https://doi.org/10.32283/rep.9b1fb879

⎇ⓥታᣉ૕೙
ᧄ⎇ⓥߪ‫ޔ‬ᢥㇱ⑼ቇ⋭߆ࠄᐔᚑ  ᐕᐲ‫ޟ‬ᄢቇߦ߅ߌࠆක≮ੱ㙃ᚑផㅴ╬ᆔ⸤੐ᬺ‫ࠍޠ‬ฃߌᣣᧄ⋴⼔♽ᄢቇද⼏ળ㜞╬ᢎ⢒ⴕ᡽ኻ╷ᆔຬળߩ‫♽⼔⋴ޟ‬ᄢቇ㒮ߦ߅ߌࠆᢎ⢒ߩၮḰ╷ቯߣ⹏ଔߦ㑐ߔࠆ⺞ᩏ⎇ⓥ‫ߢ࠻ࠢࠚࠫࡠࡊޠ‬ታᣉߒߚ‫ޕ‬ࡊࡠࠫࠚࠢ࠻ᆔຬ㐳↰ ▸ሶ㧔౓ᐶ⋵┙ᄢቇ㧕㜞╬ᢎ⢒ⴕ᡽ኻ╷ᆔຬᱜᧁ ᴦᕺ㧔ජ⪲ᄢቇ㧕↰ ▸ሶ㧔౓ᐶ⋵┙ᄢቇ㧕
㊁᎑ ૒↱⟤㧔㜞⍮⋵┙ᄢቇ㧕㓶⷏ ᥓᕺ⟤㧔ᓼፉᄢቇ㧕⪉ᴧ ౖሶ㧔⡛〝ട⋴⼔ᄢቇ㧕ᄥ↰ ༑ਭሶ㧔ᘮᙥ⟵Ⴖᄢቇ㧕 ࡊࡠࠫࠚࠢ࠻ᆔຬ↰ ▸ሶ㧔౓ᐶ⋵┙ᄢቇ㧕
㊁᎑ ૒↱⟤㧔㜞⍮⋵┙ᄢቇ㧕ᮮየ ੩ሶ㧔ᐢፉᄢቇ㧕㜞⷗ᴛ ᕺ⟤ሶ㧔ᄢ㒋ᐭ┙ᄢቇ㧕↰੗ 㓷ሶ㧔㜞⍮⋵┙ᄢቇ㧕Ꮏ⮮ ⟤ሶ㧔౓ᐶ⋵┙ᄢቇ㧕㜞⷗ ⟤଻㧔౓ᐶ⋵┙ᄢቇ㧕᫪  ⩵ሶ㧔౓ᐶ⋵┙ᄢቇ㧕᫪ᧄ ⟤ᥓሶ㧔౓ᐶ⋵┙ᄢቇ㧕










⋡ ᰴ㩷㩷╙㧝┨ ⎇ⓥߩ᭎ⷐ࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮
㧝㧚⎇ⓥߩ⢛᥊࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮
㧞㧚⎇ⓥ⋡⊛࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮
㧟㧚ฦ⺞ᩏߩ᭎ⷐ࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮

╙㧞┨ ࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯⺞ᩏ࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮
㧝㧚⺞ᩏᣇᴺ࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮
㧞㧚⚿ᨐ࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮
㧟㧚ୃᱜߒߚ೨ᦼ ୃ჻ ⺖⒟ୃੌ↢߇ୃᓧߔߴ߈ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫࡮࡮ޠ‬╙㧟┨ ࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯ෳട⠪ߦኻߔࠆ⾰໧⚕⺞ᩏ࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮
㧝㧚⺞ᩏᣇᴺ࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮
㧞㧚⚿ᨐ࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮
㧟㧚⠨ኤ࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮
㧠㧚ୃᱜߒߚ೨ᦼ ୃ჻ ⺖⒟ୃੌ↢߇ୃᓧߔߴ߈ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫࡮࡮ޠ‬╙㧠┨ ⋴⼔♽ᄢቇද⼏ળળຬᩞߦኻߔࠆ⾰໧⚕⺞ᩏ࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮
㧝㧚⺞ᩏᣇᴺ࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮
㧞㧚⚿ᨐ࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮
㧟㧚⠨ኤ࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮

