍʇɸʪɋ

ᶨϥԯʍ‫ݳ‬ಂᶩ
ዿɉ²´ɉ಻ɉಢϥԯʎɊႾΟϥʍᠳʱᏀʅɊᏴϥʊԎझɶɾฬϥ‫ى‬ʍᶳԔʍᶲϒͫʍᢉીʊʧʪ૭៖ʱ
ʡʂʅɊɲʫʱ‫ݳ‬ಂɸʪɲʇɫʆɬʪɋ
ɉϊɉԯɉɉɉᶱᶮಢϥԯʎɊఖಢ˨˻̎˴̉̍ˇʸ৔Ⴞࠜϥឮዒʍఖᶨ²ºººशᶵಏᶱఖᶩɪʨఆᜓɸʪɋ
ɉɉɉᶲᶮಢࠜϥʍዿᶱಜ঱‫ى‬ʎɊዿ²²಻ዿᶱ᮴ᶨͫឧʍႻϥԯዿ²±಻ዿᶱ᮴ᶩʍ᝿኏ʊɪɪʮʨɹɊఖ
ಢ˨˻̎˴̉̍ˇʸ৔ႾࠜϥឮዒᆌᢰκʱʡʂʅҰʅʪɋɉɉɉᶳᶮಢϥԯʎɊ²ºººश²±ಏ´±ఖʊͥᧅ௑ฬɶɊ‫׽‬ఖʧʩఆᜓɸʪɋ
ɉɉɉᶴᶮಢϥԯʎɊ³±±³शᶶಏᶲఖʊͥᧅ௑ฬɶɊ‫׽‬ఖʧʩఆᜓɸʪɋ
ɉɉɉᶵᶮಢϥԯʎɊ³±±·शᶹಏᶶఖʊͥᧅ௑ฬɶɊ‫׽‬ఖʧʩఆᜓɸʪɋ
ɉɉɉᶶᶮಢϥԯʎɊ³±±¸शᶹಏᶸఖʊͥᧅ௑ฬɶɊ‫׽‬ఖʧʩఆᜓɸʪɋ
ɉɉɉᶷᶮಢϥԯʎɊ³±±ºशᶷಏ²ºఖʊͥᧅ௑ฬɶɊ‫׽‬ఖʧʩఆᜓɸʪɋ
ɉɉɉᶸᶮಢϥԯʎɊ³±²±शᶷಏ²ºఖʊͥᧅ௑ฬɶɊ‫׽‬ఖʧʩఆᜓɸʪɋ
ɉɉɉᶹᶮಢϥԯʎɊ³±²±श²³ಏ²²ఖʊͥᧅ௑ฬɶɊ‫׽‬ఖʧʩఆᜓɸʪɋ
ɉɉɉ²±ᶮಢϥԯʎɊ³±²²शᶷಏ³µఖʊͥᧅ௑ฬɶɊ‫׽‬ఖʧʩఆᜓɸʪɋ

࠷լʍ᥸ᏈҳʎɊɚ¸·²-±¸º´ ᰖࣽᇊಟᄑᧂͪಟᄗ๽૔²¸¶±-ᶱ ᰖࣽ‫ᧅ֚ࠜࠜށ‬ᇉᠷࠜቿ ༒๬ᝃࠍለ
ኴ࠺๨ϊɉఖಢ˨˻̎˴̉̍ˇʸ৔ႾࠜϥɉTEL±¹¸-¹º²-³³µ± ᶨFAXӉᶩ ˷̎́ʸ˟̂ˏʎhumanpsy@med.kagawa-u.ac.jpᶨఖಢ˨˻̎˴̉̍ˇʸ৔Ⴞࠜϥ࡬ᄍᶩʆɡʪɋʉɩɊWEB᫟ФʍඋլʎɊঃɬᏙɬࢫࣉ቟ͥ๤ᶨ೅֋‫ࠜށ‬ᶩʍʡʇʆ
ᜓʮʫʅɣʪɋ

Ż¡·²¡Ż

ఖಢ˨˻̎˴̉̍ˇʸ৔Ⴞࠜϥ঱‫ᦦى‬଱᝿኏ዿᶱ಻ɉఖಢ˨˻̎˴̉̍ˇʸ৔Ⴞࠜϥϥԯዿ²±಻ʊ࠳ʠʪ঱‫ى‬ʍᦦ଱ጇʱᦞฬʊ࠷ఆɸʪɾʠʊɊɲʍ
᝿኏ʱ࠳ʠʪɋ
ዿᶲ಻ɉఖಢ˨˻̎˴̉̍ˇʸ৔Ⴞࠜϥʍ঱‫ᦦى‬଱ʍጫႾඋլʎঞ៌ᦦ଱ʍΟᄒɫᆌᄉɸʪᶳ̌ಏϒԳʱ‫ܛ‬ཇʇɶʅɊঞ៌ీʍಢࠜϥႾΟϥɫᦦ଱ጫႾ߆‫ى‬ϥᶨϒͬɊ߆‫ى‬ϥʇɣɥᶩʱᎻᐨɶʅɲʫʱᜓɥɋ
ɉɉᶲɉ߆‫ى‬ϥʎɊᶳ‫׾‬ʍ߆‫ى‬ʊʧʂʅථીɴʫɊɼʍϐᜟᡭϙʇɶʅᦦ଱ጫႾ߆‫ى‬ᫎʱ࠳ʠʉɰʫʏʉ
ʨʉɣɋɉɉᶳɉ߆‫ى‬ϥʍΟլʎɊࠜϥΟլࢋɫଉঞɸʪɋ
ዿᶳ಻ɉႾΟʍ࠳‫ى‬ʎঞԔʍ᫙ฬϥ‫ى‬ʍΣᦦʊʧʪႾΟᶨϒͬɊΣᦦႾΟʇɣɥᶩ²±‫ו׾‬ʒϥᫎବ‫׾‬ʊʧʪႾΟᶨϒͬɊବ‫׾‬ႾΟʇɣɥᶩ²±‫׾‬ʇɸʪɋɉɉᶲɉणϙႾΟʍ࠳‫ى‬ʎঞԔʍ᫙Ɋᖏऴ‫׾‬ʇɸʪɋዿᶴ಻ɉ߆‫ى‬ϥʎϒͬʍඋլʱᜓɥɋ
ɉɉɉᦦ଱࠷ఆఖ኏ʍሯ࠳ʇӆቌɉɉɉɉঞ៌ᦦ଱ʍɾʠʍ߆‫ى‬ϥɫીዒɶɾఖʧʩᶶ̌ಏϒӑʊᦦ଱࠷ఆఖ኏ʇ࠷ఆ૜Ꮩɬʊ᫟ɸʪឞᄘ
ಅʱЀીɶɊɲʫʱӆቌɸʪɋɉɉɉᦦ଱‫׮‬ठʍЀીʇӆቌɉɉɉɉᦦ଱‫׮‬ठʎ঱‫ى‬௑ᦦशʍᶱಏᶱఖʍϥ‫׾ى‬ፖʊʧʩЀીɶɊዿᶶ಻ʊʧʪବ࠳ఖʍᶱɪಏϒԳʊӆቌɸʪʡʍʇɸʪɋɾɿɶɊԳश्ʝʆʍϥᡸಠᎡᒓʎᦦ଱‫׮‬ठɪʨ԰ᬐɸʪɋ
ɉɉɉᦦ଱ʍ࠷ఆʇ᫕በᏃೖʍሯ࠳

ɉɉɉɉಢ᝿࠳ዿᶶ಻ʊʧʩ‫׎‬ฬʉᦦ଱ʱ࠷ఆɸʪɋ᫕በᏃೖʍሯ࠳ʎዿᶸ಻ʊʧʩɲʫʱᜓɥɋ
ɉɉɉɉ᫕በʊᬫɶʅϥ‫ى‬ʍϙੜʉዒʀϥɣʱ៖ʠʪɫɊϥ‫ܬ‬ʍᧉ‫׹‬ʊʧʩκ௦ʱԧᬈɸʪɲʇɫɡʪɋ
ɉɉɉᦦ଱Ꮓೖʍ‫ؙܫ‬ɉɉɉɉ߆‫ى‬ϥʎ᫕በඋլʍᎹΛাɊɼʍᏃೖʱणϙႾΟϥʊ‫ؙܫ‬ɸʪɋɉɉɉɼʍψᦦ଱ʱ‫׎‬ฬɪʃӒཛྷʊᜓɥʍʊ৕᝸ʇ৲ʮʫʪඋլʱᜓɥɋ

ዿᶵ಻ɉᦦ଱ි‫ו‬ʒ᜴ᦦ଱ිʎᦦ଱‫׮‬ठʊឧᤓɴʫʪфκʊͮɧʨʫʪɋɉɉᶲ ᦦ଱‫׮‬ठʍЀીɴʫʪ૗࠳ಜఖʊໟ‫ݹ‬ʊࢍ϶ɸʪʡʍʎᦦ଱ි‫ו‬ʒ᜴ᦦ଱ිʱಐɶʉɣɋ
ዿᶶ಻ɉᦦ଱ʎᦦ଱‫׮‬ठឧᤓϥ‫ى‬ʍΣᦦʊʧʩ࿵ឧ‫૸׾‬በʇɸʪɋ૸በʎ૗࠳ʍ૸በᄍᎧʱᄍɣʪᧇУ૸በʇɶɊବ࠳ʍఖϊʝʆʍ໤ִʍɡʪʡʍʱʡʂʅಐ՞ʇɸʪɋɼʍψ࿵՞ʇʉʪ૸በӑࡄʎ߆‫ى‬ϥʍ࠳ʠʪʇɲʬʊʧʪɋ
ዿᶷ಻ɉ૸በʎΣᦦႾΟʊʃɣʅʎᶳ‫᥸׾‬ឧʇɶɊᆹΟʊʃɣʅʎ֫ឧʇɸʪɋ
ዿᶸ಻ɉঞᦦᒓʍሯ࠳ʎৃበ᮵ʊʧʪɋɾɿɶɊตʍ‫׹ܬ‬ʎɲʍᬈʩʆʎʉɣɋ
ɉɉɉ‫׽‬࿢ᒓʍᄉɷɾ‫׹ܬ‬ʎଇᦦʊʧʂʅ຅ʠʪɋ