╙㧡┨ ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈⢻ജ࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮ 㧝㧚⋴⼔ቇߩ೨ᦼ ୃ჻ ⺖⒟ୃੌ↢߇ୃᓧߔߴ߈⢻ജ࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮ 㧞㧚੹ᓟߩ⺖㗴࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮
ᒁ↪ᢥ₂࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮࡮⾗ᢱ ⾗ᢱ㧝 ࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯ෳടᄢቇ৻ⷩ ⾗ᢱ㧞 ࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯㧦ࠗࡦ࠲ࡆࡘ࡯ࠟࠗ࠼ ⾗ᢱ㧟 ࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯ෳട⠪ߦታᣉߒߚ⋴⼔ቇߩඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߦ
߅ߌࠆୃᓧߔߴ߈⢻ജߩ⺞ᩏ↪⚕ ⾗ᢱ㧠 ⋴⼔♽ᄢቇද⼏ળળຬᩞߦታᣉߒߚ⋴⼔ቇߩඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߦ߅ߌ
ࠆୃᓧߔߴ߈⢻ജߩ⺞ᩏ↪⚕ ⾗ᢱ㧡 ‫ޟ‬##%0㧦ୃ჻ᢎ⢒ߩࠛ࠶࠮ࡦࠪࡖ࡞‫⻠ߩޠ‬Ṷ᭎ⷐ╙┨ ⎇ⓥߩ᭎ⷐ
㧝㧚⎇ⓥߩ⢛᥊⋴⼔ቇߩᄢቇ㒮ᢎ⢒ߪ‫ޔ‬ᤘ๺ 54 ᐕߦජ⪲ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼ߦ߅޿ߡୃ჻⺖⒟‫ޔ‬ᤘ๺ 63 ᐕߦ⡛〝ട⋴⼔ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼ߦ߅޿ߡඳ჻ᓟᦼ⺖⒟ߩ⸳⟎ߦ઻޿‫ޔ‬㐿ᆎߐࠇߚ‫ߩߘޕ‬ᓟ‫♽⼔⋴ޔ‬ᄢቇߩჇടߦ઻޿‫ߩ♽⼔⋴ޔ‬ᄢቇ㒮ᢎ⢒⺖⒟߽Ⴧടߩ৻ㅜࠍㄡߞߡ
޿ࠆ‫♽⼔⋴ޕ‬ᄢቇ㒮ߦ߅ߌࠆᢎ⢒ߪ‫⼔⋴ޔ‬ታ〣ߩ⾰ߩะ਄ߦ⽸₂ߢ߈ࠆ⎇ⓥ⠪ߥࠄ߮ߦᢎ
⢒⠪ߩ⢒ᚑߦട߃‫ޔ‬㜞ᐲߥ⋴⼔ታ〣⢻ജࠍ߽ߟታ〣ኅࠍ⢒ᚑߒ‫⼔⋴ޔ‬ታ〣ߩ⾰ߩะ਄ߩታ
⃻ߣቇⴚߩ⊒ዷࠍ࿑ߞߡ޿ࠆ‫ޕ‬
ᐔᚑ14ᐕ9᦬ߦᄢቇၮḰදળ߇‫ޟ‬ᄢቇ㒮ၮḰ‫ߦޠ‬ၮߠ޿ߡ⋴⼔ቇ⎇ⓥ⑼ߩಽ⑼ᢎ⢒ၮḰࠍ߹ߣ߼‫⼔⋴ޔ‬ታ〣ߩ⻉ᵴേߩ⾰ߩะ਄ߦ⽸₂ߢ߈ࠆ⎇ⓥ⠪ਗ߮ߦᢎ⢒⠪ߩ⢒ᚑߣ޿߁ၮᧄ
⊛૶๮ߦട߃‫⼔⋴ޔ‬ታ〣ߦ߅ߌࠆኾ㐷ᕈߩ㜞޿⡯ോࠍᜂ߁ੱ᧚‫ޔߜࠊߥߔޔ‬㜞ᐲߥ⥃ᐥታ〣⢻ജࠍ߽ߟ⋴⼔⡯‫ⴕ⼔⋴ޔ‬᡽࡮▤ℂ㕙ߩᜰዉജࠍ߽ߟ⋴⼔⡯‫ޔ‬࿖㓙දജߦ៤ࠊࠆ⋴⼔⡯ߥߤࠍ⢒ߡ‫⼔⋴ޔ‬ታ〣ߩ⾰ߩ㜞ᐲൻࠍታ⃻ߒߟߟቇⴚߩ⊒ዷࠍ࿑ࠆߚ߼‫ޔ‬ฦᄢቇ㒮ߪ‫ߘޔ‬ࠇߙࠇߦ‫ߥ߁ࠃߩߤޔ‬ℂᔨߣ⋡⊛ࠍᜬߞߡᢎ⢒⎇ⓥࠍផㅴߔࠆ߆ࠍ᣿␜ߔࠆߣߣ߽ߦ‫ߘޔ‬ߩ⻉ᵴേࠍㅢߒߡ‫ࠍ᧚ੱߥ߁ࠃߩߤޔ‬⢒ᚑߒ‫ޔ‬ቇⴚ⊛ၮ⋚ߩ᜛లߣ⋴⼔ታ〣ߩᡷ㕟ߩផㅴߦߤߩࠃ߁ߥᣇᴺߢ⽸₂ߔࠆ߆ࠍ␜ߔᔅⷐ߇޽ࠆߣߒߡ޿ࠆ‫ޔߚ߹ޕ‬ᐔᚑ17ᐕߩਛᄩᢎ⢒ክ⼏ળ╵↳‫ޟ‬ᣂᤨઍߩᄢቇ㒮ᢎ⢒‫੹ޔߡ޿߅ߦޠ‬ᓟᄢቇ㒮߇ᜂ߁ߴ߈ੱ᧚㙃ᚑᯏ⢻ߪ‫ޔ‬Ԙ⎇ⓥ⠪╬ߩ㙃ᚑ‫ޔ‬ԙ㜞ᐲኾ㐷⡯ᬺੱߩ㙃ᚑ‫ޔ‬Ԛᄢቇᢎຬߩ㙃ᚑ‫ޔ‬ԛ㜞ᐲߢ⍮⊛ߥ⚛㙃ߩ޽ࠆੱ᧚ߩ㙃ᚑߢ޽ࠅ‫ୃޔ‬჻⺖⒟ߪ‫ޔ‬᏷ᐢߊᷓ޿ቇ⼂ߩᶩ㙃ࠍ࿑ࠅ‫⎇ޔ‬ⓥ⢻ജ߹ߚߪߎࠇߦ
ട߃ߡ㜞ᐲߩኾ㐷⊛ߥ⡯ᬺࠍᜂ߁ߚ߼ߩථ⿧ߒߚ⢻ജࠍၭ߁ߎߣࠍ⋡⊛ߣߒߚ߁߃ߢ‫ޔ‬ฦᄢቇ㒮ߩੱ᧚㙃ᚑߦ߆߆ࠆ⋡⊛ߩ᣿⏕ൻ߿ᢎ⢒ߩታ⾰ൻ߇᳞߼ࠄࠇࠆߣߣ߽ߦ‫ޔ‬࿖㓙⊛ߦㅢ↪ߒ‫ޔ‬ା㗬ᕈߩ޽ࠆᄢቇ㒮ᢎ⢒ߩ⾰ࠍ⏕଻ߔࠆߚ߼ߩ࿖㓙⊛ߥᄢቇ㒮ᢎ⢒ߩ⾰଻⸽ࠪࠬ࠹ࡓߩ᭴▽߇ᔅⷐߣ⸥ߒߡ޿ࠆ‫ޔߦࠄߐޕ‬ᐔᚑ23ᐕߩਛᄩᢎ⢒ክ⼏ળ╵↳‫࡞ࡃ࡯ࡠࠣޟ‬ൻ␠ળߩᄢቇ㒮ᢎ⢒‫ޔߪߢޠ‬ᄢቇ㒮ᢎ⢒ߩታ⾰ൻߦะߌߚขࠅ⚵ߺ߇⌕ታߦⴕࠊࠇߡ޿ࠆਛ‫ޔ‬ඳ჻⺖⒟‫ୃޔ‬჻⺖⒟ߥߤ᣿⏕ߥቇ૏ࡊࡠࠣ࡜ࡓߣߒߡߩᄢቇ㒮ᢎ⢒ࠍ⏕┙ߒ‫ޔ‬ቇ↢ߩ⾰ࠍ଻⸽ߔࠆ૕♽ߩᢛ஻߇㊀ⷐߢ޽ࠅ‫ޔ‬ක≮♽ᄢቇ㒮ߪ‫ޔ‬࿖㓙⊛ߦㅢ↪ߔࠆක≮♽ੱ᧚ࠍ㙃ᚑߔࠆߣ޿߁ⷰὐ߆ࠄ‫ޔ‬ᮡḰ⊛ߥ࡟ࡌ࡞ߩ⏕଻߽᳞߼ࠄࠇߡ޿ࠆߎߣ߇⸥ߐࠇߡ޿ࠆ‫ߩߎޕ‬ࠃ߁ߦ‫♽⼔⋴ޔ‬ᄢቇ㒮ߦ߅޿ߡ߽‫ޔ‬⢒ᚑߔࠆੱ᧚௝ࠍ᣿⏕ߦߔࠆߣߣ߽ߦ‫ޔ‬਎⇇ߦㅢ↪ߔࠆᄢቇ㒮ᢎ⢒ࠍឭଏߔࠆߎߣ߇᳞߼ࠄࠇ‫ޔ‬ᢎ⢒ߩ⾰ࠍ଻⸽ߔࠆࠪࠬ࠹ࡓߩ᭴▽߇༛✕ߩ⺖㗴ߣߥߞߡ޿ࠆ‫ޕ‬ᣣᧄ⋴⼔♽ᄢቇද⼏ળߪ‫ޔ‬㜞ᐲታ〣⋴⼔Ꮷߩ⢒ᚑߦ㑐ߒߡߪᄢቇ㒮ᢎ⢒ߢⴕ߁ߎߣߩᣇ
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߼ࠆ⢻ജߣ࡟ࡌ࡞ߩ⋧㆑ࠍቯ߼ߥ߇ࠄ‫ޔ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ୃੌ↢߇౒ㅢߒߡୃᓧߔߴ
߈10ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬77㗄⋡ࠍឭ␜ߒߚ‫ޔߦࠄߐޕ‬ᣣᧄ⋴⼔♽ᄢቇද⼏ળߦട⋖ߒߡ޿ࠆ137⺖⒟ߩᄢቇ㒮ᢎ⢒⠪ߦ⾰໧⚕⺞ᩏࠍታᣉߒ‫ޔ‬ឭ␜ߒߚ⢻ജߪ᭎ߨᅷᒰߢ޽ࠆ－ －ߣߩ࿁╵ࠍᓧࠆߎߣ߇ߢ߈ߚ‫ޔߒ߆ߒޕ‬࿁෼₸߿࿁╵⠪ߩಽᏓ߆ࠄࠊ߇࿖ߦ߅ߌࠆඳ჻೨
ᦼ(ୃ჻)⺖⒟ߩᢎ⢒⠪ߩᗧ⷗ࠍ෻ᤋߔࠆߦߪ‫ࠆߥࠄߐޔ‬ᬌ⸛߇ᔅⷐߢ޽ࠆߣ⠨߃‫ޔ‬ᐔᚑ24
ᐕᐲߩ⎇ⓥ⋡⊛ࠍએਅߩࠃ߁ߦ⸳ቯߒߡ‫⎇ޔ‬ⓥࠍታᣉߒߚ‫ޕ‬ߐࠄߦ⎇ⓥࠍㅴ߼ࠆߦ޽ߚࠅ‫ࠞ࡝ࡔࠕޔ‬วⴐ࿖ߢߪ‫ޔ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ୃੌ⠪߇߽ߟߴ߈⢻ജߣߒߡ‫ޟ‬The Essentials of Master’s Education in Nursing‫ޠ‬㧔American
Association of Colleges of Nursing, 2011)ࠍឭ␜ߒߡ޿ࠆߎߣ߆ࠄ‫ࠞ࡝ࡔࠕޔ‬วⴐ࿖ߩࠨࡒ
ࡘࠛ࡞ࡔ࡝࠶࠻ᄢቇ⋴⼔ቇㇱߩㄭ⮮ᚱᕺ᳁ߦ‫ࠞ࡝ࡔࠕޔ‬วⴐ࿖ߦ߅ߌࠆࠛ࠶࠮ࡦࠪࡖ࡞ߩ
ᵴ↪ߦ㑐ߔࠆ⻠Ṷࠍଐ㗬ߒߚ‫⻠ޔ߅ߥޕ‬Ṷߩⷐᣦߣ૶↪ߐࠇߚࡄࡢ࡯ࡐࠗࡦ࠻ߪ‫⾗ޔ‬ᢱ㧡ߦ⸥タߒߚ‫ޕ‬㧞㧚⎇ⓥ⋡⊛ ᧄ⎇ⓥ⋡⊛ߪ‫ߩࠄ߆ࠇߎޔ‬ᣣᧄߦ߅ߌࠆ⋴⼔♽ᄢቇ㒮ඳ჻೨ᦼ⺖⒟㧔ୃ჻⺖⒟㧕ߦ߅޿ߡ‫ୃޔ‬჻㧔⋴⼔ቇ㧕ߩቇ૏ࠍ᝼ਈߐࠇࠆୃੌ↢߇౒ㅢߒߡୃᓧߔߴ߈⢻ജࠍ᣿ࠄ߆ߦ
ߔࠆߎߣߢ޽ࠆ䇯䈠䈱䈢䉄䈮䇮એਅ䈱⺞ᩏ䉕ታᣉ䈜䉎䈖䈫䈮䉋䉍䇮ᐔᚑ 23 ᐕᐲ䈮᣿䉌䈎䈫䈭䈦䈢ඳ჻೨ᦼ䋨ୃ჻䋩⺖⒟ୃੌ↢䈏ୃᓧ䈜䈼䈐 10 䈱䇸⢻ജ䇹䈫䇸⢻ജ䈱ౝኈ䇹䉕␜䈜 77 㗄⋡䈱ᵞ✵䉕ⴕ䈦䈢䇯㧝㧕ࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯⺞ᩏᣣᧄ⋴⼔♽ᄢቇද⼏ળߩળຬᩞߩ⎇ⓥ⑼㐳╬ࠍኻ⽎ߣߒߚࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯ࠍⴕ
޿‫ޔ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߩୃੌ↢߇౒ㅢߒߡᜬߟߴ߈⢻ജߩᮡḰ⊛ߥ࡟ࡌ࡞ࠍᬌ⸛ߔ
ࠆߎߣࠍ⋡⊛ߣߔࠆ‫ޕ‬㧞㧕ࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯ෳട⠪ߦኻߔࠆ⾰໧⚕⺞ᩏࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯ࠃࠅౣᬌ⸛ߒߚ‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈⢻ജ‫ޠ‬
ߩ 10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬40 㗄⋡ࠍ␜ߒ‫࡯ࡘࡆ࠲ࡦࠗࡊ࡯࡞ࠣޔ‬ෳട⠪ߩหᗧ߇ᓧࠄࠇࠆ‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈⢻ജ‫ࠍޠ‬᣿ࠄ߆ߦߔࠆߎߣࠍ
⋡⊛ߣߒߚ‫ޕ‬㧟㧕ᣣᧄ⋴⼔♽ᄢቇද⼏ળળຬᩞߦኻߔࠆ⾰໧⚕⺞ᩏࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯ෳട⠪ߦኻߔࠆ⾰໧⚕⺞ᩏߩ⚿ᨐࠍ〯߹߃ᬌ⸛ߒߚ‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈⢻ജ‫ ߩޠ‬10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬42 㗄⋡ࠍ␜ߒ‫ޔ‬ᣣᧄߩ⋴⼔♽ᄢቇߩหᗧ߇ᓧࠄࠇࠆ‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈⢻ജ‫ࠍޠ‬᣿ࠄ߆ߦߔࠆߎߣࠍ⋡⊛ߣߒߚ‫ޕ‬㧟㧚ฦ⺞ᩏߩ᭎ⷐ
㧝㧕ࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯⺞ᩏ ৻⥸␠࿅ᴺੱᣣᧄ⋴⼔♽ᄢቇද⼏ળߩળຬᩞߢ‫♽⼔⋴ޔ‬ᄢቇ㒮ߩ⎇ⓥ⑼㐳‫ޔ‬ᄢቇ㒮⸳⟎ࠍḰ஻ߒߡ޿ࠆቇㇱ㐳╬ࠍኻ⽎ߣߒߚ‫ޕ‬㧢ળ႐ߢታᣉᣣࠍ᳿ቯߒ‫ޔ‬ᣣᧄ⋴⼔♽ᄢቇද⼏ળળຬᩞઍ⴫⠪ተߦࡔ࡯࡞ߦߡ᩺ౝߒ‫ޔ‬ෳടᏗᦸࠍ൐ߞߚ‫ޕ‬ෳടᄢቇߪ‫ޔ‬39 ᄢቇ㧔࿖┙ 11ᄢቇ‫ ┙౏ޔ‬15 ᄢቇ‫ ┙⑳ޔ‬13 ᄢቇ㧕ߢ‫ޔ‬ౝ 2 ᩞߪᄢቇ㒮⸳⟎ࠍḰ஻ߒߡ޿ࠆᄢቇߢ޽ߞߚ
㧔⾗ᢱ 1㧕
‫⺞ޕ‬ᩏෳട⠪ߪ 45 ੱߢ޽ࠅ‫ޔ‬㧝ળ႐ߦߟ߈ 2 ੱ㨪12 ੱߩෳടߢ޽ࠅ‫ޔ‬㧝ᄢቇ߆－ －ࠄⶄᢙฬ⺞ᩏߦෳടߒߚᄢቇ߽޽ߞߚ‫࠻ࠢࠚࠫࡠࡊࠆ޽ߢ࡯࠲࡯࠹࡝ࠪࠔࡈޔ߅ߥޕ‬ᆔຬߪ‫ޔ‬ෳട⠪ߦ฽߼ߥ߆ߞߚ‫ޕ‬⺞ᩏߪ‫࠼ࠗࠟ࡯ࡘࡆ࠲ࡦࠗޔ‬㧔⾗ᢱ 2㧕ߦၮߠ߈‫ޔ‬ෳട⠪ߩᗧ⷗ࠍ⡬ขߒߚ‫ޕ‬ᗧ⷗ߪ 10ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ ߔ␜ࠍޠ‬77 㗄⋡ߘࠇߙࠇߦߟ޿ߡ዆ߨߚ‫ޕ‬㜞ᐲታ〣⋴⼔ࠦ࡯ࠬ‫⎇ޔ‬ⓥࠦ࡯ࠬߪ㑐ଥߥߊ‫ޔ‬‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߦ߅޿ߡ‫ୃޔ‬჻㧔⋴⼔ቇ㧕ߩቇ૏ࠍ᝼
ਈߐࠇࠆୃੌ↢߇ୃᓧߔߴ߈ 10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫♽⼔⋴߇ޠ‬ᄢቇ㒮ᢎ⢒ߩࠦࠕߣߥࠅ߁ࠆ߆ࠍ዆ߨࠆߣߣ߽ߦ‫⎇ᧄޔ‬ⓥߢឭ␜ߒߚ‫ޟ‬⢻ജ‫ޠ‬એᄖߦᔅⷐߣᕁࠊࠇࠆ⢻ജ߿‫ޔ‬ᢎ⢒⠪ߣߒߡߩ⢻ജߦߟ޿ߡߩᗧ⷗߽዆ߨߚ‫࡯ࡘࡆ࠲ࡦࠗޕ‬ౝኈߪදജ⠪ߩหᗧࠍᓧߡ㍳㖸ߒߚ‫࡯ࡘࡆ࠲ࡦࠗޕ‬ౝኈߪ‫ޔ‬ㅙ⺆㍳ߦ߅ߎߒ‫ޔ‬10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ߔ␜ࠍޠ‬77 㗄⋡ߩ⴫⃻߿ౝኈߩ♖㍰ൻߦ㑐ߔࠆ▎ᚲࠍ᛽಴ߒ‫࠻ࠢࠚࠫࡠࡊޔ‬ᆔຬ 8 ੱߢᬌ⸛ߒߚ‫ޕ‬ߘߩ⚿ᨐ‫ޔ‬ඳ჻೨ᦼ⺖⒟㧔ୃ჻⺖⒟㧕ߦ߅޿ߡ‫ୃޔ‬჻ୃੌ↢߇ୃᓧߔߴ߈⢻ജߪ 10 ߩ‫ޟ‬⢻ജ‫ޔ߇ࠆ޽ߪߢޠ‬ᐔᚑ 23 ᐕᐲߦ␜ߒߚ‫ޟ‬⢻ജ‫৻ߩޠ‬ㇱࠍᄌᦝߔࠆߣߣ߽ߦ‫ޔ‬ฦ‫ޟ‬⢻ജ‫ߦޠ‬ߟ޿ߡߩ⺑᣿ࠍㅊടߒߚ‫ޟޔߦࠄߐޕ‬⢻ജߩౝኈ‫ ࠍޠ‬77 㗄⋡߆ࠄ 40 㗄⋡ߦߒߚ‫ޔ߅ߥޕ‬ᧄ⺞ᩏߩ⹦⚦ߪ‫ ╙ޔ‬2 ┨ߦ⸥ߒߚ‫ޕ‬㧞㧕ࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯ෳട⠪ߦኻߔࠆ⾰໧⚕⺞ᩏࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯ෳട⠪ߥࠄ߮ߦ㜞╬ᢎ⢒ⴕ᡽ኻ╷ᆔຬળᆔຬߩ⸘ 47 ੱࠍኻ⽎ߦ‫ޔ‬ୃᱜߒߚ‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈⢻ജ‫ ߩߡߒߣޠ‬10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬40 㗄⋡ߦ㑐ߔࠆ⾰໧⚕⺞ᩏ㧔⾗ᢱ 3㧕ࠍታᣉߒߚ‫ޕ‬࿁╵⠪ߦߪ‫ୃޔ‬ᓧߔߴ߈ 10‫ޟ‬หᗧߒߥ޿‫ޠ‬‫ޟ‬หᗧߔ
ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬40 㗄⋡ߩ⴫⃻ߥࠄ߮ߦౝኈߦ㑐ߒߡ‫ޔ‬ࠆ‫ޠ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ࠍߟ৻߆ࠇߕ޿ߩޠ‬ㆬᛯߒ‫ޔ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ࠍޠ‬ㆬᛯߒߚ㓙ߦߪ‫ߩߘޔ‬ℂ↱ߣୃᱜ᩺ࠍ⸥ㅀߔࠆࠃ߁ଐ㗬ߒߚ‫⺞ޕ‬ᩏߪㇷㅍᴺߢታᣉߒ‫⾰ޔ‬໧⚕ߩ࿁෼ߪᐔᚑ 25 ᐕ 1 ᦬ 9 ᣣ߆ࠄ 28 ᣣ߹ߢⴕߞߚ‫⾰ޕ‬໧⚕ߦ࿁╵ߒ‫ޔ‬㄰ାߩ޽ߞߚ߽ߩࠍᧄ⺞ᩏߩදജ⠪ߣߒߚ‫ޕ‬ή⸥ฬߦࠃࠆ⾰໧⚕⺞ᩏߣߒߚ߇‫⸥ޔ‬タౝኈߩ⏕⹺ߩߚ߼ߦ‫ޔ‬࿁╵⠪⥄り߇ੌ⸃ߒߚ႐วߪ‫ޔ‬࿁╵⠪⥄ࠄ⾰໧⚕ߦ᳁ฬߩ⸥タࠍߔࠆࠃ߁ଐ㗬ߒߚ‫ޕ‬‫ޟ‬หᗧߒߥ޿‫ޠ‬‫ޟ‬ඳ჻೨ᦼ㧔ୃ‫ޟ‬หᗧߔࠆ‫ޠ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ߩޠ‬ᐲᢙಽᏓਗ߮ߦୃᱜ᩺ߩ⸥ㅀߦࠃࠅ‫ޔ‬჻㧕⺖⒟ߢୃᓧߔߴ߈⢻ജ‫ࠍޠ‬ᬌ⸛ߒߚ‫ޕ‬‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈⢻ജ‫ ߩߡߒߣޠ‬10 ߩ‫ޟ‬⢻ജ‫⴫ߩޠ‬⺞ᩏߩ⚿ᨐ‫ޔ‬⃻ߩ৻ㇱࠍᄌᦝߔࠆߣߣ߽ߦ‫ޟޔ‬⢻ജߩౝኈ‫৻ߩ⃻⴫ޔ߽ߡ޿ߟߦޠ‬ㇱࠍᄌᦝߒ‫ޔ‬2 㗄⋡ㅊടߒߡ 42 㗄⋡ߣߒߚ‫ޔߚ߹ޕ‬‫ߩ⺆↪߁޿ߣޠࠬࡦ࠺ࡆࠛޟ‬ᗧ๧ߔࠆౝኈ߇ਇ᣿⍎ߢ޽ߞߚߚ߼‫⺑ߩ⺆↪ޔ‬᣿ࠍ⸥タߔࠆߣߣ߽ߦ‫⺑ߩ⺆↪ߩޠ⼔⋴ޟߣޠࠕࠤޟޔ‬᣿ߣ߽ߦ৻⽾ᕈࠍ଻ߡࠆࠃ߁⴫⃻ߩ⛔৻ࠍ࿑ߞߚ‫⺞ᧄޔ߅ߥޕ‬ᩏߩ⹦⚦ߪ‫ ╙ޔ‬3 ┨ߦ⸥ߒߚ‫ޕ‬㧟㧕ᣣᧄ⋴⼔♽ᄢቇද⼏ળળຬᩞߦኻߔࠆ⾰໧⚕⺞ᩏᧄ⺞ᩏߪ‫␠⥸৻ޔ‬࿅ᴺੱᣣᧄ⋴⼔♽ᄢቇද⼏ળߩળຬᩞߢ‫♽⼔⋴ޔ‬ᄢቇ㒮ߩ⎇ⓥ⑼㐳‫ޔ‬ᄢቇ㒮⸳⟎ࠍḰ஻ߒߡ޿ࠆቇㇱ㐳╬ 209 ᄢቇࠍኻ⽎ߦ‫࡯ࡘࡆ࠲ࡦࠗࡊ࡯࡞ࠣޔ‬ෳട⠪ߦኻߔࠆ⾰໧⚕⺞ᩏߩ⚿ᨐߦࠃࠅୃᱜߒߚ‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈⢻ജ‫ߒߣޠ‬ߡߩ 10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬42 㗄⋡ߦ㑐ߔࠆ⾰໧⚕⺞ᩏ㧔⾗ᢱ 4㧕ࠍታᣉߒߚ‫ޕ‬࿁╵⠪ߦߪ‫ୃߩߘޔ‬ᓧߔߴ߈ 10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬42 㗄⋡ߩ⴫⃻ߥࠄ߮ߦౝኈ
ߦ㑐ߒߡ‫ޔ‬‫ޟ‬หᗧߒߥ޿‫ޟޠ‬หᗧߔࠆ‫ࠍߟ৻߆ࠇߕ޿ߩޠ‬ㆬᛯߒ‫ޔ‬‫ޟ‬หᗧߒߥ޿‫ࠍޠ‬ㆬᛯߒߚ－ －㓙ߦߪ‫ߩߘޔ‬ℂ↱ࠍ⸥ㅀߔࠆࠃ߁ଐ㗬ߒߚ‫⺞ޕ‬ᩏߪㇷㅍᴺߢታᣉߒ‫⾰ޔ‬໧⚕ߩ࿁෼ߪᐔᚑ
25 ᐕ 2 ᦬ 18 ᣣ߆ࠄ 3 ᦬ 8 ᣣ߹ߢⴕߞߚ‫⾰ޕ‬໧⚕ߦ࿁╵ߒ‫ޔ‬㄰ାߩ޽ߞߚ߽ߩࠍᧄ⺞ᩏߩදജ⠪ߣߒ‫ޔ‬ή⸥ฬߦࠃࠆ⺞ᩏߣߒߚ‫ޟޕ‬หᗧߒߥ޿‫ޠ‬‫ޟ‬หᗧߔࠆ‫ߩޠ‬ᐲᢙಽᏓਗ߮ߦ‫ޟ‬หᗧߒߥ޿‫ޠ‬ℂ↱ߩ⸥ㅀߦࠃࠅ‫ޟޔ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈⢻ജ‫ࠍޠ‬ᬌ⸛ߒߚ‫ޕ‬‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈⢻ജ‫ ߩߡߒߣޠ‬10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻⺞ᩏߩ⚿ᨐ‫ޔ‬ജߩౝኈ‫৻ߩ⃻⴫ޔߪߡ޿ߟߦޠ‬ㇱࠍᄌᦝߒ‫⼔⋴ޔ‬ቇߩඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ࠍୃੌߒ
ߚୃੌ↢߇ୃᓧߔߴ߈⢻ജߣߒߡߩ 10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬42 㗄⋡ࠍ᣿ࠄ߆ߦ
ߒߚ‫⺞ᧄޔ߅ߥޕ‬ᩏߩ⹦⚦ߪ‫╙ޔ‬㧠┨ߦ⸥ߒߚ‫ޕ‬－ －╙㧞┨ ࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯⺞ᩏ㧝㧚⺞ᩏᣇᴺ㧝㧕ኻ⽎ ৻⥸␠࿅ᴺੱᣣᧄ⋴⼔♽ᄢቇද⼏ળߩળຬᩞߢ‫♽⼔⋴ޔ‬ᄢቇ㒮ߩ⎇ⓥ⑼㐳‫ޔ‬ᄢቇ㒮⸳⟎ࠍḰ஻ߒߡ޿ࠆቇㇱ㐳╬ࠍኻ⽎ߣߒߚ‫ోޕ‬࿖ࠍ㧢࿾඙ࡉࡠ࠶ࠢ㧔ർᶏ㆏࡮᧲ർ‫ޔ‬㑐᧲࡮↲ା⿧‫ޔ‬ർ㒽࡮᧲ᶏ‫ޔ‬㑐⷏㧔a㧕㧦౓ᐶ⋵ਛᔃ‫ޔ‬㑐⷏㧔b㧕㧦ᄢ㒋ਛᔃ‫ޔ‬྾࿖‫ޔ‬ਛ࿖࡮਻Ꮊ㧔ᴒ✽฽߻㧕ߦಽߌ‫ޔ‬࿾඙ࡉࡠ࠶ࠢߏߣߦ㐿௅႐ᚲߣታᣉᣣࠍ᳿ቯߒ‫ޔ‬ᣣᧄ⋴⼔♽ᄢቇද⼏ળળຬᩞઍ⴫⠪ተߦࡔ࡯࡞ߦߡ᩺ౝߒ‫ޔ‬ෳടᏗᦸࠍ൐ߞߚ‫ޔ߅ߥޕ‬࿾඙ࡉࡠ࠶ࠢߦ㑐ଥߥߊ‫ޔ‬ෳടน⢻ߣߒߚ‫ޕ‬㧞㧕࠺࡯࠲෼㓸ᣇᴺࠗࡦ࠲ࡆࡘ࡯ࠟࠗ࠼㧔⾗ᢱ 2㧕ߦၮߠ߈‫ޔ‬ᗧ⷗ࠍ⡬ขߒߚ‫ޕ‬ᗧ⷗ߪ 10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ ߔ␜ࠍޠ‬77 㗄⋡ߘࠇߙࠇߦߟ޿ߡ዆ߨߚ߇‫ޔ‬㜞ᐲታ〣⋴⼔ࠦ࡯ࠬ‫⎇ޔ‬ⓥࠦ࡯ࠬߦ߆߆ࠊࠄߕ‫ޔ‬‫ޟ‬ඳ჻೨ᦼ⺖⒟㧔ୃ჻⺖⒟㧕ߦ߅޿ߡ‫ୃޔ‬჻㧔⋴⼔ቇ㧕ߩቇ૏ࠍ᝼ਈߐࠇࠆୃ
ੌ↢߇ୃᓧߔߴ߈ 10 ߩ⢻ജߣߘߩౝኈ‫♽⼔⋴߇ޠ‬ᄢቇ㒮ᢎ⢒ߩࠦࠕߣߥࠅ߁ࠆ߆ࠍ዆ߨࠆ
ߣߣ߽ߦ‫⎇ᧄޔ‬ⓥߢឭ␜ߒߚ‫ޟ‬ඳ჻೨ᦼ⺖⒟㧔ୃ჻⺖⒟㧕ߦ߅޿ߡ‫ୃޔ‬჻㧔⋴⼔ቇ㧕ߩቇ૏ࠍ᝼ਈߐࠇࠆୃੌ↢߇ୃᓧߔߴ߈ 10 ߩ⢻ജ‫ޠ‬એᄖߢ‫ޔ‬ᔅⷐߣᕁࠊࠇࠆ⢻ജ߿‫ޔ‬ᢎ⢒⠪ߣߒߡߩ⢻ജߦߟ޿ߡߩᗧ⷗߽዆ߨߚ‫࡯ࡘࡆ࠲ࡦࠗޕ‬ౝኈߪදജ⠪ߩหᗧࠍᓧߡ㍳㖸ߒߚ‫ޕ‬㧟㧕࠺࡯࠲෼㓸ᦼ㑆
ᐔᚑ 24 ᐕ 10 ᦬ 30 ᣣ㨪11 ᦬ 16 ᣣߩᦼ㑆ߦࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯ࠍታᣉߒߚ‫ޕ‬㧠㧕ಽᨆᣇᴺࠗࡦ࠲ࡆࡘ࡯ౝኈࠍㅙ⺆㍳ߦ߅ߎߒ‫ޔ‬10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ ߔ␜ࠍޠ‬77 㗄⋡ߩ⴫⃻߿ౝኈߩ♖㍰ൻߦ㑐ߔࠆ▎ᚲࠍ᛽಴ߒ‫⎇ޔ‬ⓥ⠪ 8 ੱߢᬌ⸛ࠍⴕߞߚ‫ޕ‬
㧡㧕୶ℂ⊛㈩ᘦ
ࠗࡦ࠲ࡆࡘ࡯㐿ᆎ೨ߦ‫ޔ‬ෳട⠪ߦኻߒଐ㗬ᦠࠍ↪޿ߡ⺞ᩏ⋡⊛߿ᣇᴺߥࠄ߮ߦએਅߩ㈩ᘦὐࠍ⺑᣿ߒ‫ޔ‬หᗧᦠߦ⟑ฬࠍᓧߚ਄ߢ‫⺞ᧄޔ‬ᩏࠍታᣉߒߚ‫ޕ‬Ԙ⎇ⓥදജߦࠃࠆ⽶ᜂߩシᷫ޽ࠄ߆ߓ߼⺞ᩏᣣᤨߣᔅⷐᤨ㑆ࠍឭ␜ߒ‫ޔ‬දജน⢻ߥኻ⽎ࠍ൐ߞߚ‫⎇ޔߚ߹ޕ‬ⓥදജߦ઻޿⊒↢ߔࠆ੤ㅢߦߟ޿ߡ↳⺧߇޽ߞߚ႐วߪ‫⽶ޔ‬ᜂߒߚ‫ޕ‬ԙᜎุߔࠆᮭ೑
࿁╵ߒߚߊߥ޿ౝኈߦߟ޿ߡ╵߃ߥߊߡ߽⦟޿ߎߣ‫ޔ‬ㅜਛߢㄉㅌߔࠆߎߣ߽น⢻ߢ޽ࠆߎߣࠍ⺑᣿ߒߚ‫ޕ‬ㅜਛㄉㅌߔࠆ㓙ߦߪ‫⸒⊒ޔ‬⠪ߩ⊒⸒ౝኈࠍ࠺࡯࠲߆ࠄ೥㒰ߔࠆߎߣࠍ⎇ⓥଐ㗬ᤨߦ⺑᣿ߒߚ‫ޕ‬Ԛ୘ੱᖱႎߩ଻⼔ࠗࡦ࠲ࡆࡘ࡯ߦࠃࠅᓧࠄࠇߚ࠺࡯࠲ߩ࿕᦭ฬ⹖ߪඞฬൻߔࠆߣߣ߽ߦ‫ࠍߒߎ⿠ࡊ࡯࠹ޔ‬－ －ᬺ⠪ߦଐ㗬ߔࠆ㓙ߦߪ‫ޔ‬㓹↪ᄾ⚂ߦၮߠ߈‫ޔ‬ᖱႎߩᯏኒ଻ᜬ㧔╙ਃ⠪ߦኻߔࠆᖱႎ㐿␜࡮ṳᵨߩ⑌ᱛ‫ޔ‬ᖱႎߩ⋡⊛ᄖߩ૶↪⑌ᱛ‫ޔ‬ᖱႎߩ෩㊀▤ℂ‫ޔ‬ᬺോቢੌᓟߩ㄰ㆶߥࠄ߮ߦ⸥㍳ߩᶖ෰㧕ࠍᔀᐩߔࠆࠃ߁ദ߼ߚ‫⎇ޕ‬ⓥߦࠃࠅᓧࠄࠇߚ࠺࡯࠲ߪߔߴߡ⎇ⓥ⚳ੌᓟᶖ෰߹ߚ
ߪ⎕᫈ߔࠆߎߣࠍ⺑᣿ߒߚ‫ޕ‬㧞㧚⚿ᨐ㧝㧕࿁╵⠪ߩ᭎ⷐ
ෳടᄢቇߪ‫ޔ‬39 ᄢቇ㧔࿖┙ 11 ᄢቇ‫ ┙౏ޔ‬15 ᄢቇ‫ ┙⑳ޔ‬13 ᄢቇ㧕ߢ‫ޔ‬ౝ 2 ᩞߪᄢቇ㒮⸳⟎ࠍḰ஻ߒߡ޿ࠆᄢቇߢ޽ߞߚ㧔⾗ᢱ 1㧕‫⺞ޕ‬ᩏදജ⠪ߪ 45 ฬߢ޽ࠅ‫ޔ‬㧝ᄢቇ߆ࠄⶄᢙฬ
⺞ᩏߦදജߒߚᄢቇ߽޽ߞߚ㧔⴫ 1㧕‫ޕ‬⴫ 1. 㐿௅႐ᚲ೎ෳടੱᢙ