ɉɉɉด‫ى‬ʍᄉɷɾ‫׹ܬ‬ʎต࿢ᒓʱʡʂʅᝆɥɋɾɿɶɊต‫ۋ‬௑ᦦಜఖʍᶱशϒԳʊᬈʩᦞᄍɸʪɋ

ɉɉɉԳ᮴ʊʧʂʅᦦԎɴʫɾᒓʍϙಜʎɊԳϙᒓʍ฾ʩʍಜ᫙ʇɸʪɋ

ɉɉɉႾΟ‫ו‬ʒᆹΟʍ‫ח‬ఄʊঞᦦɶɾ‫׹ܬ‬ʎɊႾΟʍঞᦦʱҥҳɶɊᆹΟʎต࿢ᒓʱʡʂʅɡʅʪɋ

Ż¡·³¡Ż

ఖಢ˨˻̎˴̉̍ˇʸ৔Ⴞࠜϥ঱‫ᦦى‬଱᝿኏ዿᶹ಻ɉϥᫎବ‫׾‬ʍɾʠʍᦦ଱ʎΣᦦႾΟʊʧʩ࿵ឧ‫׾‬ʍ૸በʆᜓɥɋɾɿɶɊ‫׽‬࿢ᒓʍ‫׹ܬ‬ʎଇᦦʊʧʂʅ຅ʠʪɋ
ɉɉᶲɉด‫ى‬ʍᄉɷɾ‫׹ܬ‬ʎɊต࿢ᒓʱʡʂʅᝆɥɋ
ɉɉᶳɉԳ᮴ʊʧʂʅᦦԎɴʫɾᒓʍϙಜʎɊԳϙᒓʍ฾ʩʍಜ᫙ʇɸʪɋ
ዿ²±಻ɉବ‫׾‬ႾΟʎɊ˨˻̎˴̉̍ˇʸ৔Ⴞࠜᮾ‫ܕ‬ʊɩɰʪᯑᗾʉඋᐠɡʪɣʎఖಢ˨˻̎˴̉̍ˇʸ৔Ⴞࠜϥʗʍᡧႈ्ጇʊ‫ܛ‬ʄɣʅϥᫎɫବ‫׾‬ɸʪɋ
ዿ²²಻ɉणϙႾΟʎΣᦦႾΟ‫ו‬ʒବ‫׾‬ႾΟʍʉɪɪʨϥᫎɫବ‫׾‬ɸʪɋ
ዿ²³಻ɉϥᫎʎɊϥᫎɊणϙႾΟɊႾΟɊᆹΟ‫ו‬ʒΟլࢋᫎʊʃɣʅᏴϥʆ૭៖ʱɥʪʡʍʇɸʪɋ
ዿ²´಻ɉಢ᝿࠳ʍ௑ฬʎႾΟϥԎझᒓʍᶳԔʍᶲϒͫʍᢉીʊʧʪᠳ຅ʇᏴϥԎझᒓʍ૭៖ʊʧʩᜓʮʫ
ʪɋᬃɉԯɉɲʍ᝿኏ʎɊ³±±µशᶸಏ³·ఖʧʩఆᜓɸʪɋ
ɉɉᶲɉɲʍ᝿኏ʎɊ³±²±श²³ಏ²²ఖʊ௑ฬɶɊ‫׽‬ఖʧʩఆᜓɸʪɋŻ¡·´¡Ż