㐿௅႐ᚲ

දജੱᢙ

ർᶏ㆏࡮᧲ർࡉࡠ࠶ࠢ㧦㧔㕍᫪⋵┙଻ஜᄢቇ㧕7ੱ㑐᧲࡮↲ା⿧㧦㧔౎㊀ᵮ୾ᭉㇱ㧕12 ੱർ㒽࡮᧲ᶏ㧦㧔ᗲ⍮⋵┙ᄢቇฬฎደ㚞೨ࠨ࠹࡜ࠗ࠻ࠠࡖࡦࡄࠬ㧕10 ੱ㑐⷏㧔౓ᐶ㧕
㧦౓ᐶ⋵┙ᄢቇ㧕4ੱ㑐⷏㧔ᄢ㒋㧕
㧦㧔ᄢ㒋ᐭ┙ᄢቇਛਯፉࠨ࠹࡜ࠗ࠻㧕2ੱ྾࿖㧦㧔㜞⍮⋵┙ᄢቇ㧕

3ੱਛ࿖࡮਻Ꮊ㧔ᴒ✽฽߻㧕㧦㧔ᐢፉᄢቇ㧕

7ੱ㧞㧕ୃᓧߔߴ߈‫ޟ‬⢻ജ‫ޟ߮ࠃ߅ޠ‬⢻ജߩౝኈ‫ߦޠ‬㑐ߔࠆᗧ⷗ߘࠇߙࠇߩ‫ޟ‬⢻ജ‫ޟ߮ࠃ߅ޠ‬⢻ജߩౝኈ‫ߡ޿ߟߦޠ‬એਅߦㅀߴࠆ‫ޕ‬㧔㧝㧕‫ޟ‬Σ.⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ޠࠆߊߟࠍࠬࡦ࠺ࡆࠛޔ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈߎߩ⢻ജߪ‫ޔ‬‫ޟ‬㕖Ᏹߦ㊀ⷐߛߒ‫ޔ‬ᔅⷐߛߣᕁ߁‫ޠ‬‫ޟ‬ኾ㐷⋴⼔Ꮷࠦ࡯ࠬߦ߽⎇ⓥ⠪ࠦ࡯ࠬߦ߽ᄢ੐‫ޔߦ߁ࠃ߁޿ߣޠ‬㊀ⷐߥ⢻ജߢ޽ࠆߣ޿߁ᗧ⷗߇಴ߚ‫ޔߒ߆ߒޕ‬‫߇࡞࡯ࠧޟ‬㜞޿‫ୃޕ‬჻⺖⒟ߢ߅ߐ߃ࠆߣߎࠈ߇‫ࠍࠬࡦ࠺ࡆࠛ”ޔ߆ߩߥࠈߎߣ”ࠆߊߟࠍࠬࡦ࠺ࡆࠛ“ޔ‬ត᳞ߢ߈ࠆ”ߣ޿߁ߣߎࠈߥߩ߆‫ޠ‬‫ޟ‬૗߆ߩ࠹࡯ࡑߦߟ޿ߡ੹޽ࠆࠛࡆ࠺ࡦࠬࠍ߈ߞߜࠅߣ㓸߼ࠄࠇ‫ޔ‬ߘࠇࠍ⛔วߒߡ⎇ⓥߩᒻߦߔࠆ‫ޔ‬ታ〣ߩᡷༀߦ૶߁‫ୃ߇ࠈߎߣ߁޿ߣޔ‬჻ߥߩߛߣᕁ߁‫ޠ‬ߣ޿߁ࠃ߁ߦ‫ࠍࠬࡦ࠺ࡆࠛޔ‬૞ࠆ߹ߢߪ‫ୃޔ‬჻⺖⒟ߦ߅޿ߡߪ࡟ࡌ࡞߇㜞޿ߣ޿߁ᗧ⷗߇
಴ߚ‫ޔߚ߹ޕ‬‫߁޿ߣޠࠆߊߟࠍࠬࡦ࠺ࡆࠛޟ‬ౝኈߪ࡟ࡌ࡞߇㜞޿ߣ޿߁ߎߣߦ㑐ㅪߒߡ‫ޔ‬10㗄⋡ߩ⢻ജߩ㗅⇟ߣߒߡ‫ᦨޔ‬ೋߦ᧪ߥ޿ᣇ߇ࠃ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬ࠛࡆ࠺ࡦࠬࠍ૞ࠆ߹ߢߪ㔍ߒ޿ߣ޿߁ᗧ⷗ࠍ〯߹߃‫ߦࠬࡦ࠺ࡆࠛޟޔ‬ၮߠ߈⑼ቇ⊛ߦតⓥ
ߢ߈ࠆ‫⺖ߩ⼔⋴ޟޠ‬㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫⺖ޔ‬㗴⸃᳿߇ߢ߈ࠆ‫ޠ‬‫⺖ߩ⼔⋴ޟ‬㗴ࠍ⑼ቇ⊛ߦត᳞ߒ‫ࠬࡦ࠺ࡆࠛޔ‬㧔޽ࠆ޿ߪ“ᣂߒ޿⍮⷗”)ࠍߟߊࠆ㧔޽ࠆ޿ߪ“ᵴ↪ߔࠆ”㧕‫ޠ‬‫⺖ߩ⼔⋴ޟ‬㗴ࠍ⑼ቇ⊛ߦត᳞ߔࠆ‫⺖ߩ⼔⋴ޟޠ‬㗴ࠍ⑼ቇ⊛ߦត᳞ߒ‫ࠍࠬࡦ࠺ࡆࠛޔ‬ታ〣ߩਛ߆ࠄ⷗಴ߔ‫޿ߣޠ‬߁ୃᱜ᩺߇಴ߚ‫ޕ‬－ －ԙ ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈa㧚 ‫ޟ‬⢻ജߩౝኈ‫࡞ࡌ࡟ߩޠ‬‫ޟ‬⢻ജߩౝኈ‫ޔߪߡ޿ߟߦޠ‬‫ޟ‬1㧚⋴⼔ቇߩតⓥߔࠆߴ߈⺖㗴ߦߟ޿ߡ‫ޔ‬ኤ⍮ߒㅊ᳞ߔࠆ‫ޠ‬‫ޟ‬㧡.⋴⼔ታ〣ߢߩ໧㗴ࠍ⸃᳿ߔࠆߚ߼ߦ‫ޔ‬ᔅⷐߥࠛࡆ࠺ࡦࠬࠍ⎇ⓥߔࠆ‫ୃߪޠ‬჻⺖⒟ߢ
ߪ㔍ߒ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬b㧚 ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬㊀ⶄ‫ޟ‬1.⋴⼔ቇߩតⓥߔࠆߴ߈⺖㗴ߦߟ޿ߡ‫ޔ‬ኤ⍮ߒㅊ᳞ߔࠆ‫ ޟޠ‬2㧚␠ળߦ߅ߌࠆᣂߚߥ⺖㗴ࠍᗵ⍮ߒ‫ߩߘޔ‬ኻᔕߦߟ޿ߡᬌ⸛ߔࠆ‫ޠ‬‫ ޟ‬3㧚⋴⼔ߩᣂߚߥ໧޿‫⺖ޔ‬㗴ߦኻߒߡ‫⎇ޔ‬ⓥᣇ
ᴺࠍ㚟૶ߒߡត᳞ߔࠆ‫ޠ‬‫ޟ‬4㧚ᣂߚߥ⍮⼂߿వㅴ⊛ߥᛛⴚࠍត⚝ߒ‫ޔ‬ᵴ↪ߔࠆ‫ޟޠ‬5.⋴⼔ታ〣ߢߩ໧㗴ࠍ⸃᳿ߔࠆߚ߼ߦ‫ޔ‬ᔅⷐߥࠛࡆ࠺ࡦࠬࠍ⎇ⓥߔࠆ‫ޟޠ‬8㧚໧㗴ࠍ⸃᳿ߔࠆߚ߼ߩࠛ
ࡆ࠺ࡦࠬࠍᬌ⚝ߔࠆ‫ߦࠇߙࠇߘ߇ޠ‬㘃ૃߒߚߣߎࠈ߇޽ࠆߣ޿߁ᗧ⷗߇಴ߚ‫ޟޔߚ߹ޕ‬6㧚
EBP㧔Evidence-based practice㧕ࠍ♽⛔⊛ߦℂ⸃ߔࠆ‫ޠ‬‫ޟ‬7㧚ࠛࡆ࠺ࡦࠬࠍࠢ࡝࠹ࠖ࡯ࠢߒ‫ޔ‬⹏ଔߔࠆ‫ޟޠ‬8㧚໧㗴ࠍ⸃᳿ߔࠆߚ߼ߩࠛࡆ࠺ࡦࠬࠍᬌ⚝ߔࠆ‫⺖ߩ⼔⋴ޔߪޠ‬㗴ࠍ⑼ቇ⊛ߦតⓥߔࠆㆊ⒟ߩਛߢቇ߱ߩߢ‫ߡ߃޽ޔ‬಴ߔߩߪ⚦߆ߔ߉ࠆߣ޿߁ᗧ⷗߿‫ࠍࠬࡦ࠺ࡆࠛޔ‬ត᳞ߔࠆ߹ߢߩࡊࡠ࠮ࠬߣࠧ࡯࡞ߣߢᢛℂࠍߒߚ߶߁߇ࠃ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬߹ߚ‫ޔ‬‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬㊀ⶄߦ㑐ㅪߒߡ‫ޔ‬ឭ␜ߩ㗅⇟ࠍᬌ⸛ߒߚ߶߁߇ࠃ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬c㧚 ㅊടߔߴ߈‫ޟ‬⢻ജߩౝኈ‫ޠ‬
8 㗄⋡ߩ‫ޟ‬⢻ജߩౝኈ‫ޠ‬એᄖߦ‫ޔ‬‫ޟ‬̌⑼ቇ⊛ߦតⓥߒ̍ߣ޽ࠆߩߢ‫ߩઁޔ‬⡯⒳߿ઁߩቇ໧૕
♽ࠍᏎ߈ㄟࠎߛ‫⎇ߥ࡞ࡃ࡯ࡠࠣޔ‬ⓥ⚵❱ࠍ࡝࡯࠼ߔࠆ⢻ജࠍ㙃߁‫߁޿ߣޠ‬ౝኈ߿‫ޟޔ‬ታ〣ߦࠛࡆ࠺ࡦࠬࠍ૶߃ࠆ‫ߦޠ‬㑐ߔࠆౝኈ߇޽ߞߚࠄࠃ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬d㧚 ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ߩޠ‬ᢛวᕈ‫ޟ‬Σ.⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ޔߣޠࠆߊߟࠍࠬࡦ࠺ࡆࠛޟߩޠࠆߊߟࠍࠬࡦ࠺ࡆࠛޔ‬ୃᓧߔߴ߈⢻ജߩౝኈ߇วߞߡ޿ߥ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬e㧚 ‫ޟ‬⢻ജߩౝኈ‫⃻⴫ߩޠ‬‫ޟ‬ᗵ⍮‫ޟߣޠ‬ኤ⍮‫ߪޠ‬㆑޿߇޽ࠆߩ߆ߣ޿߁ᗧ⷗߿‫ޔ‬‫ޟ‬ㅊ᳞ߔࠆ‫ޠ‬‫ޟ‬ᬌ⸽ߔࠆ‫ޠ‬‫ޟ‬តⓥߔࠆ‫ޠ‬‫ޟ‬ᵴ↪ߔࠆ‫ޠ‬‫⎇ޟ‬ⓥߔࠆ‫ޠ‬‫ޟ‬ℂ⸃ߔࠆ‫߇⃻⴫ߣޠ‬ᄙ޿ߎߣߦኻߒߡ‫ޔ‬ᢥ⸒ߩᢛℂ߇ᔅⷐߢ޽
ࠆߣ޿߁ᗧ⷗߇಴ߚ‫ޔߚ߹ޕ‬‫⺑ޔߢߩ޿ߊߦࠅ߆ࠊ߇࡞ࡌ࡟ޠࠬࡦ࠺ࡆࠛޟ‬᣿߇ᔅⷐߢ޽ࠆ
ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬Ԛ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜ᩺‫ޟ‬Σ㧚⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ޔߪޠࠆߊߟࠍࠬࡦ࠺ࡆࠛޔ‬‫ޠࠆߊߟࠍࠬࡦ࠺ࡆࠛޟ‬߹ߢߪ࡟ࡌ࡞߇㜞޿ߣ޿߁ᗧ⷗߇ᄙߊ‫ޔߚ߹ޔ‬ታ〣ߔࠆᤨߦࠛࡆ࠺ࡦࠬࠍ↪޿ࠆߣ޿߁ߎ
ߣࠍ␜ߒߚ޿ߚ߼‫ޔ‬‫⺖ߩ⼔⋴ޟ‬㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ࠍࠬࡦ࠺ࡆࠛޔ‬ᵴ↪ߔࠆ‫ୃߦޠ‬ᱜߒߚ‫ޕ‬－ －߹ߚ‫ߔ␜߇ࠬࡦ࠺ࡆࠛޔ‬ౝኈ߇વࠊࠆࠃ߁ߦ‫ޔ‬‫ୃޟ‬჻⺖⒟ୃੌ↢ߪ‫⼔⋴ޔ‬ታ〣߿ࠤࠕឭଏߩ
႐ߦ߅޿ߡ‫⇼ޔ‬໧ࠍ߽ߜត᳞ߔࠆᘒᐲߢ‫⸃ޔ‬᳿ߔߴ߈⋴⼔ߩ⺖㗴ࠍ⷗಴ߔߎߣ‫ߦࠄߐޔ‬ᣢሽߩ᭽‫ࠍࠬࡦ࠺ࡆࠛߩ࡞ࡌ࡟ߥޘ‬෼㓸‫⛔ޔ‬วߒ‫⎇ࠍࠄࠇߘޔ‬ⓥ߿ታ〣ߦᵴ↪ߒ‫⺖ޔ‬㗴⸃᳿ߦ❬޿ߢ޿ߊߎߣ߇᳞߼ࠄࠇࠆ‫⺑߁޿ߣޠޕ‬᣿ᢥࠍട߃ߚ‫ޕ‬‫ޟ‬⢻ജߩౝኈ‫ߦޠ‬㑐ߒߡߪ‫ޔ‬㊀ⶄߔࠆౝኈࠍᢛℂߒ‫ޔ‬8 㗄⋡߆ࠄ 4 㗄⋡ߦᢛℂߔࠆߣߣ߽
ߦ‫ޔ‬ᢥ⸒ࠍୃᱜߒߚ‫ޟޔߚ߹ޕ‬⢻ജߩౝኈ‫ߩޠ‬㗅⇟ࠍᄌᦝߒߚ㧔⴫ 2㧕‫ޕ‬⴫ 2.‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜߦ㑐ߔࠆኻᾖ⴫㧔ᣥ㧕⢻ജ㧔ୃᱜ㧕⢻ജ

⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ࠛޔ‬⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ࠛޔ‬ࡆ࠺ࡦࠬࠍߟߊࠆ

ࡆ࠺ࡦࠬࠍᵴ↪ߔࠆ㧔ᣥ㧕ୃᓧߔߴ߈⢻ജߩౝኈ㧝㧚⋴⼔ቇߩតⓥߔࠆߴ߈⺖㗴ߦ㧔ୃᱜ㧕ୃᓧߔߴ߈⢻ജߩౝኈ

஻⠨
ᢥ⸒ୃᱜ

஻⠨

೥㒰

㊀ⶄߒߡ޿ࠆߚ߼

೥㒰

㊀ⶄߒߡ޿ࠆߚ߼

㧟㧚⋴⼔ߩᣂߚߥ໧޿‫⺖ޔ‬㗴ߦኻ ೥㒰

㊀ⶄߒߡ޿ࠆߚ߼

ߟ޿ߡ‫ޔ‬ኤ⍮ߒㅊ᳞ߔࠆ
㧞㧚␠ળߦ߅ߌࠆᣂߚߥ⺖㗴ࠍᗵ⍮ߒ‫ߩߘޔ‬ኻᔕߦߟ޿ߡᬌ⸛ߔࠆ

ߒߡ‫⎇ޔ‬ⓥᣇᴺࠍ㚟૶ߒߡត᳞ߔ
ࠆ㧠㧚ᣂߚߥ⍮⼂߿వㅴ⊛ߥᛛⴚࠍ㧠㧚ᣂߚߥ⍮⼂߿వㅴ⊛ߥᛛⴚࠍᄌᦝߥߒត⚝ߒ‫ޔ‬ᵴ↪ߔࠆត⚝ߒ‫ޔ‬ᵴ↪ߔࠆ㧡㧚⋴⼔ታ〣ߢߩ໧㗴ࠍ⸃᳿ߔࠆ

㧝㧚⋴⼔ታ〣ߢߩ໧㗴ࠍ⸃᳿ߔࠆ

ߚ߼ߦ‫ޔ‬ᔅⷐߥࠛࡆ࠺ࡦࠬࠍ⎇ⓥ

ߚ߼ߦ‫ޔ‬ᔅⷐߥࠛࡆ࠺ࡦࠬࠍត᳞ߔࠆߔࠆ㧢 㧚 EBP 㧔 Evidence-based

㧟㧚Evidence-based practice ࠍ ᢥ⸒ୃᱜ‫ޔ‬㗅⇟ᄌᦝ

practice㧕ࠍ♽⛔⊛ߦℂ⸃ߔࠆ

ℂ⸃ߔࠆ㧣㧚ࠛࡆ࠺ࡦࠬࠍࠢ࡝࠹ࠖ࡯ࠢ

㧞㧚ࠛࡆ࠺ࡦࠬ࡟ࡌ࡞ࠍᛕ್⊛ߦߒ‫⹏ޔ‬ଔߔࠆ

⺒⸃ߒ‫⹏ޔ‬ଔߔࠆ㧤㧚໧㗴ࠍ⸃᳿ߔࠆߚ߼ߩࠛࡆ࠺

೥㒰ᢥ⸒ୃᱜ‫ޔ‬㗅⇟ᄌᦝᢥ⸒ୃᱜ‫ޔ‬㗅⇟ᄌᦝ

㊀ⶄߒߡ޿ࠆߚ߼

ࡦࠬࠍᬌ⚝ߔࠆ－ －㧔㧞㧕‫ޟ‬Τ㧚⋴⼔ߩኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ㧕ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈ‫ޟ‬ᖚ⠪߿ኅᣖߩ࠮࡞ࡈࡑࡀࠫࡔࡦ࠻ജࠍઃߌࠆ‫࠻ࡦࡔࠫࡀࡑࡈ࡞࠮ޔ‬ജࠍᒁ߈಴ߔ‫ߣޔ‬޿߁ౝኈ߇౉ߞߡ޿ߥ޿߇‫ޔ‬ᔅⷐߥ⢻ജߣᕁ߁‫ޟޠ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆߢߪߥߊ‫ޔ‬ታ〣ၮ⋚ࠍߟߊࠆߦߥࠇ߫‫౒ߦࠬ࡯ࠦߩߡߴߔޔ‬ㅢߩࠦࠕߣߥࠆ‫⼔⋴ޟޠ‬ታ〣ᛮ߈ߦߪ⎇ⓥ߽లታ
ߒߥ޿ߩߢ‫ޔ‬ታ〣ߔࠆ⢻ജߪ㊀ⷐ‫ߩ⼔⋴ߤߥޠ‬ኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ㧕ߦኻߔࠆታ〣ߦߟ޿ߡߪᔅⷐߥ⢻ജߢ޽ࠆߣ޿߁ᗧ⷗߇಴ߚ‫ޔߒ߆ߒޕ‬‫ޟ‬ቇ↢ߩࠦ࡯ࠬߦࠃࠅ೔㆐⋡ᮡ‫⹏ޔ‬ଔၮḰ߇⇣ߥࠆ‫߁޿ߣޠ‬ᗧ⷗߿‫ޟޔ‬ታ〣ࠍ⥃ᐥታ〣ߦ㒢ቯߖߕ‫ޔ‬ᐢߊߣࠄ߃ࠆᔅⷐ߇
޽ࠆ‫߁޿ߣޠ‬ᗧ⷗߽಴ߚ‫ޕ‬
߹ߚ‫ޔ‬
‫ޟ‬
̌㜞ᐲߥ̍ߩᗧ๧߇‫ޔ‬ౝኈ߆ࠄߪ⺒ߺขࠇߥ޿‫ޟޠ‬㜞ᐲታ〣ߩਛりࠍ‫ޔ‬ౝኈߣߒߡ
౉ࠇߡ߽ࠄ߃ࠆߣ޽ࠅ߇ߚ޿‫߁޿ߣޠ‬ᗧ⷗߆ࠄ‫ޟޔ‬㜞ᐲߥታ〣‫⺑ߩߡ޿ߟߦޠ‬᣿߇᳞߼ࠄࠇߚ‫ޕ‬‫ޟ‬㜞ᐲߥታ〣‫߇ޠ‬฽߻ౝኈߣߒߡ‫ୃޔ‬ᓧߔߴ߈ౝኈ߆ࠄߪ‫ޟ‬ਥ૕⊛ߥ‫⥄ޟޠ‬ᓞߒߡ‫ߣޠ‬޿߁ᗧ๧߇ࡑ࠶࠴ߔࠆߣ޿߁ᗧ⷗߿‫ޔ‬‫ޟ‬ℂ⺰ࠍᵴ↪ߒߡ‫୶ޔ‬ℂߦၮߠ޿ߡ‫ޔ‬ਥ૕⊛ߦ‫⽿ޔ‬છࠍᜬߞߡ‫⽿ޔ‬ോࠍᨐߚߔߣ޿߁ࡢ࡯࠼߇౉ࠆߣ⺑᣿ߢ߈ࠆ‫߁޿ߣޠ‬ᗧ⷗߇಴ߚ‫ޕ‬ԙ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈa㧚 ‫ޟ‬⢻ജߩౝኈ‫࡞ࡌ࡟ߩޠ‬‫ޟ‬1.⋴⼔੺౉ߦᔅⷐߥℂ⺰ࠍり૕㨯␠ળ࡮ᔃℂ࡮⚵❱ߥߤቇ㓙⊛ߥⷰὐ߆ࠄㆬᛯߒ‫⛔ޔ‬วߒߡ‫ޔ‬ᵴ↪ߔࠆ‫ޟޠ‬4㧚⋴⼔ߩࠛࡆ࠺ࡦࠬࠍታ〣ߦၮߠ޿ߡߟߊߞߡ޿ߊ‫ୃޔߪޠ‬჻⺖⒟ߢ
ߪ࡟ࡌ࡞߇㜞޿ߣ޿߁ᗧ⷗߇಴ߚ‫৻ޕ‬ᣇߢ‫ޟޔ‬5㧚ኻ⽎ߩ┙႐ߦߚߞߡ‫ޔ‬൮᜝⊛ߢ♽⛔⊛ߥࠕ࠮ࠬࡔࡦ࠻ࠍታᣉߔࠆ‫ޠ‬‫ޟ‬11㧚⋴⼔ታ〣ߦ߅޿ߡ‫⺑ޔ‬᣿⽿છࠍᨐߚߔ‫ޠ‬‫ޟ‬14㧚ࠤࠕߩ⸘↹㨯ታᣉ࡮⹏ଔߦ߅޿ߡ∛᳇߿∔ᖚ▤ℂߩ⍮⼂ࠍ↪޿ࠆ‫ޔߪޠ‬‫ޟ‬ቇㇱ࡟ࡌ࡞ߢ޽ࠆ‫ޠ‬‫࡜ࡀࠚࠫޟ‬࡞࠽࡯ࠬߢ߽น⢻ߢ޽ࠆ‫ୃޔߦ߁ࠃ߁޿ߣޠ‬ᓧߔߴ߈⢻ജߩౝኈߩ࡟ࡌ࡞߇ࡃ࡜ࡃ࡜ߢߪ
ߥ޿߆ߣ޿߁ᗧ⷗߇಴ߚ‫ోޟޔߚ߹ޕ‬૕⊛ߦ CNS ࠍࠗࡔ࡯ࠫߐߖࠆ‫ޕ‬ᣂߒ޿⍮⼂ࠍታ〣ߩਛߦ↪޿ࠆߣ޿߁ࠃ߁ߥࠗࡔ࡯ࠫߦߔࠆ‫߁޿ߣޠ‬ᗧ⷗߽಴ߚ‫ޕ‬‫ޟ‬10.ࠛࡆ࠺ࡦࠬࠍ૶ߞߡࠤࠕᡷༀߩ⸘↹࡮ታᣉ࡮⹏ଔߔࠆ‫ߪޠ‬ዋߒ᛽⽎ᐲߩ㜞޿⴫⃻ߦߥߞߡ޿ࠆ߇‫ޔ‬‫ޟ‬13㧚ᖚ⠪ਛᔃߩࠤࠕߩߚ߼ߦઁ⡯⒳ߣ߽⺞ᢛ‫ޔ‬੤ᷤߒߟߟ‫ࠍࠕࠤ⼔⋴ޔ‬ታᣉߔࠆ‫ޠ‬‫ޟ‬14㧚ࠤࠕߩ⸘↹࡮ታᣉ࡮⹏ଔߦ߅޿ߡ∛᳇߿∔ᖚ▤ℂߩ⍮⼂ࠍ↪޿ࠆ‫ޠ‬‫ޟ‬15㧚ࠤࠕߩ⸘↹࡮ታᣉ࡮⹏ଔߦ߅޿ߡ∉ቇ⊛‫␠ޔ‬ળ⊛߅ࠃ߮ⅣႺ⊛࠺࡯࠲ࠍ↪޿ࠆ‫ޠ‬‫ޟ‬16㧚ࠤࠕߩ⸘↹࡮ታᣉ࡮⹏ଔߦ߅޿ߡቇ⠌߅ࠃ߮ᢎ⢒ේೣࠍㆡ↪ߔࠆ‫ߪߤߥޠ‬ਅ૏㗄⋡ߩࠃ߁ߦߣࠇ‫ޔ‬⢻ജߩౝኈߩ࡟ࡌ࡞߇ᷙੂߒߡ޿ࠆߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬⢻ജߩౝኈߩߘࠇߙࠇ߇ᜬߟᕈ⾰ࠍᢛℂᢛ㗐ߔߴ߈ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬b㧚 ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬㊀ⶄ‫ޟ‬1㧚⋴⼔੺౉ߦᔅⷐߥℂ⺰ࠍり૕࡮␠ળ࡮ᔃℂ࡮⚵❱ߥߤቇ㓙⊛ߥⷰὐ߆ࠄㆬᛯߒ‫⛔ޔ‬วߒߡᵴ↪ߔࠆ‫ޠ‬‫ޟ‬3㧚ᦨᣂߩࠤࠕᛛⴚ߿ࠛࡆ࠺ࡦࠬߦၮߠ޿ߡ‫ࠍࠕࠤ⼔⋴ޔ‬ታ〣ߔࠆ‫ޠ‬‫ޟ‬4㧚⋴⼔ߩࠛࡆ࠺ࡦࠬࠍታ〣ߦၮߠ޿ߡߟߊߞߡ޿ߊ‫ޟޠ‬7㧚⋴⼔ߩኻ⽎ࠍ߭ࠈߊᝒ߃ߟߟ‫ޔ‬ὶὐൻߒߚኻ⽎ߦᩮ᜚ߦၮߠ޿ߡ‫ޠࠆߔ౉੺⼔⋴ޔ‬‫ޟ‬10.ࠛࡆ࠺ࡦࠬࠍ૶޿ࠤࠕᡷༀࠍ⸘↹࡮ታ－ －ᣉ࡮⹏ଔߔࠆ‫߇ޠ‬㊀ⶄߒߡ޿ࠆߣ޿߁ᗧ⷗߇಴ߚ‫ޟޔߚ߹ޕ‬5㧚ኻ⽎ߩ┙႐ߦ┙ߞߡ‫ޔ‬൮᜝⊛ߢ♽⛔⊛ߥࠕ࠮ࠬࡔࡦ࠻ࠍታᣉߔࠆ‫ޟޠ‬14㧚ࠤࠕߩ⸘↹㨯ታᣉ࡮⹏ଔߦ߅޿ߡ∛᳇߿∔ᖚ
▤ℂߩ⍮⼂ࠍ↪޿ࠆ‫ޠ‬‫ޟ‬15.ࠤࠕߩ⸘↹࡮ታᣉ࡮⹏ଔߦ߅޿ߡ∉ቇ⊛‫␠ޔ‬ળ⊛෸߮ⅣႺ⊛࠺࡯࠲ࠍ↪޿ࠆ‫ޠ‬‫ޟ‬16㧚ࠤࠕߩ⸘↹࡮ታᣉ࡮⹏ଔߦ߅޿ߡቇ⠌෸߮ᢎ⢒ේೣࠍㆡ↪ߔࠆ‫ߪޠ‬ౝኈ
߇㊀ⶄߒߡ޿ࠆߣ޿߁ᗧ⷗߽಴‫ޔ‬㗄⋡߇ 19 ୘ߣᄙߊ‫ߣ߆޿ߥߪߢߩࠆࠇࠄ߼ߣ߹ߣߞ߽ޔ‬޿߁ᗧ⷗߇಴ߚ‫ޕ‬c㧚 ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ߩޠ‬ᢛวᕈ‫ޟ‬6.⋴⼔ߩ୶ℂ✁㗔ߦၮߠ޿ߚ⋴⼔ታ〣ࠍ᥉෸ߔࠆ‫ޟޔߪޠ‬㨪᥉෸ߔࠆ‫ޔ߼ߚࠆ޽ߢޠ‬ઁߩ⢻ജߣ㗄⋡߇㆑߁ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬‫ޟ‬4㧚⋴⼔ߩࠛࡆ࠺ࡦࠬࠍታ〣ߦၮߠ޿ߡߟߊߞߡ޿ߊ‫ޟߪޠ‬Σ㧚⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ߦޠࠆߊߟࠍࠬࡦ࠺ࡆࠛޔ‬฽߹ࠇࠆߩߢߪߥ޿߆ߣ޿߁ᗧ⷗߿‫ޟޔ‬7.⋴⼔ߩኻ⽎ࠍ߭ࠈߊᝒ߃ߟߟ‫ޔ‬ὶὐൻߒߚኻ⽎ߦᩮ᜚ߦၮߠ޿ߡ‫ޔߪޠࠆߔ౉੺⼔⋴ޔ‬‫ޟ‬Ϋ.ᄙ㕙⊛ߦᄙ᭽ߥ┙႐߆ࠄಽᨆߒ‫୶ޔ‬ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ‫ߦޠ‬฽߹ࠇࠆߩߢߪߥ޿߆ߣ޿߁ᗧ⷗ߩࠃ߁ߦ‫ߩઁޔ‬⢻ജߦ฽߹ࠇࠆߩߢߪߥ޿߆ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬d㧚‫ޟ‬⢻ജߩౝኈ‫⃻⴫ߩޠ‬‫ࠎߐߊߚ߇⃻⴫߁޿ߣ”ࠬࡦ࠺ࡆࠛ“ޟ‬಴ߡ޿ࠆߩߢ‫ޔ‬̌ࠛࡆ࠺ࡦࠬߦၮߠ޿ߚ㨪̍ߢ߹ߣ߼ߡ߽޿޿ߩߢߪߥ޿߆‫ߘޔ߇ࠆ޿ߡࠇࠊ૶߇⪲⸒ߣ౉੺⼔⋴ޔࠕࠤ⼔⋴ޔࠕࠤޔ⼔⋴ޟޠ‬ߩ㆑޿߇ࠃߊಽ߆ࠄߥ޿‫ޕ‬ᢛℂߒߚᣇ߇⦟޿‫ޠޕ‬‫ޟ‬ᐢߊ‫ోޔ‬૕‫ޔ‬൮᜝⊛ߩ↪⺆ߩᢛℂ߇ᔅⷐ‫ޠ‬‫ޟ‬ᢥᧃߩ⴫⃻ࠍቇ⠌೔㆐⋡ᮡߦว⥌ߔࠆ⴫⃻ߦߘࠈ߃ߡߪߤ߁߆‫ޔߦ߁ࠃ߁޿ߣޠ‬ฦ㗄⋡ߩᢥ⸒ࠍᢛℂߔࠆᔅⷐ߇޽ࠆߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬Ԛ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜ᩺‫ޟ‬㜞ᐲߥታ〣‫⺑ߩޠ‬᣿ࠍ᳞߼ࠄࠇߚߎߣࠃࠅ‫ޔ‬‫ୃޟ‬჻⺖⒟ୃੌ↢ߪ‫ߦࠬࡦ࠺ࡆࠛޔ‬ၮߠ޿ߡᦨᣂߥࠄ߮ߦᦨༀߩࠤࠕࠍᄙ⡯⒳ߣද௛ߒߥ߇ࠄឭଏߒ‫⥄ޔ‬り߇ⴕ߁⋴⼔ߦኻߒߡ⺑᣿ߢ߈ߥߌࠇ߫ߥࠄߥ޿‫∛ޔߦࠄߐޕ‬᳇߿∔ᖚߩ⍮⼂ߦട߃‫∉ޔ‬ቇ⊛࠺࡯࠲߿␠ળ㨯ⅣႺ࠺࡯࠲߽↪޿ߥ߇ࠄ‫ޔ‬୘ੱ࡮ኅᣖߛߌߢߥߊ‫ޔ‬㓸࿅࡮࿾ၞߦ߽⋡ࠍ߻ߌߚ⋴⼔ࠍᬌ⸛ߔࠆ‫ୃޕ‬჻⺖⒟ୃੌ↢ߪ‫ޔ‬ஜᐽߣ޿߁᭎ᔨࠍ߭ࠈߊᷓߊᝒ߃‫∔ޔ‬ᖚࠍᛴ߃ߚኻ⽎߳ߩ௛߈߆ߌ߆ࠄ‫ޔ‬ੱ‫ߩޘ‬ஜᐽߩ଻ᜬ࡮Ⴧㅴߦะߌߚขࠅ⚵ߺ߹ߢ‫ޔ‬ኻ⽎ߩ⁁ᘒߦᔕߓߚ⋴⼔ࠍᗧ࿑⊛ߦⴕ߁‫ޕ‬߹ߚୃ჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኻ⽎ߦᢎ⢒⊛ᡰេ߇ᔅⷐߥᤨߦߪ‫ޔ‬ℂ⺰߿ࠛࡆ࠺ࡦࠬߦၮߠ޿ߚ
௛߈߆ߌࠍߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫⺑߁޿ߣޠޕ‬᣿ᢥࠍട߃ߚ‫ޕ‬‫ޟ‬⢻ജߩౝኈ‫ߦޠ‬㑐ߒߡߪ‫ోޔ‬૕⊛ߦ 19 㗄⋡ߪᄙ޿ߩߢ߹ߣ߼ࠄࠇࠆߩߢߪߥ޿߆ߣ޿
߁ᗧ⷗߿‫ޔ‬㊀ⶄߒߡ޿ࠆㇱಽࠍ〯߹߃‫ޔ‬‫ޟ‬⢻ജ‫⺑ߩޠ‬᣿ᢥߦട߃ߚࠅ‫ޔ‬೥㒰ࠍⴕ޿ 19 㗄⋡
߆ࠄ 8 㗄⋡ߦᢛℂߒߚ‫ޔߚ߹ޕ‬‫ޟ‬Ω㧚౏ⴐߩஜᐽߦะߌߡ‫੍ޔ‬㒐⊛ߥⷰὐࠍ〯߹߃ߡ‫ޘੱޔ‬ߩஜᐽჇㅴߦขࠅ⚵߻‫ࠍޠ‬೥㒰ߒߚߚ߼ߦ‫ߩߎޔ‬⢻ജߦ฽߹ࠇߡ޿ߚ‫ޟ‬⢻ജߩౝኈ‫⋴ޟߩޠ‬⼔ߩኻ⽎ߦኻߒߡ‫∉ޔ‬ቇ⊛ߥ⍮⼂ࠍᵴ↪ߒߡࡐࡇࡘ࡟࡯࡚ࠪࡦ࡮ࠕࡊࡠ࡯࠴ࠍታ〣ߔࠆ‫ޠ‬ࠍ⢻ജΤߦട߃ߚ‫⼔⋴ޔߪߡ޿ߟߦ⃻⴫ޕ‬⡯߇ⴕ߁ታ〣ࠍ‫⼔⋴ޔߒ⃻⴫ߣޠ⼔⋴ޟ‬⡯ߣᄙ－ 10 －

⡯⒳߇ද௛ߒߡⴕ߁ታ〣ࠍ‫ߣޠࠕࠤޟ‬඙೎ߒߡ⴫⃻ߒߚ‫ޕ‬ᢥ⸒ୃᱜ߿‫ޔ‬㗅⇟ߩᄌᦝ߽ⴕߞ
ߚ㧔⴫ 3㧕‫ޕ‬ 
⴫ 3.‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜߦ㑐ߔࠆኻᾖ⴫㧔ᣥ㧕⢻ജ㧔ୃᱜ㧕⢻ജ

஻⠨⋴⼔ߩኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸࿅࡮ ⋴⼔ߩኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸࿅࡮ ᄌᦝߥߒ࿾ၞ㧕ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ ࿾ၞ㧕ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆ㧔ᣥ㧕ୃᓧߔߴ߈⢻ജߩౝኈ㧝㧚⋴⼔੺౉ߦᔅⷐߥℂ⺰ࠍり〣ߔࠆ㧔ୃᱜ㧕ୃᓧߔߴ߈⢻ജߩౝኈ஻⠨೥㒰㊀ⶄߒߡ޿ࠆߚ߼

೥㒰ਇ᣿⏕ߥߚ߼

㧟㧚ᦨᣂߩࠤࠕᛛⴚ߿ࠛࡆ࠺ࡦࠬ

㧝㧚ᦨᣂߩࠤࠕᛛⴚ߿ࠛࡆ࠺ࡦࠬ

ᢥ⸒ୃᱜߦၮߠ޿ߡ‫ࠍࠕࠤ⼔⋴ޔ‬ታ〣ߔࠆߦၮߠ޿ߡ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆ㧠㧚⋴⼔ߩࠛࡆ࠺ࡦࠬࠍታ〣ߦၮ೥㒰㊀ⶄߒߡ޿ࠆߚ߼

㧡㧚ኻ⽎ߩ┙႐ߦߚߞߡ‫ޔ‬൮᜝⊛ ೥㒰

㊀ⶄߒߡ޿ࠆߚ߼

૕࡮␠ળ࡮ᔃℂ࡮⚵❱ߥߤቇ㓙⊛ߥⷰὐ߆ࠄㆬᛯߒ‫⛔ޔ‬วߒߡᵴ↪
ߔࠆ㧞㧚୘ੱ෻ᔕ߿㓸࿅ജേ⊛ℂ⺰ࠍ୘ੱߩࠤࠕ/ኻᔕߦ↢߆ߔߠ޿ߡߟߊߞߡ޿ߊ

ߢ♽⛔⊛ߥࠕ࠮ࠬࡔࡦ࠻ࠍታᣉ
ߔࠆ㧢㧚⋴⼔ߩ୶ℂ✁㗔ߦၮߠ޿ߚ⋴㧞㧚ឭଏߐࠇߡ޿ࠆක≮ߩ୶ℂᕈ⼔ታ〣ࠍ᥉෸ߔࠆ

ࠍ್ᢿߒታ〣ߔࠆ㧣㧚⋴⼔ߩኻ⽎ࠍ߭ࠈߊᝒ߃ߟ

೥㒰

ᢥ⸒ୃᱜ

7‫ޔ‬8 ࠍ 3 ߦ⛔วߒߚߟ‫ޔ‬ὶὐൻߒߚኻ⽎ߦᩮ᜚ߦၮߠ

ߚ߼޿ߡ‫ࠆߔ౉੺⼔⋴ޔ‬㧤㧚⋴⼔ߩኻ⽎ࠍో૕ߣߒߡᝒ߃

7‫ޔ‬8 ࠍ 3 ߦ⛔วߒߚ೥㒰ߚ߼ߡ ࠤࠕߩ႐߳௛߈߆ߌ‫ޔ‬ㆡಾߦ⋴⼔੺౉ߔࠆ 㧥㧚ቇ㓙⊛ߥⷞὐߦၮߠ޿ߡ‫ޔ‬ᄙ 㧠㧚ᄙ⡯⒳ߣߣ߽ߦක≮ߩ቟ోᕈ
᭽ߥᣇᴺߢࠤࠕߩ቟ోᕈࠍ⏕଻ᢥ⸒ୃᱜ‫ޔ‬㗅⇟ᄌᦝࠍ⏕⹺ߒ‫଻ޔ‬㓚ߔࠆߔࠆ10㧚ࠛࡆ࠺ࡦࠬࠍ૶޿ࠤࠕᡷༀࠍ

೥㒰

㊀ⶄߒߡ޿ࠆߚ߼

⸘↹࡮ታᣉ࡮⹏ଔߔࠆ

－ 11 －

11. ⋴⼔ታ〣ߦ߅޿ߡ‫⺑ޔ‬᣿⽿છ೥㒰‫ޟ‬⢻ജ‫⺑ߩޠ‬᣿ᢥߦ

ࠍᨐߚߔ

౉ࠇߚߚ߼

12.੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍ㧣㧚੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍㅢߓ‫ޔ‬ஜᐽࠍଦㅴߐߖࠆᣇᴺࠍりㅢߓ‫ޔ‬ஜᐽࠍ଻ᜬჇㅴߔࠆ

ᢥ⸒ୃᱜ‫ޔ‬㗅⇟ᄌᦝߦઃߌࠆ
13.ᖚ⠪ਛᔃߩࠤࠕߩߚ߼ߦઁ⡯㧡㧚ኻ⽎ਛᔃߦ‫⼔⋴ޔ‬⡯߅ࠃ߮ᄙᢥ⸒ୃᱜ‫ޔ‬㗅⇟ᄌᦝ⒳ߣ߽⺞ᢛ‫ޔ‬੤ᷤߒߟߟ‫ ࠤ⼔⋴ޔ‬⡯⒳ߣߩ⺞ᢛࠍⴕ޿‫ޔ‬ද௛ߒߡࠤ
ࠕࠍታᣉߔࠆ