ᐁɉᭂɉ᝿ɉ኏
ᶱᶮ‫׾‬ኋᶺಢϥ៕ʎɔ˨˻̎˴̉̍ˇʸለኴɕʇኋɶɊᖓ௮‫׾‬ʎJournal of Human Care StudiesʇɸʪɋᶲᶮϜᄘ̍ᐁᭂᶺಢϥ៕ʎঞԔʍ᫙Ɋशᶲ‫ۋ‬ᆌᜓɸʪʡʍʇɶɊɼʍϜᄘ̍ᐁᭂʎणϙႾΟʊʧʩථીɴ
ʫʪ෤᫟៕ᐁᭂ߆‫ى‬ϥɫଉঞɸʪɋ
ᶳᶮ෤᫟៕ʊ᫟ɸʪΟլʎঞԔʍ᫙ɊࠜϥΟլࢋɫ‫כ‬ʩ૨ɥʡʍʇɸʪɋ
ᶴᶮӑࡄᶺಢϥ៕ʎɊಢࠜϥฬϥ‫ى‬ʍ˨˻̎˴̉̍ˇʸ৔Ⴞࠜʊ᫟ɸʪಠԗᜓʍ៵௮ʱ୤ᤓɸʪɋಢϥ៕ʊʎɊˀ̀ˎˠ́ʉӑࡄʍለኴ‫ؙܫ‬ʆɡʪׄᗾ៵௮Ɋʝɾᥟោᆔɡʪɣʎោ᰺ᆔӑࡄʍለኴ‫ؙܫ‬ʆɡʪ‫ؙ̍ܫ‬ᢁ௶ጇʍ៵௮ᶻऍᯃលɊ࢘ಙɊၔᭂɊಅើጇʍᐁᭂ߆‫ى‬ϥʊʧʪКᯈ៵௮ᶻ‫ו‬ʒಢࠜϥ‫ܫ‬ጇɫ‫י‬᩻ɴʫʪɋᶵᶮ૸ኢ៵௮ʎɊᐁᭂ߆‫ى‬ϥʊʧʂʅ࡟೿ɴʫɊ୚૾ʍ‫׭‬؇ɫ຅࠳ɴʫʪɋɼʍᬫɊᐁᭂ߆‫ى‬ϥʎɊಢࠜϥฬϥ‫ى‬ʍᐁᭂ֩Տᒓʊ೿៦ʱКᯈɶɊɼʍ೿៦Ꮓೖʱ‫ב‬ᒑʊɶʅ୚૾ʍ‫׭‬؇ʱ຅࠳ɸʪɋ
ᶶᶮ૸ኢ៵௮ʍׄኢʎɊɔ˨˻̎˴̉̍ˇʸለኴɕʍ‫ܙ‬ጅ᝸᮴ʊཇɷɾʡʍʇɸʪɋ‫ܙ‬ጅ᝸᮴ʎɊᐁᭂ߆
‫ى‬ϥʆ࠳ʠʪɋ
ᶷᶮ୚૾៵௮ʍ୤ᤓʊ᝸ɸʪᡸᄍʎɊׄԯʇɶʅಢࠜϥʆᡥଉɸʪɫɊ‫ۑ‬ᜟጇʊ᫟ɶʅɼʍᡸᄍʍӂᧅʡɶɮʎͥᧅʱ‫ܙ‬ጅᒓʊ៰๳ɸʪɲʇɫɡʪɋ
ᶸᶮ୚૾៵௮ʍԠԨʩʎɊ‫ܙ‬ጅᒓʍऔಙᧅ௦ʊড়ɷʪɫɊɼʍᡸᄍʎ‫ܙ‬ጅᒓʍᡥଉʇɸʪɋ
ᶹᶮ૸ኢ୚૾៵௮ʎ᥏ָɶʉɣɋ
²±ᶮಢϥ៕ʊ୤ᤓɴʫɾʡʍʍᗾЀිʎɊಢࠜϥʊट࢙ɸʪɋ

‫ܙ‬ɉጅɉ᝸ɉᮾ
ᶱᶮׄᗾ៵௮ᶨArticleᶩʎ²·,±±±ࠒᇁঞᶨ‫ۑ‬ᜟʡ؉ʟᶩɊ‫ؙ̍ܫ‬ᢁ௶៵௮ᶨReportᶩ̍࢘ಙʎ²³,±±±᷾²·,±±±
ࠒᇁঞʇɸʪɋ
ᶲᶮͫឧ៵௮ʎAᶴԟᄍᎧʊ´³ࠒĆ³¶ᜓ²์ʍࠒ៊ʠ̍ᜓ៊ʠɊᖓ௮ׄኢʍ‫׹ܬ‬ʎɊAᶴԟʆ˖ˬ́ˏ˰̎
ˏχපʊɸʪɋᖓ௮ʍ‫׹ܬ‬Ɋಢ៕ᶱ᮱ɡɾʩ¹±±ៜ኏्ʊᇁঞɸʪʡʍʇɶʅ୳ጣɸʪɋˀ̀ˎˠ́ׄ
ኢʊʎɊᜟᯌ̍ᗾᒓ‫̍׾‬૗࢙෤᫟‫׾‬ʱឧɶɾ˕ʺ˞́˰̎ˎɊɩʧʒɼʫʨʍᖓឰʎಢ௮ʇʎԠʊಅɮ
ɲʇɋׄኢʎᶱʃʍ˫ʷʺ́ᶨ‫ۑ‬ᜟʎಢ௮ʊ᡹ʩϊɰʪথॾᶩʊɶʅɊͬឧΟլࢋʝʆ᭙ࠍ˷̎́ʊʅ
༐ϊ̍ᥡϊɶɊ‫ׄ׽‬ኢʡΟլࢋʝʆᧇᥡɸʪɲʇɋ
ᶳᶮׄᗾ៵௮ɩʧʒᢁ௶៵௮ʎׄԯʇɶʅɊ٨ᯌᶨᆾᆔᶩɊఄຫɊᏃೖɊᒑࡗɊ௮ႈɪʨʉʪɲʇɫಙʝ
ɶɣɋɉᶴᶮӂʅʍ៵௮ʊʎᖓ௮ʸˬˏ˞˿˅˞ʱʃɰʪɋʸˬˏ˞˿˅˞ʎɊ٨ᯌᶨObjectivesᶩɊఄຫᶨMethodᶩɊᏃೖᶨResultsᶩɊᏃ៵ᶨConclusionᶩʉʈʱ²±±᷾²¸¶ៜϒӑʆፍཿʊʝʇʠʪɋ૸ኢీʊʎɊʸˬˏ˞˿˅˞ʍఖಢៜׄኢᶨ‫ح‬௮૱᩻ᶩʡ༐ϊɸʪɲʇɋᖓ௮ʸˬˏ˞˿˅˞ɩʧʒఖಢៜׄኢᶨ‫ح‬௮૱᩻ᶩʊ
ɼʫɽʫᶳ᷾ᶵៜʍ˃̎̅̎˟ʱʃɰʪɋʉɩɊᖓ௮ʸˬˏ˞˿˅˞ʎΟլࢋʊʧʂʅഊ᫦ɸʪʍʆᏀ

Ż¡·µ¡Ż

ᡸ²±,±±±Ӓʱ᝸ɸʪɋ
ᶵᶮಢ௮ʍឧᥙʎፍཿʆనពʊɶɊంϔ‫׾‬ЋɣɊঞᄍུࠒɊጣᄍ௦ࠒʱᄍɣɊ‫ۑ‬ᜟʎɼʍ‫ށ‬ɬɴʱಢ௮ʊ
୳ጣɶʅ૗࠳ೕ௦ʊᎡʠʪɲʇɋ૗࠳ೕ௦ʱᢲɧɾԔʊʃɣʅʎᗾᒓᡥଉʇɸʪɋ
ᶶᶮ‫ۑ‬ɩʧʒӟᇍʎɼʍʝʝ୤ᤓ‫׭‬ᓧʉᲝనʉʡʍʱ୯ԎɸʪɲʇɋʉɩɊ‫ۑ‬ɫˁ˿̎ʍ‫׹ܬ‬ʊʎᗾᒓᡥ
ଉʊʉʪɋᶷᶮᜟʍ‫׹ܬ‬ʎͫʊTable ²ɊTable ³ɡʪɣʎᜟᶱɊᜟᶲʍʧɥʊɊ‫ۑ‬ʍ‫׹ܬ‬ʊʎͬʊFigure ²ɊFigure ³ɡʪɣʎ‫ۑ‬ᶱɊ‫ۑ‬ᶲʍʧɥʊᥱɶᄰ‫׳‬ʱʃɰɊɼʫɽʫʊ᝾ԎɶʱʃɰʪɋᜟɊ‫ۑ‬ɊӟᇍʉʈʍᯌɊ៥న
௮Ɋ‫ۑ‬ᜟͼʍ௮ࠒʎᖓ௮ʊɶʅʡʧɣɋ
ᶸᶮ௦ࠒʎׄԯʇɶʅጣᄍ௦ࠒʱᄍɣʪɋឞᨃ֫ϴʎׄԯʇɶʅ‫۔‬ᬫ֫ϴʱᄍɣʪɋ
ᶹᶮᄬៜʎͥᕓʊᄍɣʨʫʅɣʪʡʍʊᬈʪɋɾɿɶɊԞԎʍీʊɼʍఙʱనឧɸʪɋ
²±ᶮᓯີʎᥱɶᄰ‫׳‬ʱʃɰʅԠᎧʊಅɬɊಢ௮ͼʍᄰ‫׳‬ʇࡩড়ɸʪʧɥʊ឵ᶱᶩ឵ᶲᶩʍʧɥʊឧɸɋ
²²ᶮ‫۔ݹ‬κ‫׾‬Ɋۨ‫׾‬ጇʍ‫ۓ‬ಐ‫׾‬ៀϒ‫ݹ‬ʎឰៜʱᄍɣɊ৕᝸ʉ‫׹ܬ‬ɊԞԎʍʇɬׄៜʱϊɸʪɲʇɋ
²³ᶮಢ௮ʆঃᄍɴʫɾ௮ႈʍ᧖ԝʎɊᗾᒓ‫׾‬ʍʸ́˫ʷ˯˙˞᮵ʇɸʪɋ
ɉɉ௮ႈ୤ᤓපॾʎɊᭉ៕ʍ‫׹ܬ‬ᶺᗾᒓ‫̍׾‬ᆌᜓशᶨ᝷౩ᶩ
̍ᯌ‫̍׾‬ᭉ៕‫̍׾‬ऍ‫׳‬௦̍୤ᤓ᮱ʇɸʪɋ֫
ᜓಢʍ‫׹ܬ‬ᶺᗾᒓ‫̍׾‬ᆌᜓशᶨ᝷౩ᶩ
̍ಅ‫̍׾‬ᆌᜓ૗̍ঃᄍ̍‫ב‬ᒑጜ૗ʍ᮱ʇɸʪɋᒍឰʍ‫׹ܬ‬ᶺׄӍʍᗾᒓ‫̍׾‬ᆌᜓशᶨ᝷౩ᶩ
̍ಅ‫̍׾‬ᆌᜓ૗ᶨᗾᒓ‫׾‬ʍឰៜ̍ᒍឰᒓ‫̍׾‬ᒍឰಅʍᆌᜓश̍ಅ‫̍׾‬ᆌᜓ૗ᶩʇɸʪɋɲʍʇɬɊ‫ح‬௮Ɋท௮ʱ٨ʮɹɊᭉ៕ʍऍ௦ʎ˲̎́˟ᶨ‫ࠒރ‬Ɋɡʪɣʎາᏺʍʸ̉˖̎˿ʺ
̉ᶩʊɊʝɾท௮ʍᭉ៕‫׾‬ɩʧʒಅ‫׾‬ʎʺ˕̀˙˅ᶨ௸Ϲ Ɋɡʪɣʎ࠷ᏺʍʸ̉˖̎˿ʺ̉ᶩʊɸʪɋ
ɉɐԁАɑɉఖᨂׄᨁనᶨ²ºººᶩᶮᶼˇʸᶾʍంɶɣᒑɧʇ࢘᫕ɉలቾ቎
ɉಟᨂ‫ح‬ϐᶨ³±±±ᶩᶮఖಢκʍ৬ʩʍᜟԎఄຫʇɼʍࡩκᆔম᮰ɉ৔Ⴞࠜለኴᶬ¸±ᶬµºµ-¶±³ᶮɉSourialᶬSᶮᶨ²º··ᶩ
µ±µᶮɉ An analysis and evaluation on Watson's theory of human careᶮJournal of Advanced Nursingᶮ³µᶬµ±³ᶮɉKleinmanᶬ
Aᶮ
ᶨ²º¹¹ᶩᶮPatients and healers in the contexts of cultureᶮUniversity of California Pressᶮᶨ˅˿ʺ̉˴̉ᶬ
Aᶮ
๼‫ף‬ᨁह̍ΤಟᄑᎴ̍ͫᨂᡓ৙ᶨឰᶩ
ᶨ²ºº·ᶩᶮ
ᅕʍៜʩ᷾੾৷ʍᅕʱʠɯʪᔴॅκᯕࠜɉ៝дಅ૖ᶩɉʉɩɊɼʍψᜟឧʍ៍ᎲʊʃɣʅʎɊɖAPA៵௮Ѐી˴ˡ˻ʸ́ɗᶨ֚ࠜಅᬎɊ³±±µशᶩɡʪɣʎఖಢ৔
Ⴞࠜϥᆌᜓʍɔ‫ܙ‬ጅ̍૸ኢʍ૜ʒɬɕ
ᶨ³±±¶श၅ᶩʱ‫ב‬ဆʍɲʇɋ