ࠕߔࠆ

14.ࠤࠕߩ⸘↹࡮ታᣉ࡮⹏ଔߦ߅

೥㒰

㊀ⶄߒߡ޿ࠆߚ߼

೥㒰

㊀ⶄߒߡ޿ࠆߚ߼

೥㒰

㊀ⶄߒߡ޿ࠆߚ߼

17.ᖱႎᛛⴚߩ೑↪ߦߟ޿ߡ‫ޔ‬ᖚ㧟㧚୶ℂ⊛ߦㆡᱜߥᖱႎᛛⴚߩ೑

ᢥ⸒ୃᱜ‫ޔ‬㗅⇟ᄌᦝ⠪ࠍᢎ⢒ߔࠆ

↪ࠍଦㅴߔࠆ

18.ታ〣/ᢎ⢒/⎇ⓥߦ㓙ߒ⥄ࠄߩ㧢㧚⋴⼔ߦߟ޿ߡߩ⺑᣿ജࠍ߽ⴕὑࠍ⺑᣿ߒ‫౒ޔ‬หࠍផㅴߔࠆ

ߜ‫ޔ‬ද௛ࠍផㅴߔࠆ

19.⋴⼔ታ〣࡮ᢎ⢒࡮⎇ⓥ߇߽ߚ೥㒰㊀ⶄߒߡ޿ࠆߚ߼

㧤㧚⋴⼔ߩኻ⽎ߦኻߒߡ‫∉ޔ‬ቇ⊛ᣥΩ-7 ࠃࠅ⒖േ޿ߡ∛᳇߿∔ᖚ▤ℂߩ⍮⼂ࠍ↪
޿ࠆ
15.ࠤࠕߩ⸘↹࡮ታᣉ࡮⹏ଔߦ߅
޿ߡ∉ቇ⊛‫␠ޔ‬ળ⊛߅ࠃ߮ⅣႺ⊛࠺࡯࠲ࠍ↪޿ࠆ
16.ࠤࠕߩ⸘↹࡮ታᣉ࡮⹏ଔߦ߅
޿ߡቇ⠌߅ࠃ߮ᢎ⢒ේೣࠍㆡ↪
ߔࠆᢥ⸒ୃᱜ‫ޔ‬㗅⇟ᄌᦝࠄߔ੺౉ലᨐࠍ੍᷹ߒ‫ߩ౉੺ޔ‬ㆡᱜࠍ್ᢿߔࠆ

ߥ⍮⼂ࠍᵴ↪ߒߡࡐࡇࡘ࡟࡯ࠪ
࡚ࡦ࡮ࠕࡊࡠ࡯࠴ࠍታ〣ߔࠆ㧔㧟㧕‫ޟ‬Υ㧚⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡታ〣ߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈ‫ߩ⾰ޟ‬ᡷༀߦะߌߡታ〣ߔࠆ‫߁޿ߣޠ‬ὐߦߟ޿ߡ‫ޔ‬‫ࠍ⾰ޟ‬ಽᨆߒ‫ޔߡ⷗ࠍࡓࠞ࠻࠙ࠕޔ‬ᡷༀߒߚ߆ߤ߁߆ߩ⹏ଔ߇ߢ߈ࠆ‫❱⚵ޟޠ߆޿ߥߪߢߣߎ߁޿ߣޔ‬਄ߩ⾰ߩᡷༀߩ઀⚵ߺࠍߟߊࠆߣ޿߁ࠃ߁ߥౝኈߪ▤ℂ⠪ߩᣇߦ౉ࠆߩߢ‫⼔⋴“ޔ‬ታ〣”ߩ⾰ࠍᡷༀߔࠆߣ޿߁ౝኈ߇㊀ⷐߛߣᕁ߁‫߁޿ߣࠆࠇ⷗ߣߞߜ߈ࠍࡓࠞ࠻࠙ࠕߩ౉੺ޔߪߦ߼ߚߩߘޕ‬ౝኈ߇ᔅⷐߛߣᕁ
߁‫⹏ߩࡓࠞ࠻࠙ࠕޔߦ߁ࠃ߁޿ߣޠ‬ଔߦ㑐ߔࠆ⢻ജ߇㊀ⷐߢ޽ࠆߣ޿߁ᗧ⷗߇ߢߚ‫߆ߒޕ‬ߒ‫ޔ‬‫⎇ޟ‬ⓥࠦ࡯ࠬߦኻߒߡߪ‫⺰ޔ‬ᢥ૞ᚑߣ᡽╷ߦኻᔕߔࠆߎߣࠍࠦࠕߣߒߡ᳞߼ࠄࠇࠆߣ࿎

－ 12 －

㔍ߢ޽ࠆ‫߁޿ߣޠ‬ᗧ⷗߽಴ߚ‫ޕ‬‫ߩ⾰ޟ‬ᡷༀ߇ਇ᣿⏕ߢ޽ࠆ‫߁޿ߣޠ‬ᗧ⷗ߩࠃ߁ߦ‫ޔ‬‫ߩ⾰ޟ‬ᡷༀ‫ࠍߣߎߥ߁ࠃߩߤ߇ޠ‬ᜰߔߩ߆ߩ⺑᣿߇᳞߼ࠄࠇߚ‫ޕ‬ᢥ⸒ߦߟ޿ߡߪ‫ޔ‬‫ߩ⾰ޟ‬ᡷༀߦะߌߡታ〣ߔࠆ‫ޟࠍޠ‬ផㅴߔࠆ‫ޟߪ޿ࠆ޽ޠ‬ขࠅ⚵߻‫ޠ‬‫ޟ‬ᄌ㕟ߔࠆ⢻ജࠍၭ߁‫ߦޠ‬ᄌᦝߣ޿߁ୃᱜ᩺߇಴ߚ‫ޕ‬ԙ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈa㧚 ‫ޟ‬⢻ജߩౝኈ‫࡞ࡌ࡟ߩޠ‬‫ޟ‬1.ኻ⽎ߦߣߞߡߩലᨐߛߌߢߥߊ⾌↪ኻലᨐ‫᦭⊛❱⚵ޔ‬ലᕈߥߤߩⷰὐࠍ฽߼ߡ⹏ଔߔ
ࠆ‫ޠ‬‫ޟ‬5.ᖱႎࠪࠬ࠹ࡓ‫∉ߣ⸘⛔ޔ‬ቇߩේℂࠍ↪޿ߡ‫ߩࡓࠞ࠻࠙ࠕޔ‬ᡷༀ߿࡝ࠬࠢૐᷫߩߚ߼
ߩᚢ⇛ࠍ┙ߡࠆ‫ୃߪޠ‬჻⺖⒟ߢߪ࿎㔍ߢ޽ࠆߣ޿߁ᗧ⷗߇಴ߚ‫৻ޕ‬ᣇ‫ޔ‬‫ޟ‬㧝㧚ኻ⽎ߦߣߞߡߩലᨐߛߌߢߥߊ⾌↪ኻലᨐ‫᦭⊛❱⚵ޔ‬ലᕈߥߤߩⷰὐࠍ฽߼ߡ⹏ଔߔࠆ‫ޟޠ‬4㧚ࠤࠕߩ⾰ࠍᡷༀߔࠆߚ߼ߦࠛࡆ࠺ࡦࠬࠍ↪޿ߡ⚵❱߿㓸࿅߳௛߈߆ߌࠆ‫ޟޠ‬5㧚ᖱႎࠪࠬ࠹ࡓ‫⸘⛔ޔ‬ߣ∉ቇߩේℂࠍ↪޿ߡ‫ߩࡓࠞ࠻࠙ࠕޔ‬ᡷༀ߿࡝ࠬࠢૐᷫߩߚ߼ߩᚢ⇛ࠍ┙ߡࠆ‫ޟޠ‬6㧚᡽╷⊛ߥⷰὐߢࠤࠕߩ⾰଻⸽߿࡝ࠬࠢࡑࡀࠫࡔࡦ࠻ࠍℂ⸃ߔࠆ‫ߩޠ‬㗄⋡ߪኾ㐷⋴⼔Ꮷࠦ࡯ࠬ࡮
⎇ⓥࠦ࡯ࠬߩࠦࠕߢ޽ࠆߣ޿߁ᗧ⷗߽಴ߚ‫ޕ‬߹ߚ‫⎇ޔ‬ⓥࠦ࡯ࠬߢߪ‫ޟ‬2㧚ᦨᣂߩᖱႎࠍᵴ↪ߒߡ㧔ታ〣ࠟࠗ࠼࡜ࠗࡦࠍ↪޿ߡ㧕‫ޔ‬ታ〣ߣࠤࠕߩⅣႺࠍᡷༀߔࠆ‫ޟޠ‬3㧚ࠤࠕߩࠪࠬ࠹ࡓࠍ⸳⸘ߒࠤࠕࠍᜬ⛯⊛ߦᡷༀߔࠆ‫ߪޠ‬㔍ߒߊᱷߔߣߔࠇ߫‫ߦ⊛⛯⛮ࠍࠕࠤޟޔ‬ᡷༀߔࠆߚ߼ߦࠤࠕߩࠪࠬ࠹ࡓࠍ⹏ଔߒ‫ޔ‬ឭ᩺ߔࠆ‫ߣޠ‬޿߁ᗧ⷗߇಴ߚ‫ޕ‬b㧚 ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬㊀ⶄ‫ޟ‬3㧚ࠤࠕߩࠪࠬ࠹ࡓࠍ⸳⸘ߒࠤࠕࠍᜬ⛯⊛ߦᡷༀߔࠆ‫ޠ‬‫ޟ‬4㧚ࠤࠕߩ⾰ࠍᡷༀߔࠆߚ߼ߦ
ࠛࡆ࠺ࡦࠬࠍ↪޿ߡ⚵❱߿㓸࿅߳௛߈߆ߌࠆ‫޿ߥߪߢߩࠆࠇࠄ߼ߣ߹ޔߢߩࠆ޿ߡૃߪޠ‬߆ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬c㧚 ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ߩޠ‬ᢛวᕈ‫ޟ‬Τ-17㧦ᖱႎᛛⴚߩ೑↪ߦߟ޿ߡ‫ޔ‬ᖚ⠪ࠍᢎ⢒ߔࠆ‫ޟࠍޠ‬Υ㧚⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡታ〣ߔࠆ‫ߦޠ‬⒖േߔࠆߩߪߤ߁߆ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬Ԛ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜ᩺‫ߩ⾰ޟ‬ᡷༀ‫߇ޠ‬ਇ᣿⏕ߣ޿߁ᗧ⷗߇޽ߞߚߚ߼‫ޔ‬‫ޟ‬⢻ജ‫ߔ␜߇ޠ‬ౝኈߣߒߡ‫ޔ‬‫ୃޟ‬჻⺖⒟ୃੌ↢ߪ‫ᦨޔ‬ᣂߩᖱႎࠍᵴ↪ߒߡ‫⼔⋴ޔ‬ታ〣߿ࠤࠕⅣႺࠍᡷༀߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫ࠍޠ‬⸥タߒߚ‫ޕ‬߹ߚ‫ޔ‬‫߇⼔⋴ޟ‬ឭଏߐࠇࠆኻ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡታ〣ߔࠆ‫߇⼔⋴ޟࠍޠ‬ឭଏߐࠇࠆኻ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡขࠅ⚵߻‫ୃߣޠ‬ᱜߒߚ‫ޕ‬ ‫ޟ‬⢻ജߩౝኈ‫ޔߪߡ޿ߟߦޠ‬‫ޟ‬⢻ജ‫⺑ߩޠ‬᣿ᢥߦ౉ࠇࠆߣߣ߽ߦ‫ޔ‬ᢥ⸒ࠍୃᱜߒߚ㧔⴫ 4㧕‫ޕ‬－ 13 －

⴫ 4.‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜߦ㑐ߔࠆኻᾖ⴫㧔ᣥ㧕⢻ജ㧔ୃᱜ㧕⢻ജ

⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦኻ⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡታ〣ߔࠆߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡขࠅ⚵߻㧔ᣥ㧕ୃᓧߔߴ߈⢻ജߩౝኈ㧔ୃᱜ㧕ୃᓧߔߴ߈⢻ജߩౝኈ㧝㧚ኻ⽎ߦߣߞߡߩലᨐߛߌߢߥ

㧝㧚⾌↪ኻലᨐ‫᦭⊛❱⚵ޔ‬ലᕈߥߊ⾌↪ኻലᨐ‫᦭⊛❱⚵ޔ‬ലᕈߥߤߤߩⷰὐࠍ฽߼‫ޔ‬ኻ⽎ߦߣߞߡߩ

ߩⷰὐࠍ฽߼ߡ⹏ଔߔࠆ

ലᨐࠍ⹏ଔߔࠆ

஻⠨
ᢥ⸒ୃᱜ

஻⠨
ᢥ⸒ୃᱜ

㧞㧚ᦨᣂߩᖱႎࠍᵴ↪ߒߡ㧔ታ〣 ೥㒰‫ޟ‬⢻ജ‫⺑ߩޠ‬᣿ᢥߦࠟࠗ࠼࡜ࠗࡦࠍ↪޿ߡ㧕‫ޔ‬ታ〣ߣ

౉ࠇߚߚ߼

ࠤࠕߩⅣႺࠍᡷༀߔࠆ
㧟㧚ࠤࠕߩࠪࠬ࠹ࡓࠍ⸳⸘ߒࠤࠕ

೥㒰‫ޟ‬⢻ജ‫⺑ߩޠ‬᣿ᢥߦࠍᜬ⛯⊛ߦᡷༀߔࠆ

౉ࠇߚߚ߼㧠㧚ࠤࠕߩ⾰ࠍᡷༀߔࠆߚ߼ߦࠛ

㧞㧚ࠤࠕߩ⾰ࠍᡷༀߔࠆߚ߼ߦࠛ

ࡆ࠺ࡦࠬࠍ↪޿ߡ⚵❱߿㓸࿅߳ࡆ࠺ࡦࠬࠍ↪޿ߡ⚵❱߿㓸࿅߳

௛߈߆ߌࠆ

௛߈߆ߌࠆ

㧡㧚ᖱႎࠪࠬ࠹ࡓ‫∉ߣ⸘⛔ޔ‬ቇߩ 㧟㧚ᖱႎࠪࠬ࠹ࡓ‫∉ߣ⸘⛔ޔ‬ቇߩේℂࠍ↪޿ߡ‫ߩࡓࠞ࠻࠙ࠕޔ‬ᡷༀ⍮⼂ࠍ↪޿ߡ‫ߩࡓࠞ࠻࠙ࠕޔ‬ᡷༀ߿࡝ࠬࠢૐᷫߩߚ߼ߩᚢ⇛ࠍ┙߿࡝ࠬࠢૐᷫߩߚ߼ߩᚢ⇛ࠍ┙ߡࠆߡࠆ㧢㧚᡽╷⊛ߥⷰὐߢࠤࠕߩ⾰଻⸽㧠㧚᡽╷⊛ߥⷰὐߢࠤࠕߩ⾰଻⸽߿࡝ࠬࠢࡑࡀࠫࡔࡦ࠻ࠍℂ⸃ߔ߿࡝ࠬࠢࡑࡀࠫࡔࡦ࠻ࠍℂ⸃ߔ

ࠆ

ࠆ

ᄌᦝߥߒ

ᄌᦝߥߒ

ᄌᦝߥߒ

㧔㧠㧕
‫ޟ‬Φ㧚ࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ޠࠆߔ࠻ࡦࡔࠫࡀࡑޔ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈ‫߇ࠕࠤޟ‬ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ߪޠࠆߔ࠻ࡦࡔࠫࡀࡑޔ‬ඳ჻⺖⒟࡟ࡌ
࡞ߢ޽ࠅ‫ୃޔ‬჻⺖⒟ߢߪ‫ࠍࡓ࠹ࠬࠪޟޔ‬ಽᨆߒ‫ޔ‬ᡷༀᣇᴺࠍ⠨߃ࠄࠇࠆ‫ޠ‬૏ߛࠈ߁ߣ޿߁ᗧ
⷗߇಴ߚ‫ߩࠕࠦޔߚ߹ޕ‬⢻ജߢ޽ࠆߩ߆⇼໧ߢ޽ࠆߣ޿߁ᗧ⷗߽಴ߚ‫ޕ‬‫ࠍ❱⚵ޟ‬ಽᨆߔࠆ‫ߪߣޠ‬૗ࠍಽᨆߔࠆߎߣߥߩ߆ಽ߆ࠅߦߊߊ‫❱⚵ޔ‬᭴ㅧߦߥߞߡ޿ߊ
ߣ▤ℂ⠪ߩ઀੐ߦߥࠆߩߢ‫ޔ‬‫ߩࠕࠤޟ‬ⅣႺߣߒߡߩ⚵❱ࠍಽᨆߔࠆ‫ୃ߁޿ߣޠ‬ᱜ᩺߇಴ߚ‫ޕ‬߹ߚ‫ޔ‬‫߇ࠕࠤޟ‬ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߔࠆ‫⥄ޟޠ‬ಽ߇ᚲዻߔࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫߇ࠕࠤޟޠࠆߔ࠻ࡦࡔࠫࡀࡑޔ‬ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ࠫࡀࡑޔ‬ࡔࡦ࠻ജࠍ⊒ើߔࠆ‫ୃ߁޿ߣޠ‬ᱜ߽᩺಴ߚ‫ޕ‬－ 14 －

ԙ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈa㧚 ‫ޟ‬⢻ജߩౝኈ‫࡞ࡌ࡟ߩޠ‬‫ޟ‬⢻ജߩౝኈ‫ޔߡߒߣޠ‬‫ޟ‬ታᣉߔࠆ‫ߢ߹ޠ‬᳞߼ࠆߩߪ㔍ߒ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޟߦ․ޕ‬4㧚
⚵❱ߦߣߞߡᔅⷐߥ੐ᨩࠍᢎ⢒ࡊࡠࠣ࡜ࡓߣߒߡ╷ቯߒ‫ޔ‬ታᣉߔࠆ‫⺖ߩ❱⚵ޟޔߪޠ‬㗴ࠍᬌ⸛ߢ߈ߡ‫ߩߘޔ‬ᡷༀߩᣇ╷ߩ㧝ߟߣߒߡᢎ⢒ᡰេࠍ৻✜ߦߢ߈ࠆ‫ޠ‬૏ߢ޽ࠈ߁ߣ޿߁ᗧ⷗
߇಴ߚ‫ޟޔߚ߹ޕ‬3㧚ᖚ⠪ਛᔃߩࠤࠕࠍታ〣ߔࠆߦ޽ߚࠅ‫ޔ‬ᔅⷐߣߥࠆઁ⡯⒳߿⾗ḮࠍᏎ߈ㄟߺߥ߇ࠄ⚵❱ࠍ▤ℂߔࠆ‫▤ࠍࠕࠤޟߪޠ‬ℂߔࠆ‫߫ࠇ޽ߢޠࠆߔ࠻ࡦࡔࠫࡀࡑޔ‬ኾ㐷⋴⼔Ꮷ߿‫ޔ‬ኾ㐷ߩୃ჻ࠍୃੌߒߚੱߩ⢻ജߣ⠨߃ࠄࠇࠆ߇‫▤ࠍ❱⚵ޟޔ‬ℂߔࠆ‫▤ߪߩޠ‬ℂ⠪ߩ઀੐ߢ޽ࠆߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬b.‫ ޟ‬⢻ജߩౝኈ‫ߩޠ‬㊀ⶄ‫ޟ‬2㧚୘ߩࡑࡀࠫࡔࡦ࠻ߣ⚵❱ߩࡑࡀࠫࡔࡦ࠻ߩਔ஥㕙߆ࠄ‫߃ᝒߡߒߣࡓ࠹ࠬࠪࠍ⼔⋴ޔ‬ࠆ‫ޟޔߪޠ‬1㧚⚵❱ߩ⪾⮮ࠍಽᨆߒ‫✭ࠍ⮮⪾ޔ‬๺ߔࠆߚ߼ߩᣇ⇛ࠍឭ᩺ߔࠆ‫ߩ߼ߚ߁ⴕࠍޠ‬⍮⼂ߩㇱಽߛߞߚࠅ‫ࠍߡోޔ‬൮᜝ߒߡ޿ࠆߩߢ‫ޔ‬ήߊߡ߽ࠃ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬Ԛ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜ᩺‫߇ࠕࠤޟ‬ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ߪߢ߹ޠࠆߔ࠻ࡦࡔࠫࡀࡑޔ‬㔍ߒ޿ߣ޿߁ᗧ⷗߿‫ޔ‬‫ࠍ❱⚵ޟ‬ಽᨆߔࠆ‫▤߇⃻⴫߁޿ߣޠ‬ℂ⠪ߩ઀੐ߣߒߡฃߌᱛ߼ࠄࠇࠆߚ߼‫ޔ‬‫ࠤޟ‬ࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ࠕࠤޔ‬ⅣႺࠍᡷༀߔࠆ‫ୃߣޠ‬ᱜߒߚ‫ޔߚ߹ޕ‬⚵❱ࠍಽᨆߔࠆߎߣߩᗧ࿑߇વࠊࠆࠃ߁ߦ‫ୃޟ‬჻⺖⒟ୃੌ↢ߪ‫⺖ࠆ޿ߡߓ↢ߦ❱⚵ޔ‬㗴ࠍಽᨆߒ‫߇ࠕࠤ޿⦟ࠅࠃޔ‬ឭଏߐࠇࠆࠃ߁ߦࠤࠕⅣႺࠍ⺞ᢛߔࠆߎߣ߿ᢎ⢒⊛ߦ௛߈߆ߌࠆ
ߎߣ߇᳞߼ࠄࠇࠆ‫ࠕࠤޕ‬ⅣႺࠍᡷༀߔࠆߦߪ቟ోߢ᦭ലߥࠤࠕᛛⴚ߿ᖱႎᛛⴚߩ೑↪ߦߟ޿ߡ‫ޔ‬ኾ㐷⡯ߦኻߒᢎ⢒⊛ߦ௛߈߆ߌࠆߎߣ߽฽߹ࠇࠆ‫⺑߁޿ߣޠޕ‬᣿ᢥࠍട߃ߚ‫ޕ‬‫ޟ‬⢻ജߩౝኈ‫ޔߪߡ޿ߟߦޠ‬‫ߩࡓ࠹ࠬࠪ߿❱⚵ޟ‬ಽᨆ‫ޠ‬‫ࠕࠤޟ‬ⅣႺࠍᡷༀߔࠆ‫߁޿ߣޠ‬⢻ജ߇ࠊ߆ࠆࠃ߁ߦᢥ⸒ࠍୃᱜߒߚࠅ‫ޔ‬‫ޟ‬⢻ജ‫⺑ߩޠ‬᣿ᢥߦ౉ࠇߚ‫ޔߚ߹ޕ‬㗅⇟ࠍᄌᦝߒߚ㧔⴫5㧕‫ޕ‬
⴫ 5‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜߦ㑐ߔࠆኻᾖ⴫㧔ᣥ㧕⢻ജ㧔ୃᱜ㧕⢻ജ

ࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ߔ࠻ࡦࡔࠫࡀࡑޔ‬ࠬ࠹ࡓࠍಽᨆߒ‫ࠕࠤޔ‬ⅣႺࠍᡷༀࠆߔࠆ㧔ᣥ㧕ୃᓧߔߴ߈⢻ജߩౝኈ㧔ୃᱜ㧕ୃᓧߔߴ߈⢻ജߩౝኈ㧝㧚⚵❱ߩ⪾⮮ࠍಽᨆߒ‫ ࠍ⮮⪾ޔ‬㧞㧚ࠤࠕⅣႺߣߒߡߩ⚵❱ࠍಽᨆ✭๺ߔࠆߚ߼ߩᣇ⇛ࠍឭ᩺ߔࠆ

ߒ‫⺖ޔ‬㗴⸃᳿ߩߚ߼ߩᣇ⇛ࠍឭ᩺ߔࠆ

－ 15 －

஻⠨ᢥ⸒ୃᱜ஻⠨ᢥ⸒ୃᱜ‫ޔ‬㗅⇟ᄌᦝ㧞㧚୘ߩࡑࡀࠫࡔࡦ࠻ߣ⚵❱ߩࡑ㧝㧚୘ߣ⚵❱ߩਔ஥㕙߆ࠄ‫⼔⋴ޔ‬ࡀࠫࡔࡦ࠻ߩਔ஥㕙߆ࠄ‫ࠍ⼔⋴ޔ‬ࠍࠪࠬ࠹ࡓߣߒߡᝒ߃ࠆ

ᢥ⸒ୃᱜ‫ޔ‬㗅⇟ᄌᦝࠪࠬ࠹ࡓߣߒߡᝒ߃ࠆ
㧟㧚ᖚ⠪ਛᔃߩࠤࠕࠍታ〣ߔࠆߦ㧟㧚ኻ⽎ਛᔃߩࠤࠕࠍታ〣ߔࠆߦ޽ߚࠅ‫ޔ‬ᔅⷐߣߥࠆઁ⡯⒳߿⾗Ḯᒰߚࠅ‫ޔ‬ᔅⷐߣߥࠆᄙ⡯⒳߿⾗ḮࠍᏎ߈ㄟߺߥ߇ࠄ⚵❱ࠍ▤ℂߔࠍᏎ߈ㄟߺߥ߇ࠄࠤࠕⅣႺࠍᡷࠆༀߔࠆ㧠㧚⚵❱ߦߣߞߡᔅⷐߥ੐ᨩࠍᢎ

㧠㧚⚵❱ߩ⺖㗴ߦߟ޿ߡᢎ⢒⊛ߦ⢒ࡊࡠࠣ࡜ࡓߣߒߡ╷ቯߒ‫ޔ‬ታᣉ

௛߈߆ߌࠆ

ᢥ⸒ୃᱜ

ᢥ⸒ୃᱜ

ߔࠆ
㧡㧚቟ోߢ᦭ലߥࠤࠕᛛⴚ߅ࠃ߮

೥㒰‫ޟ‬⢻ജ‫⺑ߩޠ‬᣿ᢥߦᖱႎᛛⴚߩ೑↪ߦߟ޿ߡ‫ޔ‬ᢎ⢒ࡊ౉ࠇߚߚ߼ࡠࠣ࡜ࡓࠍ⸳ቯߒ‫ޔ‬ታᣉߔࠆ㧔㧡㧕‫ޟ‬Χ㧚ࠤࠕࠍផㅴߢ߈ࠆ႐߿ੱ⊛ⅣႺࠍᢛ߃‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈߎߩ‫ޟ‬⢻ജ‫౒ߦࠬ࡯ࠦࠆࠁࠄ޽ޟߪޠ‬ㅢߩࠦࠕߢ޽ࠅ‫ޔ‬㊀ⷐߢ޽ࠆ‫߁޿ߣޠ‬ᗧ⷗߇޽ߞ
ߚ‫ޔߒ߆ߒޕ‬‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޟ‬ើߔࠆ‫ޔߪߢߌߛ߁޿ߣޠ‬૗ߩߚ߼ߩ࡝࡯࠳࡯ࠪ࠶ࡊߥ
ߩ߆߇ࠊ߆ࠅߦߊ޿ߚ߼‫⺑ޔ‬᣿߇ᔅⷐߢ޽ࠆߣ޿߁ᗧ⷗߿‫ߦ߁ࠃࠆߥߦࠕࠤ޿⦟ࠅࠃ੹ޔ‬࡝࡯࠳࡯ࠪ࠶ࡊࠍ⊒ើߔࠆߣ޿߁ᗧ๧߇ࠊ߆ࠆࠃ߁ߥ⴫⃻ߦߒߚᣇ߇ࠃ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬ԙ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈa㧚 ‫ޟ‬⢻ജߩౝኈ‫࡞ࡌ࡟ߩޠ‬‫ޟ‬5.⋴⼔ߣක≮ࠨ࡯ࡆࠬߩឭଏߦᓇ㗀ࠍਈ߃ࠆࠤࠕߩᡷༀᣇᴺࠍਥዉߔࠆ‫ୃޔߪޠ‬჻⺖⒟ߢߪ㔍ߒߊ‫ޔ‬‫ޟ‬ឭ᩺ߢ߈ࠆ‫߁޿ߣࠆ޽ߢ࡞ࡌ࡟߁޿ߣޠ‬ᗧ⷗߇಴ߚ‫ޔߚ߹ޕ‬‫ޟ‬6㧚ක≮࠴࡯ࡓߩਛߢ‫ઁޔ‬⡯⒳ߦኻߒߡ⋴⼔ߩᓎഀ߿ଔ୯ࠍ⴫⃻ߒ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ߩࠕࠤޔ‬ើߔࠆ‫ޠ‬ߦߟ޿ߡ߽㊀ⷐߛ߇㔍ߒ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬b㧚 ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬㊀ⶄ‫ޟ‬⢻ജߩౝኈ‫ޟߩޠ‬1㧚ᣂߒ޿⍮⼂߿ࡕ࠺࡞ࠍታ〣ߦዉ౉ߔࠆߚ߼ߩᚻᴺࠍℂ⸃ߒ‫ߩߘޔ‬ታ⃻ߦะߌߡ࡝࡯࠳࡯ࠪ࠶ࡊࠍ⊒ើߔࠆ‫ޟޠ‬2㧚ࠢ࡝࠹ࠖࠞ࡞ࠪࡦࠠࡦࠣ߿࡝ࡈ࡟࡚ࠢࠪࡦ
ࠍขࠅ౉ࠇߚ࡝࡯࠳࡯ࠪ࠶ࡊࠍ⊒ើߔࠆ‫ޟޠ‬3㧚ᄌൻࠍଦߔ⍮⼂ߣᛛⴚࠍᵴ↪ߒߡ‫ߩࠕࠤޔ‬ᡷༀߦะߌߡ࡝࡯࠳࡯ࠪ࠶ࡊࠍ⊒ើߔࠆ‫ޔߪޠ‬㕖Ᏹߦౕ૕⊛ߥ⍮⼂߿ࠬࠠ࡞ߢ޽ࠅ‫ޔ‬⢻ജࠍ⊒ើߔࠆߚ߼ߦ૗ࠍߒߥߌࠇ߫޿ߌߥ޿߆߹ߢ౉ࠇࠆᔅⷐߪߥ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ߎޕ‬ࠇࠄߩ‫ޟ‬⢻ജ‫ޟޔߪޠ‬4㧚㓸࿅߿⚵❱ߩ႐ߩ࠳ࠗ࠽ࡒ࠭ࡓࠍ⺒ߺߥ߇ࠄ‫ޔ‬㓸࿅߿⚵❱ࠍേ߆ߔ‫ޠ‬‫ޟ‬5. ⋴⼔ߣක≮ࠨ࡯ࡆࠬߩឭଏߦᓇ㗀ࠍਈ߃ࠆࠤࠕߩᡷༀᣇᴺࠍਥዉߔࠆ‫ޠ‬‫ޟ‬6㧚ක≮࠴࡯ࡓߩਛߢ‫ઁޔ‬⡯⒳ߦኻߒߡ⋴⼔ߩᓎഀ߿ଔ୯ࠍ⴫⃻ߒ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ߩࠕࠤޔ‬ើߔ－ 16 －

ࠆ‫ߢޠ‬ಽ߆ࠆߩߢߪߥ޿߆ߣ޿߁ᗧ⷗߇಴ߚ‫ޟޔߚ߹ޕ‬4㧚㓸࿅߿⚵❱ߩ႐ߩ࠳ࠗ࠽ࡒ࠭ࡓ
ࠍ⺒ߺߥ߇ࠄ‫ޔ‬㓸࿅߿⚵❱ࠍേ߆ߔ‫ޠ‬‫ޟ‬5. ⋴⼔ߣක≮ࠨ࡯ࡆࠬߩឭଏߦᓇ㗀ࠍਈ߃ࠆࠤࠕߩ
ᡷༀᣇᴺࠍਥዉߔࠆ‫ޠ‬‫ޟ‬6㧚ක≮࠴࡯ࡓߩਛߢ‫ઁޔ‬⡯⒳ߦኻߒߡ⋴⼔ߩᓎഀ߿ଔ୯ࠍ⴫⃻ߒ‫ޔ‬ࠤࠕߩ࡝࡯࠳࡯ࠪ࠶ࡊࠍ⊒ើߔࠆ‫ߪޠ‬㘃ૃߒߡ޿ࠆߚ߼ᢛℂߢ߈ࠆߩߢߪߥ޿߆ߣ޿߁ᗧ
⷗߇಴ߚ‫ޕ‬Ԛ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜ᩺‫ࠍࠕࠤޟ‬ផㅴߢ߈ࠆ႐߿ੱ⊛ⅣႺࠍᢛ߃‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆ‫࠶ࠪ࡯࠳࡯࡝ߩޠ‬ࡊ߇‫ޔ‬૗ߩߚ߼ߩ࡝࡯࠳࡯ࠪ࠶ࡊߢ޽ࠆߩ߆ࠊ߆ࠅߦߊ޿ߣ޿߁ᗧ⷗߇಴ߚߚ߼‫ޔ‬‫ୃޟ‬჻⺖⒟ୃੌ↢ߪ‫ߩࠕࠤޔ‬ᡷༀߦะߌߡ‫ޔ‬㓸࿅߿⚵❱ߦ௛߈߆ߌ‫ޔ‬ᄌൻࠍ⿠ߎߔᓎഀࠍᜂ߁ߎߣ
߇᳞߼ࠄࠇࠆ‫ޔߦ߼ߚߩߘޕ‬ᔅⷐߥ⍮⼂࡮ᛛⴚࠍᵴ↪ߒ‫ࡈ࡝߿ࠣࡦࠠࡦࠪ࡞ࠞࠖ࠹࡝ࠢޔ‬࡟࡚ࠢࠪࡦࠍขࠅ౉ࠇߡ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬‫⺑߁޿ߣޠ‬᣿ᢥࠍട߃ߚ‫ޟޔߚ߹ޕ‬⢻ജߩౝኈ‫ౕ߇ޠ‬૕⊛ㆊ߉ࠆߣ޿߁ᗧ⷗߿‫ޔ‬㊀ⶄߒߡ޿ࠆౝኈ߇޽ࠆߣߩ
ᗧ⷗ࠃࠅ‫ޔ‬‫ޟ‬⢻ജ‫⺑ߩޠ‬᣿ᢥߦ౉ࠇߚࠅ‫ޔ‬೥㒰ࠍⴕ޿ 6 㗄⋡߆ࠄ 3 㗄⋡߳ᢛℂߒߚ‫ޔߚ߹ޕ‬ᢥ⸒ࠍୃᱜߒߚ㧔⴫ 6㧕‫ޕ‬
⴫ 6.‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜߦ㑐ߔࠆኻᾖ⴫㧔ᣥ㧕⢻ജ㧔ୃᱜ㧕⢻ജ

ࠤࠕࠍផㅴߢ߈ࠆ႐߿ੱ⊛ⅣႺ

ࠤࠕࠍផㅴߢ߈ࠆ႐߿ੱ⊛ⅣႺ

ࠍᢛ߃‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠍᢛ߃ࠆߚ߼ߦ‫ࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬

ࠆ

ࠍ⊒ើߔࠆ

㧔ᣥ㧕ୃᓧߔߴ߈⢻ജߩౝኈ㧔ୃᱜ㧕ୃᓧߔߴ߈⢻ജߩౝኈ㧝㧚ᣂߒ޿⍮⼂߿ࡕ࠺࡞ࠍታ〣ߦ㧝㧚ᣂߒ޿⍮⼂߿ࡕ࠺࡞ࠍታ〣ߦዉ౉ߔࠆߚ߼ߩᚻᴺࠍℂ⸃ߒ‫ߘޔ‬ዉ౉ߔࠆߚ߼ߩᚻᴺࠍℂ⸃ߒ‫ߘޔ‬ߩታ⃻ߦะߌߡ࡝࡯࠳࡯ࠪ࠶ࡊ

ߩታ⃻ߦะߌߡ࡝࡯࠳࡯ࠪ࠶ࡊ

ࠍ⊒ើߔࠆ

ࠍ⊒ើߔࠆ

㧞㧚ࠢ࡝࠹ࠖࠞ࡞ࠪࡦࠠࡦࠣ߿࡝

೥㒰

஻⠨
ᢥ⸒ୃᱜ

஻⠨
ᄌᦝߥߒ

‫ޟ‬⢻ജ‫⺑ߩޠ‬᣿ᢥߦࡈ࡟࡚ࠢࠪࡦࠍขࠅ౉ࠇߚ࡝࡯

౉ࠇߚߚ߼࠳࡯ࠪ࠶ࡊࠍ⊒ើߔࠆ㧟㧚ᄌൻࠍଦߔ⍮⼂ߣᛛⴚࠍᵴ↪

೥㒰‫ޟ‬⢻ജ‫⺑ߩޠ‬᣿ᢥߦߒߡ‫ߩࠕࠤޔ‬ᡷༀߦะߌߡ࡝࡯࠳

౉ࠇߚߚ߼࡯ࠪ࠶ࡊࠍ⊒ើߔࠆ㧠㧚㓸࿅߿⚵❱ߩ႐ߩ࠳ࠗ࠽ࡒ࠭

㧞㧚㓸࿅߿⚵❱ߩ႐ߩ࠳ࠗ࠽ࡒ࠭

ࡓࠍ⺒ߺߥ߇ࠄ‫ޔ‬㓸࿅߿⚵❱ࠍേࡓࠍಽᨆߒ‫ޔ‬㓸࿅߿⚵❱ࠍേ߆ߔ߆ߔ

－ 17 －

ᢥ⸒ୃᱜ㧡㧚⋴⼔ߣක≮ࠨ࡯ࡆࠬߩឭଏߦ

㧟㧚ᦨༀߩක≮ࠨ࡯ࡆࠬࠍឭଏߔ

ᓇ㗀ࠍਈ߃ࠆࠤࠕߩᡷༀᣇᴺࠍ

ࠆߚ߼ߦࠤࠕߩᡷༀࠍਥዉߔࠆ

ᢥ⸒ୃᱜ

ਥዉߔࠆ
㧢㧚ක≮࠴࡯ࡓߩਛߢ‫ઁޔ‬⡯⒳ߦ ೥㒰

㊀ⶄߒߡ޿ࠆߚ߼

ኻߒߡ⋴⼔ߩᓎഀ߿ଔ୯ࠍ⴫⃻ߒ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ߩࠕࠤޔ‬ើߔࠆ㧔㧢㧕‫ޟ‬Ψ㧚࠴࡯ࡓࠍᒻᚑߒ‫ޔ‬ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈ‫ࠍࡓ࡯࠴ޟ‬ᒻᚑߒ‫ޔ‬ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫ޟ߁޿ߣޠ‬⢻ജ‫ࠬ࡯ࠦ⺰ୃޟޔߪޠ‬㧔⎇ⓥ⠪ࠦ࡯ࠬ㧕ߦ߅޿ߡߪ‫ߩ࡞࠼࡯ࡂޔ‬㜞޿⢻ജߛߣᕁ߁‫ޟޠ‬ኾ㐷⋴⼔Ꮷߢߪ⛘ኻᔅⷐߢ޽ࠆ‫ߪߡߞࠃߦࠬ࡯ࠦޔߦ߁ࠃ߁޿ߣޠ‬㔍ߒ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬‫ޟ‬ᄙ⡯⒳㑆ߣද௛ߒߡ⋴⼔ࠤࠕࠍឭଏߔࠆ‫ޔߪߦ߼ߚޠ‬ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߔࠆᔅⷐ߇
޽ࠅ‫ࠍࡓ࡯࠴ޔ‬૞ࠆߎߣ߆ࠄᆎ߼ߥ޿ߣ޿ߌߥ޿ߩߢ‫ޔ‬‫ޟ‬⢻ജ‫ޔߪߡߒߣޠ‬‫ޟ‬ᄙ⡯⒳㑆ߣද௛ߒߡ⋴⼔ࠤࠕࠍឭଏߔࠆ‫߁޿ߣ߆޿ߥߪߢߩ޿ࠃߢޠ‬ᗧ⷗߇޽ߞߚ‫ޟޔߚ߹ޕ‬ኾ㐷ᕈߩ⋧
㆑ࠍዅ㊀ߒߚ਄ߢ‫ߦޠ‬ട߃ߡ‫ޔ‬නߥࠆࠦ࡯࠺ࠖࡀ࡯࠻ߢߪߥߊ‫ߩ⥄⁛⼔⋴ޔ‬ኾ㐷ᕈߦၮߠ޿ߡ޿ࠆߎߣ߇ࠊ߆ࠆ⴫⃻߇ᔅⷐߢ޽ࠆߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬ԙ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈa㧚‫ޟ‬⢻ജߩౝኈ‫࡞ࡌ࡟ߩޠ‬‫ޟ‬1㧚ኾ㐷⡯㑆࠴࡯ࡓߣലᨐ⊛ߥㅪ៤㑐ଥࠍ▽ߊߚ߼ߦ‫ޔ‬੕޿ࠍዅ㊀ߒߚࠦࡒࡘ࠾ࠤ࡯ࠪ
࡚ࡦࠍߣࠆ‫ޟޠ‬2㧚࠴࡯ࡓߩ⋴⼔Ꮷ߿ઁ⡯⒳ߦኻߒߡࠤࠕߩᗧ࿑߿ᔅⷐᕈࠍ⺑᣿ߒ‫ޔ‬ㅪ៤ߔࠆ‫߼ߚࠆ޽ߢߣߎࠆߔ߽ߢࠬ࡯࠽࡞࡜ࡀࠚࠫߪޠ‬ਇⷐߢ޽ࠆߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬߹ߚ‫ߢࠬ࡯ࠦࠆࠁࠄ޽ޔ‬ᔅⷐߥ⢻ജߢ޽ࠆߣ޿߁ᗧ⷗ߩ৻ᣇ‫ޔ‬‫ޟ‬5.ක≮࠴࡯ࡓߦ߅޿ߡ⋴⼔Ꮷ߿ઁ⡯⒳ߩࠦࡦࠨ࡞࠹࡯࡚ࠪࡦࠍታᣉߔࠆ‫ߦࡦ࡚ࠪ࡯࠹࡞ࠨࡦࠦߩޠ‬㑐ߒߡߪ‫ޟޔ‬ඳ჻
⺖⒟ߩ೨ᦼࠦࠕߦߔࠆߦߪ࡟ࡌ࡞߇㜞ㆊ߉ࠆ‫ޔ‬ኾ㐷⋴⼔Ꮷߩୃੌᤨὐߢ߽㔍ߒ޿ߩߢ‫“ޔ‬ታᣉᣇᴺࠍℂ⸃ߔࠆ”ߦߣߤ߼ࠆ߶߁߇ࠃ޿‫߁޿ߣޠ‬ᗧ⷗߽಴ߚ‫ޕ‬
ઁࠍዅ㊀ߔࠆߣ޿߁ߎߣ߇⋴⼔Ꮷߦᰳߌߡ޿ࠆ᳇߇ߔࠆߚ߼‫ޟޔ‬1㧚ኾ㐷⡯㑆࠴࡯ࡓߣല
ᨐ⊛ߥㅪ៤㑐ଥࠍ▽ߊߚ߼ߦ‫ޔ‬੕޿ࠍዅ㊀ߒߚࠦࡒࡘ࠾ࠤ࡯࡚ࠪࡦࠍߣࠆ‫ߚࠇ౉ߪޠ‬ᣇ߇ࠃ޿ߣ߁ᗧ⷗߇಴ߚ‫৻ޕ‬ᣇߢ‫ޔ‬‫ޟ‬3.࡝࡯࠳࡯ࠪ࠶ࡊࠬࠠ࡞ࠍ↪޿ߡ‫ޔ‬ක≮࠴࡯ࡓߩઁߩࡔࡦ
ࡃ࡯ࠍᢎ⢒ߒ‫ޔ‬ᜰዉߒ‫ޔ‬ഥ⸒ߔࠆ‫ޠ‬‫ޟ‬5.ක≮࠴࡯ࡓߦ߅޿ߡ⋴⼔Ꮷ߿ઁ⡯⒳ߩࠦࡦࠨ࡞࠹࡯
࡚ࠪࡦࠍታᣉߔࠆ‫ޔߪޠ‬ታ㓙ߦⴕ߁ߣ࠴࡯ࡓ߆ࠄߪߓ߆ࠇߡߒ߹߁‫ޟޔߦ․ޕ‬3㧚࡝࡯࠳࡯ࠪ࠶ࡊࠬࠠ࡞ࠍ↪޿ߡ‫ޔ‬ක≮࠴࡯ࡓߩઁߩࡔࡦࡃ࡯ࠍᢎ⢒ߒ‫ޔ‬ᜰዉߒ‫ޔ‬ഥ⸒ߔࠆ‫ߪޠ‬ᄖߒߚᣇ߇ࠃ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬b㧚‫ޟ‬⢻ജߩౝኈ‫⃻⴫ߩޠ‬‫ઁޟ‬⡯⒳‫ޟߪޠ‬ᄙ⡯⒳‫ߦޠ‬ᄌᦝߒߚᣇ߇ࠃ޿ߣ޿߁ᗧ⷗߿‫ޟߣޠ࡞ࠠࠬޟޔ‬ᛛⴚ‫↪૶ߩޠ‬－ 18 －

ࠍ⛔৻ߒߚᣇ߇ࠃ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޔߚ߹ޕ‬‫ޟߣޠࡓ࡯࠴ޟ‬ක≮࠴࡯ࡓ‫߇ޠ‬ᷙ࿷ߒߡ޿ࠆߎߣࠍᢛℂߒߚᣇ߇ࠃ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬Ԛ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜ᩺ ‫ޟ‬ᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫ߩࡓ࡯࠴ޔߪߦ߼ߚޠ‬ᒻᚑ߇ᔅⷐߦߥࠆߚ߼‫ࠍࡓ࡯࠴ޟޔ‬ᒻᚑߒ‫ࠍޠ‬೥㒰ߒ‫ޟޔ‬ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫ୃߣޠ‬ᱜߒߚ‫ޕ‬߹ߚ‫ޔ‬‫ޟ‬ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߔࠆ‫ޟޠ‬ᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫߇ߣߎޠ‬વࠊࠆࠃ߁ߦ‫ୃޟޔ‬჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኾ㐷⡯㑆ߩലᨐ⊛ߥㅪ៤㑐ଥࠍଦߔߚ߼ߦ‫⋧ޔ‬੕ߦቇ⠌ߔࠆⅣႺࠍ⺞ᢛߒߚࠅ‫⼔⋴ޔ‬⡯߿ᄙ⡯⒳߆ࠄߩ⋧⺣ߦᔕߓߚࠅߒߡ‫ޔ‬ᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫ߩߘޕ‬㓙ߦߪ‫ઁࠍ⼔⋴ޔ‬⡯⒳ߦ⺑᣿ߔࠆ⢻ജ߇᳞߼ࠄࠇࠆ‫ޕ‬‫⺑߁޿ߣޠ‬᣿ᢥࠍട߃ߚ‫ޕ‬ ‫ޟ‬⢻ജߩౝኈ‫ޟޔߪߡ޿ߟߦޠ‬⢻ജ‫⺑ߩޠ‬᣿ᢥߦ౉ࠇߚࠅ‫ޔ‬ᢥ⸒ࠍୃᱜߒߚ㧔⴫ 7㧕‫ޕ‬⴫ 7.‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜߦ㑐ߔࠆኻᾖ⴫㧔ᣥ㧕⢻ജ㧔ୃᱜ㧕⢻ജ

࠴࡯ࡓࠍᒻᚑߒ‫ޔ‬ኾ㐷ᕈߩ⋧㆑ࠍኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ

ዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ

஻⠨
ᢥ⸒ୃᱜ

ផㅴߔࠆ

㧔ᣥ㧕ୃᓧߔߴ߈⢻ജߩౝኈ㧔ୃᱜ㧕ୃᓧߔߴ߈⢻ജߩౝኈ஻⠨㧝㧚ኾ㐷⡯㑆࠴࡯ࡓߣലᨐ⊛ߥㅪ㧝㧚ኾ㐷⡯㑆ߩലᨐ⊛ߥㅪ៤㑐ଥ ᢥ⸒ୃᱜ៤㑐ଥࠍ▽ߊߚ߼ߦ‫ޔ‬੕޿ࠍዅ㊀ࠍ▽ߊߚ߼ߦ‫ޔ‬੕޿ࠍዅ㊀ߒߚࠦߒߚࠦࡒࡘ࠾ࠤ࡯࡚ࠪࡦࠍߣࠆ

ࡒࡘ࠾ࠤ࡯࡚ࠪࡦࠍߣࠆ

㧞㧚࠴࡯ࡓߩ⋴⼔Ꮷ߿ઁ⡯⒳ߦኻ

㧞㧚⋴⼔Ꮷ߿ઁ⡯⒳ߦኻߒߡ⋴⼔ߒߡࠤࠕߩᗧ࿑߿ᔅⷐᕈࠍ⺑᣿ߩᗧ࿑߿ᔅⷐᕈࠍ⺑᣿ߒ‫ޔ‬ද௛ߔߒ‫ޔ‬ㅪ៤ߔࠆ

ࠆ㧟㧚࡝࡯࠳࡯ࠪ࠶ࡊࠬࠠ࡞ࠍ↪޿

೥㒰

ᢥ⸒ୃᱜ

‫ޟ‬⢻ജ‫⺑ߩޠ‬᣿ᢥߦߡ‫ޔ‬ක≮࠴࡯ࡓߩઁߩࡔࡦࡃ࡯ࠍ

౉ࠇߚߚ߼ᢎ⢒ߒ‫ޔ‬ᜰዉߒ‫ޔ‬ഥ⸒ߔࠆ㧠㧚⋴⼔ߣߒߡߩኾ㐷ᕈߣቇ㓙⊛೥㒰‫ޟ‬⢻ജ‫⺑ߩޠ‬᣿ᢥߦߥⷞὐࠍ߽ߞߡઁ⡯⒳ߣᨵエߦ

౉ࠇߚߚ߼

ද௛ߔࠆ
㧡㧚ක≮࠴࡯ࡓߦ߅޿ߡ⋴⼔Ꮷ߿೥㒰‫ޟ‬⢻ജ‫⺑ߩޠ‬᣿ᢥߦઁ⡯⒳ߩࠦࡦࠨ࡞࠹࡯࡚ࠪࡦࠍ

౉ࠇߚߚ߼

ታᣉߔࠆ
㧢㧚⃻႐ߩ⋴⼔ߩ⺖㗴ࠍนⷞൻ㧟㧚ኻ⽎ߩ⺖㗴ࠍนⷞൻߒ‫ઁޔ‬⡯ߒ‫ઁޔ‬⡯⒳ߣද௛ߒߡ⸃᳿ߦዉߊ

⒳ߣද௛ߒߡ⸃᳿ߦዉߊ

－ 19 －

ᢥ⸒ୃᱜ㧣㧚ࠤࠕឭଏߩߚ߼ߦࠦ࡯࠺ࠖࡀ

㧠㧚ࠦ࡯࠺ࠖࡀ࡯࠲࡯ߩᓎഀࠍᜂ

࡯࠲࡯ߩᓎഀࠍᜂ޿‫ߩࡓ࠹ࠬࠪޔ‬޿‫ޔ‬ද௛ߩ౞Ṗൻࠍផㅴߔࠆ

ᢥ⸒ୃᱜ౞Ṗൻࠍផㅴߔࠆ

㧔㧣㧕‫ޟ‬Ω㧚౏ⴐߩஜᐽߦะߌߡ‫੍ޔ‬㒐⊛ߥⷰὐࠍ〯߹߃ߡ‫ߩޘੱޔ‬ஜᐽჇㅴߦขࠅ⚵߻‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈ‫ߩઁޟ‬⢻ജߦᲧߴ‫ޔ‬㕖Ᏹߦኾ㐷ᕈߦ․ൻߒߚౝኈߦߥߞߡ޿ࠆ‫ޠ‬‫ޟ‬࿾ၞ⋴⼔ߦ․ൻߒߚౝ
ኈߣߥߞߡ޿ࠆ‫⇼߆ߩࠆ޽ߢࠕࠦޟޠ‬໧‫ޔߦ߁ࠃ߁޿ߣޠ‬ኾ㐷ᕈߦ․ൻߒߚ⢻ജߢ޽ࠅ‫ࠦޔ‬ࠕߩ⢻ജߢ޽ࠆ߆⇼໧ߢ޽ࠆߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬߹ߚ‫ޔ‬‫ޔ߆ߩߥⴐ౏ߗߥޟ‬㆑๺ᗵ߇޽ࠆ‫ޠ‬‫ޔߪߩ߁޿ߣⴐ౏ޟ‬⢻ജߩ⴫⃻ߣߒߡᄢ߈޿‫ࡋޕ‬࡞ࠬࡊࡠࡕ࡯࡚ࠪࡦߣߔࠆᣇ߇ࠊ߆ࠅ߿ߔ޿‫ޠ‬‫ߩⴐ౏“ޟ‬ஜᐽߦะߌߡ”ࠍ౉ࠇߕ‫੍“ޔ‬㒐⊛ߥⷰὐࠍ߰߹߃ߡ㑐ࠊߞߡ޿ߊ”ߣߒߚᣇ߇ࠃ޿‫ߩ߳⃻⴫߁޿ߣޠⴐ౏ޟޔߤߥޠ‬ᗧ⷗߇಴ߚ‫ޕ‬‫ޟ‬㧝ੱߩ߭ߣ߇⦡‫ߥޘ‬ஜᐽ⁁ᘒߦ޽ࠆੱࠍ⛔ว⊛ߦ⷗ࠇࠆ‫߁޿ߣޠ‬ᗧ๧ว޿ࠍᜬߚߔߎߣ
߇ᄢಾߢ‫ޔߊߥߢߌߛࡦ࡚ࠪ࡯ࡕࡠࡊࠬ࡞ࡋޔ‬1 ੱߩੱߩᕆᕈᦼ߿ᘟᕈᦼ߿ᣣᏱ↢ᵴߦ߅ߌࠆஜᐽ⁁ᘒߣ߆‫ޔ‬disease management ࠍ฽ࠎߛᣇ߇ࠃ޿ߣ޿߁ᗧ⷗߽಴ߚ‫ޕ‬ԙ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈa㧚‫ޟ‬⢻ജߩౝኈ‫࡞ࡌ࡟ߩޠ‬‫ޟ‬9㧚⋴⼔ߩኻ⽎ߢ޽ࠆ㓸࿅ߦኻߒߡ‫ޔ‬ஜᐽჇㅴߦะߌߡ⋴⼔੺౉ߔࠆ‫࡞࡜ࡀࠚࠫޔߪޠ‬࠽࡯ࠬߢ߽ߢ߈ࠆߎߣߢ޽ࠅ‫ୃޔ‬჻ୃੌ↢ߦ߽ߣ߼ࠆ࡟ࡌ࡞ߢߪߥ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬b.‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬㊀ⶄ‫ޟ‬3. ౏ⴐߩஜᐽ㨯ஜᐽჇㅴߣ޿߁ⷞὐ߆ࠄ‫⼔⋴ޔ‬ታ〣ࠍዷ㐿ߔࠆ‫ޠ‬‫ޟ‬5㧚⋴⼔ߩኻ⽎ߦኻߒߡ‫߽ߦᤨࠆߥ߆޿ޔ‬ஜᐽჇㅴߣ޿߁ⷞὐ߆ࠄ௛߈߆ߌࠆ‫ޠ‬‫ޟ‬6㧚‫∔ޟ‬ᖚࠍ੍㒐ߔࠆ‫ⷰ߁޿ߣޠ‬ὐߢ㓸࿅߳ߩஜᐽᢎ⢒ࠍታᣉߔࠆ‫ޠ‬‫ޟ‬7.⋴⼔ߩኻ⽎ߦኻߒߡ‫∉ޔ‬ቇ⊛ߥ⍮⼂ࠍᵴ↪ߒߡࡐࡇࡘ࡟࡯࡚ࠪࡦ࡮ࠕࡊࡠ࡯࠴ࠍታ〣ߔࠆ‫ޠ‬‫ޟ‬8.੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍㅢߓ‫ޔ‬୘ੱ෸߮㓸࿅ߩஜᐽࠍଦㅴߐߖࠆᣇᴺࠍりߦઃߌࠆ‫ޟޠ‬9㧚⋴⼔ߩኻ⽎ߢ޽ࠆ㓸࿅ߦኻߒߡ‫ޔ‬ஜᐽჇㅴߦะߌߡ⋴⼔੺౉ߔࠆ‫߇ޠ‬㊀ⶄߒߡ޿ࠆߣ޿߁ᗧ⷗߇಴ߚ‫ୃޔߚ߹ޕ‬ᓧߔߴ߈⢻ജ߇ 10 ߽޽ࠆߩߪ‫ޔ‬ᄙߔ߉ࠆߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬c. ㅊടߔߴ߈‫ޟ‬⢻ജߩౝኈ‫ޠ‬‫∔ޟ‬ᖚࠍᛴ߃ߡ޿ࠆੱ‫ޟޠ‬㓚ኂߩ޽ࠆੱ‫ߦޠ‬ኻߔࠆ‫ޔ‬‫ߩޠ࡯࡝ࡃࠞ࡝ޟޠࠬࠣࡦ࡟࠻ࠬޟ‬᭎ᔨࠍ౉ࠇߡ᰼ߒ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬Ԛ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜ᩺㊀ⶄߒߡ޿ࠆ‫ޟ‬⢻ജߩౝኈ‫߇ޠ‬ᄙ޿ߎߣ߿‫ޔ‬‫ޟ‬⢻ജ‫ޟߩޠ‬Τ.⋴⼔ߩኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ㧕ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆ‫ޠ‬‫ޟ‬Ϊ㧚⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ‫ߦޠ‬฽߼ࠆߎߣ߇ߢ߈ࠆߣ⠨߃ࠄࠇࠆߎߣ߆ࠄ

－ 20 －

‫ޟ‬⢻ജ‫ߡߒߣޠ‬೥㒰ߒߚ‫ޕ‬㧔㧤㧕‫ޟ‬Ϊ㧚 ᡽╷߇ஜᐽߣ⋴⼔ߦ෸߷ߔᓇ㗀ࠍᛠីߒ‫ޔ‬ᡷༀߦะߌߡ᡽╷ࠍឭ⸒ߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈ‫ޟ‬᡽╷ࠍឭ⸒ߔࠆߪ‫ޔ‬ඳ჻࡟ࡌ࡞ߢ᳞߼ࠆ⢻ജߛߣᕁ߁‫ୃޟޠ‬჻ߢߪ‫ߩ⁁⃻ޔ‬໧㗴ಽᨆ߿໧㗴ឭ⿠߇ߢ߈‫ޔ‬᡽╷ឭ⸒࠴࡯ࡓߩ㧝ߟߩᓎഀࠍᜂ߁߹ߢߪߢ߈ࠆ߇‫ޔ‬᡽╷ࠍឭ⸒ߔࠆߣ
޿߁ਥዉ⊛┙႐ߪήℂߛߣᕁ߁‫߁޿ߣޠ‬ᗧ⷗ߩࠃ߁ߦ‫ޟޔ‬᡽╷ࠍឭ⸒ߔࠆ‫ୃߪߢ߹ޠ‬჻⺖⒟ߢߪ࡟ࡌ࡞߇㜞ߊ‫ޔ‬ඳ჻⺖⒟࡟ࡌ࡞ߢ᳞߼ࠆ⢻ജߢ޽ࠆߣ޿߁ᗧ⷗߇಴ߚ‫ୃޕ‬჻⺖⒟ߢߪ‫ޔ‬‫ޟ‬᡽╷ឭ⸒ࠍ⠨߃ࠄࠇࠆ‫ޟޔ߆ޠ‬᡽╷ឭ⸒ߩᵴേߦ⽸₂ߢ߈ࠆ‫߁޿ߣ߁ࠈߛߢ߹ޠ‬ᗧ⷗߇಴ߚ‫ޕ‬‫ޟ‬᡽╷ࠍឭ⸒ߔࠆ‫ߦ⃻⴫߁޿ߣޠ‬ኻߒ‫ޟޔ‬᡽╷߇ஜᐽߣ⋴⼔ߦ෸߷ߔᓇ㗀ࠍᛠីߒ‫ޔ‬ᡷༀߦะߌߡ᡽╷ࠍឭ᩺ߔࠆ‫ޠ‬‫ޟ‬᡽╷߇ஜᐽߣ⋴⼔ߦ෸߷ߔᓇ㗀ࠍᛠីߒ‫ޔ‬ᡷༀߦะߌߡ⠨᩺ߔࠆ‫ޠ‬‫ޟ‬᡽╷߇ஜᐽߣ⋴⼔ߦ෸߷ߔᓇ㗀ߦ᳇ߠ߈‫ޔ‬໧㗴ᗧ⼂ࠍ߽ߟ‫ୃ߁޿ߣޠ‬ᱜ᩺߇಴ߚ‫ޕ‬ԙ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈa.‫ޟ‬⢻ജߩౝኈ‫࡞ࡌ࡟ߩޠ‬‫ޟ‬㧝㧚ᴺᓞ࡮೙ᐲ࡮᡽╷߇⋴⼔ታ〣‫ޔ‬ஜᐽߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ‫ޠ‬ߩ㗄⋡ࠍࠦࠕߣߒ‫ࠇߘޔ‬એᄖߩ‫ޟ‬⢻ജߩౝኈ‫߁޿ߣࠆߔߣࡦ࡚ࠪࡊࠝࠍޠ‬ᗧ⷗߇಴ߚ‫ޕ‬Ԛ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜ᩺ ‫ޟ‬㧝㧚ᴺᓞ࡮೙ᐲ࡮᡽╷߇⋴⼔ታ〣‫ޔ‬ஜᐽߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ‫ޠ‬ࠍࠦࠕߣߔࠆߣ޿߁ᗧ⷗ߦၮߠ߈‫ޟޔ‬⢻ജ‫ߩⴕ⃻ޟࠍޠ‬ᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ‫ୃߣޠ‬ᱜߒߚ‫ޟߩߎޔߚ߹ޕ‬⢻ജ‫ߦࠈߎߣߔ␜߇ޠ‬ߟ޿ߡ‫ୃޟ‬჻⺖⒟ୃੌ↢ߪ‫ߩⴕ⃻ޔ‬ᴺᓞ㨯೙ᐲ࡮᡽╷߇ੱ‫ߩޘ‬ஜᐽ߿⋴⼔ߦߤߩࠃ߁ߥᓇ㗀ࠍ߽ߚࠄߒߡ޿ࠆ߆ࠍಽᨆߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫ߩߘޕ‬ಽᨆ⚿ᨐߦၮߠ߈‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ߇‫ߩߘޔ‬㓙ߦ⋴⼔ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯ⷰࠍ෻ᤋߒߚᣇ╷ࠍ⠨߃ࠆߎߣ߽᳞߼ࠄ
ࠇࠆ‫ޕ‬‫⺑߁޿ߣޠ‬᣿ᢥࠍട߃ߚ‫ޟޔߚ߹ޕ‬⢻ജΩ‫ࠍޠ‬೥㒰ߒߚߚ߼‫ޟߩߎޔ‬⢻ജΪ‫ޟࠍޠ‬⢻ജΩ‫ࠅ➅ߦޠ‬਄ߍߚ‫ޕ‬ ‫ޟ‬⢻ജߩౝኈ‫ޟޔߪߡ޿ߟߦޠ‬Ω㧚౏ⴐߩஜᐽߦะߌߡ‫੍ޔ‬㒐⊛ߥⷰὐࠍ〯߹߃ߡ‫ޘੱޔ‬ߩஜᐽჇㅴߦขࠅ⚵߻‫ߦޠ‬฽߹ࠇߡ޿ߚౝኈࠍ‫ߩޘੱޟޔ‬ஜᐽჇㅴߣ޿߁ⷞὐ߆ࠄ‫ߩ⼔⋴ޔ‬᡽╷ࠍឭ᩺ߔࠆ‫ߣޠ‬ᢥ⸒ࠍୃᱜߒߡട߃ߚ‫ޔߚ߹ޕ‬ᢥ⸒ࠍୃᱜߒߚࠅ‫ޔ‬㊀ⶄߔࠆ߽ߩࠍ೥
㒰ߒߚ㧔⴫ 8㧕‫ޕ‬
⴫ 8㧚‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜߦ㑐ߔࠆኻᾖ⴫㧔ᣥ㧕⢻ജ㧔ୃᱜ㧕⢻ജ

஻⠨᡽╷߇ஜᐽߣ⋴⼔ߦ෸߷ߔᓇ㗀ࠍ

⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ‫ޟ‬⢻ജߩౝኈ‫ߦޠ‬ᛠីߒ‫ޔ‬ᡷༀߦะߌߡ᡽╷ࠍឭ⸒⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿฽߹ࠇߡ޿ߚ߽ߩ