ׄኢᥡʩҳɔ˨˻̎˴̉̍ˇʸለኴɕᐁᭂ߆‫ى‬ϥɚ ²¶±-±±²³ɉɉ೅δᧉ༗ᡅ֙ूࢉ µ-²-´ɉఖಢᢦ֝ࠒᇉᠷ‫ࠜށ‬ɉᦘᙸӆ·ለኴ࠺๨ϊ
ɉTELᶺ±´-´µ±º-±º²µᶨFAX ӉᶩɉE-mailᶺhumancarepsy@redcross.ac.jpŻ¡·¶¡Ż

‫⎇ࠕࠤ࡮ࡦࡑ࡯ࡘࡅޡ‬ⓥ‫ޢ‬ᛩⓂ↪⚕ 㧔ࠦࡇ࡯ߒߡߏ೑↪ਅߐ޿㧕
⺰ᢥฬ
๺ᢥ
⧷ᢥ
ේⓂᨎᢙ



 ᧄᢥ   ᨎ 㧗 ࿑࡮⴫    ὐ 㧩 ว⸘    ᨎ⺰ᢥߩ⒳㘃㧔߭ߣߟߛߌ٤ࠍߟߌࠆ㧕 ේ⪺     ႎ๔࡮⾗ᢱ     ዷᦸ    ߘߩઁ㧔          㧕ᛩⓂጁᱧ㧔߭ߣߟߛߌ٤ࠍߟߌࠆ㧕        ೋ࿁ᛩⓂේⓂ            ୃᱜߥ޿ߒౣᛩⓂේⓂ
ㅪ⛊వ
ᆓ

ฬ

/KFFNGPCOG

‫ޥ‬





㔚⹤⇟ภ



(#:

'OCKN





᳁ ฬ
૑ ᚲ






ᛩⓂ⠪↪࠴ࠚ࠶ࠢࠪ࡯࠻
ᛩⓂߦ㓙ߒߡߪએਅࠍᔅߕߏ⏕⹺ਅߐ޿‫ غ‬ᛩⓂේⓂߪ‫⚕⴫ޔ‬㧔࠲ࠗ࠻࡞‫⪺ޔ‬⠪‫ޔ࠼࡯ࡢ࡯ࠠޔ‬ᚲዻ㧕‫ޔ‬ᛞ㍳‫⧷ޔ‬ᢥⷐ⚂‫ᧄޔ‬ᢥ‫ޔ‬࿑⴫ߩ㗅ߦ㗁⇟ภࠍ౉ࠇߚ㔚ሶࡈࠔࠗ࡞㧔ࡢ࡯ࡊࡠ޽ࠆ޿ߪ࠹ࠠࠬ࠻㧕ߦߒߡਅߐ޿‫ߪ⚕⴫ޔߒߛߚޕ‬ή⇟ภߦߒߡਅߐ޿‫ޕ‬‫ غ‬࿑⴫ߪᧄᢥਛߦᝌ౉ߖߕ‫ޔ‬ᝌ౉૏⟎ߩߺࠍᜰ␜ߒߡਅߐ޿‫ޕ‬‫ غ‬๺ᢥේⓂߦߪ๺ᢥᛞ㍳ߣ⧷ᢥⷐ⚂ࠍᷝઃߒ‫⧷ޔ‬ᢥේⓂߢߪ๺ᢥⷐ⚂ࠍᷝઃߒߡਅߐ޿‫ޕ‬‫࠼࡯ࡢ࡯ࠠޔ࡞࠻ࠗ࠲ غ‬㧔㨪 ୘㧕‫⪺ޔ‬⠪ฬ࡮ᚲዻᯏ㑐ฬߦߪ‫⧷ࠇߙࠇߘޔ‬ᢥࠍ૬⸥ߒߡਅߐ޿‫ޕ‬‫ غ‬ᛩⓂේⓂߪࡔ࡯࡞ߢ㔚ሶࡈࠔࠗ࡞ࠍ㧝ㇱឭ಴ߒ‫ޔ‬೎ㅜශ೚ේⓂ㧝ㇱࠍㇷㅍߒߡਅߐ޿‫ޕ‬‫ୃ غ‬ᱜේⓂߩ㓙ߪ‫ୃޔ‬ᱜ⺰ᢥਛߦୃᱜ▎ᚲߩ⴫␜㧔ࠕࡦ࠳࡯࡜ࠗࡦߥߤ㧕ߒߡਅߐ޿‫ޕ‬‫ୃ غ‬ᱜේⓂߩ㓙ߪ‫ୃޔ‬ᱜᷣߺ⺰ᢥߦୃᱜ▎ᚲߣክᩏ⠪߳ߩ࿁╵৻ⷩ⴫ࠍᷝઃߒߡਅߐ޿‫ޕ‬ේⓂឭ಴ᐕ᦬ᣣ         ᐕ   ᦬   ᣣ
ේⓂฃⓂᐕ᦬ᣣ         ᐕ   ᦬   ᣣ㧔φ✬㓸ᆔຬળ⸥タᰣ㧕ේⓂฃℂᐕ᦬ᣣ         ᐕ   ᦬   ᣣ㧔φ✬㓸ᆔຬળ⸥タᰣ㧕ఖಢ˨˻̎˴̉̍ˇʸ৔Ⴞࠜϥ঱‫¡ى‬ᶨዿ ¶ ಜᶩᶨᶪʎणϙႾΟɊΤ֝ᮬ᮵ᶩϥɉɉᫎɉɉࡷႠɉฬ֬ᶨግາ‫ࠜށ‬ᶩႾɉɉΟɉɉᢷዒɉ·ࠍᶨࢥ᫸‫ࠜށ‬ᶩɊࠪвɉᖓեᶨ೅֋‫ࠜށ‬ᶩɊሃΥɉδࠍᶨ‫ށ‬᫻ऐዒ‫ࠜށ‬ᶩɊሃࣽɉԢ๼ᶨതᑬ೔‫ࠜށ‬ᶩɊΥᧅɉШࠍᶨᒨᣈՒᇉᠷ‫ࠜށ‬ᶩɊᶪࢫࣉɉ቟ͥ
ᶨ೅֋‫ࠜށ‬ᶩɊᶪᦘᙸɉӆ·ᶨఖಢᢦ֝ࠒᇉᠷ‫ࠜށ‬ᶩɊᶪᫎᄑɉ·ᭀᶨതᑬ೔‫ࠜށ‬ᶩɊࡷࢡᄑɉ
ᬟనᶨࢥ᫸ާࠍ‫ࠜށ‬ᶩɊࢲɉ‫ͥރ‬ᶨ೅ᦶ‫ࠜށ‬ᶩɊᶪಟಳɉᆍ᎚ࠍᶨɣʀɪʮᨂʍᕼ৔Ⴞᔴॅለኴ૗ᶩɊᶪࡷႠɉฬ֬ᶨግາ‫ࠜށ‬ᶩɊাᙸɉ࠰Ⴞᶨ൫ࢡާࠜ۞‫ࠜށ‬ᶩɊ৙᡼ɉϑన
ᶨቬࣃᇊዒ֚ቿ‫ࠜށ‬ᶩɊᶪ༒๬ɉᝃࠍ
ᶨᰖࣽ‫ࠜށ‬ᶩɊᗒɉϷ‫ࠍح‬ᶨδᧉ‫ࠜށ‬ᶩɊᶪ०࿇ɉ༒κᶨᒨᣈՒᇉᠷ‫ࠜށ‬ᶩɊͪᄑಳɉ٩ࠍᶨиࠜᬎɲʇʏʇࠍʈʡʍᇁ៯࠺ᶩɊࢡࣉɉᆍ৙ࠍᶨूࣃ‫۔‬ᬫ‫ࠜށ‬ᶩᆹɉɉΟɉɉᙸྙɉϬςᶨᣃ᝾ࠜ۞ާࠍ‫ࠜށ‬ᶩɊࣃΥɉّ৙ᶨఖಢᢦ֝ࠒᡋᄑᇉᠷ‫ࠜށ‬ᶩᯗɉɉ٨ɉɉࢨ‫ܞ‬ɉّᭀᶨᒨৎ‫ࠜށ‬ᶩΟլࢋᫎɉɉ༒๬ɉᝃࠍᶨᰖࣽ‫ࠜށ‬ᶩ෤᫟៕ᐁᭂ߆‫ى‬ᶨᶪʎ߆‫ى‬ᫎɊΤ֝ᮬ᮵ᶩ¡ࢫࣉɉ቟ͥɊᶪᦘᙸɉӆ·Ɋᫎᄑɉ·ᭀɊಟಳᆍ᎚ࠍɊࡷႠɉฬ֬Ɋ༒๬ɉᝃࠍɊ०࿇ɉ༒κᐁ¡ᭂ¡া¡ឧ´¯²² ɪʨ ² शϒͫɫɾʀʝɶɾɋɲʍ‫ށ‬᭝࿔ʎɊ೅ఖಢɿɰʆʉɮɊఖಢӂϹɊɼɶʅͳᄟӂϹʊ‫ݼ‬‫ށ‬ʉম᮰ʱͮɧʝɶɾɋ‫ށ‬ໄາʆ᎜ ² ͨ ¶ ֞κʍఄɫͥᇫʍɥʀʊ‫ا‬ʱɩʇɶɊɼɶʅɣʝɿʊ᎜ ´֞κওʍκɾʀɫᜓఄͭనʍʝʝʊʉʂʅɣʝɸɋቬࣃׄᆌɪʨ཮ʫԎɶɾ௓࡭ᓧʍᓩߒʎɊ৔ʍʉ
ɪʆʎీ᫙ʇʇʡʊሯɪʊᙙʨɣʆɬʅʎɣʝɸɫɊႻ࠷ʎӂɮ௑‫ٴ‬ɴʫʅʎɣʝɺʲɋАɧʏ᫟೅ʆʎ௓࡭ᓧʎ᭑ᯞʊᦉʏʫɊࣽʆᘡከɴʫɊ‫ܛ‬ཇʱ‫ށ‬नʊᢲɧʪᨃɫ೅δཀʊ໐ʫԎɶʅɣʪɲʇɫ
ʮɪʂʅɣʝɸɋρাɣʃʊʉʫʏɲʍᆾʊ᝾ɧʉɣᓩߒɪʨᔵᄒʊʉʫʪʍɪӂɮ᝾ᥱɶɫʃɬʝ
ɺʲɋρ‫׳‬ʎఴशʍዿ ²´ ‫ށۋ‬ϥʊɩɣʅ‫כ‬ʩͫɱɾ᭝࿔ʇ˨˻̎˴̉̍ˇʸʊʃɣʅၔᭂɶʝɶɾɋ
¡³±²³°±·°´±ɉᐁᭂ߆‫ى‬ᫎɉᦘᙸɉӆ·˨˻̎˴̉̍ˇʸለኴɉዿ ²´ ऍዿ ² ‫׳‬ɉ³±²³ श · ಏ ´± ఖᆌᜓᐁɉᭂɉɉఖಢ˨˻̎˴̉̍ˇʸ৔Ⴞࠜϥᐁᭂ߆‫ى‬ϥϐᜟᒓɉɉᦘᙸɉӆ·ᆌɉᜓɉɉఖಢ˨˻̎˴̉̍ˇʸ৔ႾࠜϥϐᜟᒓɉɉࡷႠɉฬ֬
Οլࢋɉɉɚ¸·²®±¸º´ɉᰖࣽᇊಟᄑᧂͪಟᄗ๽૔²¸¶±® ᶱɉɉɉɉɉᰖࣽ‫ᧅ֚ࠜࠜށ‬ᇉᠷࠜቿɉ༒๬ᝃࠍለኴ࠺๨ϊɉɉɉɉɉఖಢ˨˻̎˴̉̍ˇʸ৔ႾࠜϥɉɉɉɉɉÕÆÍ»¡¡±¹¸®¹º²®³³µ±¡ᶨÇÂÙ Ӊᶩ¡ɉɉɉɉɉÆ®îâêí»¡¡éöîâïñôúÁîæå¯ìâèâøâ®ö¯âä¯ëñִɉԨɉɉ೅ຼԎ၅ִԨ഍ॾϥ቎ɉɉɉɉɉɚ²²´®±±´´ɉ೅δᧉ௮δ֙ಢᧈᶱ®²±®²´ɉ᷇ᷓ˥ʺ˶ಢᧈᶱ᷆
ɉɉɉɉɉÕÆÍ»¡¡±´®´¹²´®¸´²²ɉÇÂÙ»¡¡±´®´¹²´®¸´²µఖಢ˨˻̎˴̉̍ˇʸ৔Ⴞࠜϥ³±²³ᶨಢ៕୤ᤓʍឧΟʎ࿵ఀᤉᤓʱቦɷʝɸᶩ
¡¡