－ 21 －

ߔࠆ╷ࠍឭ᩺ߔࠆ

ߩᢥ⸒ࠍୃᱜߒ⢻ജߣߒߚ‫ޕ‬㧔ᣥ㧕ୃᓧߔߴ߈⢻ജߩౝኈ㧔ୃᱜ㧕ୃᓧߔߴ߈⢻ജߩౝኈ

㧝㧚ᴺᓞ࡮೙ᐲ࡮᡽╷߇⋴⼔ታ〣‫ޟ ޔ‬⢻ജ‫ߦޠ‬⒖േ஻⠨ࠦࠕߢ޽ࠆߚ߼

ஜᐽߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ
೥㒰

㊀ⶄߒߡ޿ࠆߚ߼

㧟㧚ක≮᡽╷߇୘‫ޔ‬㓸࿅‫ߦ❱⚵ޔ‬㧝㧚ක≮᡽╷߇୘‫ޔ‬㓸࿅‫ߦ❱⚵ޔ‬ᢥ⸒ୃᱜ߽ߚࠄߔᩰᏅ߿ਇᐔ╬ࠍᛠីߒ‫ޔ‬߽ߚࠄߔᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍߘߩᤚᱜߦะߌߡ⾗Ḯ࡮೙ᐲࠍᵴ

⠨᩺ߔࠆ㧞㧚౏ⴐߩஜᐽ࡮ஜᐽჇㅴ߿⋴⼔ߩኾ㐷ᕈߩะ਄ߦะߌߡ‫ޔ‬᡽╷ࠍ
ឭ᩺ߔࠆ

↪ߔࠆ
㧠㧚⋴⼔ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ㧞㧚⋴⼔ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯߇᡽╷ߦ෻ᤋߐࠇࠆࠃ߁ਥᒛߔ

୯߇᡽╷ߦ෻ᤋߐࠇࠆࠃ߁ᣇ╷ࠍࠆ⠨߃ࠆ㧡㧚⸻≮ႎ㈽㧔ක≮⚻ᷣ㧕߇⋴⼔㧟㧚⸻≮ႎ㈽߿੺⼔଻㒾ߥߤߩ᡽ࠤࠕឭଏᣇᴺ߿ࠕ࠙࠻ࠞࡓߦ෸߷

╷࡮೙ᐲ߇ࠤࠕឭଏᣇᴺ߿ࠕ࠙࠻ߔᓇ㗀ߦߟ޿ߡಽᨆߒ‫ޔ‬ᡷༀ᩺ࠍࠞࡓߦ෸߷ߔᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀឭ᩺ߔࠆ᩺ࠍឭ᩺ߔࠆ
㧠㧚ੱ‫ߩޘ‬ஜᐽჇㅴߣ޿߁ⷞὐ߆

ᢥ⸒ୃᱜ

ᢥ⸒ୃᱜ

ᣥΩ-4 ࠃࠅ⒖േࠄ‫ߩ⼔⋴ޔ‬᡽╷ࠍឭ᩺ߔࠆ

㧔㧥㧕‫ޟ‬Ϋ㧚ᄙ㕙⊛ߦᄙ᭽ߥ┙႐߆ࠄಽᨆߒ‫୶ޔ‬ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ㐷⡯ߣߒߡ
ߩ⽿ോࠍᨐߚߔ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈ‫ߩߎޟ‬⢻ജߪ߿ߪࠅ‫ޔ‬ቇㇱ࡟ࡌ࡞ߢߪߥߊୃ჻࡟ࡌ࡞ߢ᳞߼ࠄࠇࠆ⢻ജߛߣᕁ߁‫޿ߣޠ‬߁ࠃ߁ߦ‫ୃޔ‬჻࡟ࡌ࡞ߣߒߡᅷᒰߢ޽ࠆߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬ߒ߆ߒ‫ޟޔ‬ኾ㐷⡯ߣ޿߁⴫⃻߇ታ〣⠪ߛߌߩࠃ߁ߦᕁ߃ࠆ‫ޔ߿ޠ‬‫୶ޟ‬ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍ߽ߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ‫ୃޔ߫ࠇ޽ߢޠ‬ᓧߔߴ߈⢻ജߩౝኈߣ৻⥌ߔࠆߣ޿߁ᗧ⷗ߩࠃ߁ߦ‫ߦ⃻⴫ޔ‬ኻߔࠆᗧ⷗߇಴ߚ‫ޕ‬ԙ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈa.‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬㊀ⶄ‫ޟ‬3.ᖚ⠪߿ኅᣖߩᠩ⼔ߩ┙႐߆ࠄ‫ޔ‬቟ోߥࠤࠕⅣႺࠍଦㅴߒ‫୶ޔ‬ℂ⊛ታ〣ࠍ᥉෸ߔࠆ‫ޠ‬‫ޟ‬4.
୶ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆᖚ⠪߿ኾ㐷⡯ࠍഥߌࠆߚ߼ߦ‫⑼ޔ‬ቇ߿୶ℂේೣࠍᵴ↪ߔࠆ‫߇ޠ‬－ 22 －

㊀ⶄߒߡ޿ࠆߣ޿߁ᗧ⷗߇಴ߚ‫ޔߚ߹ޕ‬‫ޟ‬⢻ജߩౝኈ‫ޔߪߡߒߣޠ‬‫ޟ‬1㧚࿾ၞߩᯏ㑐㧛ኾ㐷⡯ߣද௛ߒߡ‫␠ޔ‬ળ⊛ᒙ⠪ߦኻߔࠆ୶ℂ⊛⺖㗴ߦะߌߡขࠅ⚵߻‫ޟޠ‬2㧚୘ੱ߿㓸࿅ߩᜬߟᢥ
ൻ߅ࠃ߮୶ℂ⊛஥㕙ࠍℂ⸃ߒߚ਄ߢ‫ࠍࠕࠤޔ‬ታ〣ߔࠆ‫ޠ‬‫ޟ‬3㧚ᖚ⠪߿ኅᣖߩᠩ⼔ߩ┙႐߆ࠄ‫ޔ‬቟ోߥࠤࠕⅣႺࠍଦㅴߒ‫୶ޔ‬ℂ⊛ታ〣ࠍ᥉෸ߔࠆ‫ߣ޿ࠃߢޠ‬ᕁ߁ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬ℂ↱ߣߒߡߪ‫ޟޔ‬4㧚୶ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆᖚ⠪߿ኾ㐷⡯ࠍഥߌࠆߚ߼ߦ‫⑼ޔ‬ቇ߿୶ℂේೣࠍᵴ↪ߔࠆ‫ߪޠ‬૗ࠍ૶߁߆ߢ޽ࠅ‫ޟޔ‬5㧚ኾ㐷⡯⠪ߣߒߡ‫ޔ‬ක≮ឭଏߩ⾰ߩᡷༀߦኻߒ‫⺑ޔ‬᣿⽿છࠍᨐߚߔ‫⺑ߩ߳ࠕࠤߪޠ‬᣿⽿છߢ޽ࠅ‫ޟޔ‬6㧚ࠤࠕᛛⴚ߅ࠃ߮ᖱႎᛛⴚߩ૶↪ߦ㑐ߔࠆ୶ℂ⊛ේℂ߿ၮḰࠍℂ⸃ߔࠆ‫ߪޠ‬ᣇᴺ⺰ࠍ␜ߒߡ޿ࠆߣ޿߁ᗧ⷗ߢ޽ߞߚ‫ޕ‬b.‫ޟ‬⢻ജߩౝኈ‫⃻⴫ߩޠ‬㨬ᖚ⠪㨭ߣ޿߁⸒⪲ࠍ‫ߩ⼔⋴ޟ‬ኻ⽎‫ߚߒ৻⛔ߦޠ‬ᣇ߇ࠃ޿ߣ޿߁ᗧ⷗߇޽ߞߚ‫ޕ‬Ԛ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜ᩺‫୶ޟ‬ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍ߽ߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ‫ୃޔ߫ࠇ޽ߢޠ‬ᓧߔߴ߈⢻ജߩౝኈߣ৻⥌ߔࠆߣ޿߁ᗧ⷗ߦၮߠ߈‫୶ޟޔ‬ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ‫ୃߣޠ‬ᱜߒߚ‫ޟߩߎޔߚ߹ޕ‬⢻ജ‫ୃޟߡ޿ߟߦࠈߎߣߔ␜߇ޠ‬჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኻ⽎ࠍᠩ⼔ߔࠆߚ߼ߦ୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍ㜞߼ࠆߣߣ߽ߦ‫ࠕࠤޔ‬ᛛⴚ߿ᖱႎᛛⴚ
ߩ૶↪ߦ㑐ߔࠆ୶ℂේೣ߿ၮḰࠍℂ⸃ߒߚ߁߃ߢታ〣ࠍⴕ޿‫ޔ‬ኾ㐷⡯ߣߒߡߩ୶ℂ⊛⽿ോࠍᨐߚߔߎߣ߇᳞߼ࠄࠇࠆ‫⺑߁޿ߣޠޕ‬᣿ᢥࠍട߃ߚ‫ޕ‬‫ޟ‬⢻ജߩౝኈ‫ߩߘޔߪߡ޿ߟߦޠ‬⢻ജࠍ㆐ᚑߔࠆߚ߼ߩౕ૕⊛ߥ⢻ജ߇฽߹ࠇߡ޿ࠆߣ޿
߁ᗧ⷗ࠍฃߌ‫ޔ‬‫ޟ‬⢻ജߩౝኈ‫⛔ࠍޠ‬วߒߚࠅ‫ޔ‬‫ޟ‬⢻ജ‫⺑ߩޠ‬᣿ᢥߦട߃ߚࠅߒߡ 6 㗄⋡߆ࠄ 3
㗄⋡ߦᢛℂߒߚ‫ޔߚ߹ޕ‬ᢥ⸒ࠍୃᱜߒߚ㧔⴫ 9㧕‫ޕ‬
⴫ 9.‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜߦ㑐ߔࠆኻᾖ⴫㧔ᣥ㧕⢻ജ㧔ୃᱜ㧕⢻ജ

ᄙ㕙⊛ߦᄙ᭽ߥ┙႐߆ࠄಽᨆߒ‫୶ ޔ‬ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ
୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ

஻⠨
ᢥ⸒ୃᱜ

㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ

㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ

㧔ᣥ㧕ୃᓧߔߴ߈⢻ജߩౝኈ㧔ୃᱜ㧕ୃᓧߔߴ߈⢻ജߩౝኈ஻⠨೥㒰

4 ߣ⛔วߒߚߚ߼

㧞㧚୘ੱ߿㓸࿅ߩᜬߟᢥൻ߅ࠃ߮

㧝㧚୘ੱ࡮ኅᣖ࡮㓸࿅ߩᜬߟᢥൻ

ᢥ⸒ୃᱜ

୶ℂ⊛஥㕙ࠍℂ⸃ߒߚ਄ߢ‫ࠕࠤޔ‬߿⢛᥊ࠍᛠីߒ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆ㧝㧚࿾ၞߩᯏ㑐㧛ኾ㐷⡯ߣද௛ߒߡ‫␠ޔ‬ળ⊛ᒙ⠪ߦኻߔࠆ୶ℂ⊛⺖㗴ߦะߌߡขࠅ⚵߻ࠍታ〣ߔࠆ㧟㧚ᖚ⠪߿ኅᣖߩᠩ⼔ߩ┙႐߆㧞㧚ኻ⽎ߩᠩ⼔ߩ┙႐߆ࠄ‫ޔ‬቟ో

－ 23 －

ᢥ⸒ୃᱜࠄ‫ޔ‬቟ోߥࠤࠕⅣႺࠍଦㅴߒ‫ࠕࠤߥ ୶ޔ‬ⅣႺࠍଦㅴߒ‫୶ޔ‬ℂ⊛ታ〣ℂ⊛ታ〣ࠍ᥉෸ߔࠆ

ࠍ᥉෸ߔࠆ

㧠㧚୶ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆᖚ

㧟㧚୶ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆኻ

⠪߿ኾ㐷⡯ࠍഥߌࠆߚ߼ߦ‫⑼ޔ‬ቇ⽎߿ኾ㐷⡯ࠍᡰេߔࠆߚ߼ߦ‫୶ޔ‬

߿୶ℂේೣࠍᵴ↪ߔࠆ

ℂߦ㑐ߔࠆℂ⺰ࠍᵴ↪ߔࠆᢥ⸒ୃᱜ㧡㧚ኾ㐷⡯⠪ߣߒߡ‫ޔ‬ක≮ឭଏߩ ೥㒰‫ޟ‬⢻ജ‫⺑ߩޠ‬᣿ᢥߦ⾰ߩᡷༀߦኻߒ‫⺑ޔ‬᣿⽿છࠍᨐߚ

౉ࠇߚߚ߼

ߔ
㧢㧚ࠤࠕᛛⴚ߅ࠃ߮ᖱႎᛛⴚߩ૶

4 ߣ⛔วߒߚߚ߼

೥㒰↪ߦ㑐ߔࠆ୶ℂ⊛ේℂ߿ၮḰࠍℂ⸃ߔࠆ ‫ޟ‬ά㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈ ߎߩ‫ޟ‬⢻ജ‫ޔߪޠ‬‫ୃޟ‬჻ߩቇ↢ߦߣߞߡ‫ᧄޔ‬ᒰߦ㊀ⷐߥߣߎࠈߢ޽ࠆ‫ޠ‬‫ޟ‬ᘒᐲߣ߆‫ޔ‬ᆫ൓ߣ޿߁߽ߩߢ޽ࠅ‫ޔ‬⢻ജߩᦨೋߣߒߡ⢻ജΣߦߔࠆᣇ߇ࠃ޿‫߁޿ߣޠ‬ᗧ⷗߇಴ߚ‫ޕ‬ߒ߆ߒ‫ޔ‬‫⼔⋴ޟ‬ቇߩ⊒ዷߩਛߢ⥄ಽ߇ߤ߁޿߁ᓎഀࠍᨐߚߒߡ޿ߊߩ߆⷗ㅢߔߎߣ߇ߢ߈
ࠆߣ޿߁ߎߣࠍ⴫⃻ߔࠆ‫⼔⋴ޔ߆ࠖ࠹ࠖ࠹ࡦ࠺ࠗࠕߩ⼔⋴ޟޠ‬ቇߩ⊒ዷߦነਈߢ߈ࠆࠕࠗ࠺
ࡦ࠹ࠖ࠹ࠖ߆߇ౝኈ߆ࠄߪಽ߆ࠅߦߊ޿‫ୃߩ⃻⴫ޔߦ߁ࠃ߁޿ߣޠ‬ᱜߦኻߔࠆᗧ⷗߇಴ߚ‫ޕ‬߹ߚ‫ޔ‬ቇ჻ߣ⇣ߥࠆࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖߩᷓߐࠍ⴫⃻ߒߡ᰼ߒ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬‫⼔⋴ޟ‬ቇߩ⊒ዷߦነਈߢ߈ࠆ⡯ᬺ⊛ࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ‫ୃ߁޿ߣޠ‬ᱜ᩺߇಴ߚ‫ޕ‬ԙ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈa.‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬㊀ⶄ‫ޟ‬2. ⋴⼔ቇࠍขࠅᏎߊ⺖㗴ߦߟ޿ߡߩᗵฃᕈࠍ⎇߉Ẵ߹ߒ‫ޔ‬ਥ૕ᕈࠍᜬߞߡᡷༀߔࠆ‫ޠ‬ߪ‫ޟޔ‬1㧚⋴⼔߿ක≮ߦ㑐ߔࠆ୘ੱߩືቇࠍ⊒ዷߐߖ‫⼔⋴ޔ‬ታ〣ߦ⛔วߔࠆ‫ߦޠ‬฽߹ࠇࠆߣ
޿߁ᗧ⷗߇಴ߚ‫ޕ‬‫ޟ‬3. ⥄ಽ⥄りߣห௥ߩ↢ᶦቇ⠌ࠍଦㅴߔࠆߚ߼‫߮ࠃ߅ޔ‬ታ〣ߦኾ㐷⊛⋴⼔ၮḰߣ⽿છࠍ⚵ߺㄟ߻ߚ߼ߩᣇ╷ࠍ⸳⸘ߔࠆ‫ޠ‬‫ޟ‬4. ࠃࠅ⦟޿ࠤࠕࠍ᳿ቯߔࠆߚ߼↢ᶦቇ⠌ߩࡠ࡯࡞ࡕ࠺࡞ߦߥࠆ‫߁޿ߣࠆ߈ߢ߇ߣߎࠆ߼ߣ߹ߦ✜৻ߪޠ‬ᗧ⷗߽಴ߚ‫ޕ‬b.‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ߩޠ‬ᢛวᕈ‫ޟ‬5㧚ઁ⡯⒳ߦኻߒߡኾ㐷⡯ߢ޽ࠆ⋴⼔⡯ߩ߽ߩߩ⷗ᣇࠍ᣿⏕ߦ⴫⃻ߔࠆ‫ߩ⼔⋴ߪޠ‬ኾ㐷ᕈߦ޽ߚࠆ߽ߩߥߩߢ‫ޔ‬άߩ‫ޟ‬⢻ജ‫ߣޠ‬㆑߁ߩߢߪߥ޿߆ߣ޿߁ᗧ⷗߿‫ޟޔ‬2.⋴⼔ቇࠍขࠅᏎߊ⺖㗴ߦߟ޿ߡߩᗵฃᕈࠍ⎇߉Ẵ߹ߒ‫ޔ‬ਥ૕ᕈࠍᜬߞߡᡷༀߔࠆ‫ޔߪޠ‬⢻ജΥ‫ޔ‬Φ‫ޔ‬Χߩ޿ߕࠇ߆ߦ฽߹ࠇࠆߩߢߪߥ޿߆ߣ޿߁ᗧ⷗߽಴‫ߩઁޔ‬⢻ജߣߩᢛวᕈߦኻߔࠆᗧ⷗߇
಴ߚ‫ޕ‬
߹ߚ‫ޔ‬
‫ޟ‬1㧚⋴⼔߿ක≮ߦ㑐ߔࠆ୘ੱߩືቇࠍ⊒ዷߐߖ‫⼔⋴ޔ‬ታ〣ߦ⛔วߔࠆ‫ޠ‬‫ޟ‬2. ⋴⼔ቇࠍขࠅᏎߊ⺖㗴ߦߟ޿ߡߩᗵฃᕈࠍ⎇߉Ẵ߹ߒ‫ޔ‬ਥ૕ᕈࠍᜬߞߡᡷༀߔࠆ‫ޠ‬‫ޟ‬3. ⥄ಽ⥄りߣ－ 24 －

ห௥ߩ↢ᶦቇ⠌ࠍଦㅴߔࠆߚ߼‫߮ࠃ߅ޔ‬ታ〣ߦኾ㐷⊛⋴⼔ၮḰߣ⽿છࠍ⚵ߺㄟ߻ߚ߼ߩᣇ
╷ࠍ⸳⸘ߔࠆ‫ޠ‬‫ޟ‬4. ࠃࠅ⦟޿ࠤࠕࠍ᳿ቯߔࠆߚ߼↢ᶦቇ⠌ߩࡠ࡯࡞ࡕ࠺࡞ߦߥࠆ‫࠺ࠗࠕߪޠ‬ࡦ࠹ࠖ࠹ࠖߦ㑐ㅪߔࠆߩ߆ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬Ԛ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜ᩺ ‫ޟ‬⢻ജ‫ޟޔߡ޿ߟߦޠ‬⡯ᬺ⊛ࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖߩᒻᚑ‫߁޿ߣ߆޿ߥߪߢޠ‬ᗧ⷗߽಴ߚ߇‫ޔ‬⋴⼔ቇࠍቇ߱⠪ߣߒߡߩࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖߢ޽ࠆߎߣࠍ⏕⹺ߒ‫ޔ‬⢻ജߦߟ޿ߡߪୃᱜࠍߒ
ߥ߆ߞߚ‫߇ߣߎߔ␜߇ࠖ࠹ࠖ࠹ࡦ࠺ࠗࠕޔߚ߹ޕ‬વࠊࠆࠃ߁ߦ‫ୃޟ‬჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኾ㐷⡯ߣߒߡߩືቇࠍ⊒ዷߐߖ‫ࠍⷰ⼔⋴ޔ‬᣿⏕ߦ⴫⃻ߒ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬ߐࠄߦ‫↢ޔ‬ᶦࠍㅢߓߡቇ⠌ߒߡ޿ߊᆫ൓ࠍ߽ߜ‫ᦨޔ‬ᣂߩ⍮⷗ࠍᓧߡ⋴⼔ߦᵴ↪ߔࠆദജࠍ
⛯ߌ‫⼔⋴ߩઁޔ‬⡯ߩᓎഀࡕ࠺࡞ߣߥࠆߎߣ߽᳞߼ࠄࠇࠆ‫⺑߁޿ߣޠޕ‬᣿ᢥࠍട߃ߚ‫ޕ‬ ‫ޟ‬⢻ജߩౝኈ‫ߦ߁ࠃ޿ߔ߿ࠅ߆ࠊ߇ߩ߽ߔ␜߇ࠖ࠹ࠖ࠹ࡦ࠺ࠗࠕޔߪߡ޿ߟߦޠ‬ᢥ⸒ࠍୃᱜߒߚࠅ‫ޔ‬㊀ⶄߔࠆ߽ߩࠍ೥㒰ߒߚ㧔⴫ 10㧕‫ޕ‬⴫ 10 ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ୃߩޠ‬ᱜߦ㑐ߔࠆኻᾖ⴫㧔ᣥ㧕⢻ജ㧔ୃᱜ㧕⢻ജ

஻⠨⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆࠕࠗ

⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆࠕࠗ

࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ

࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ

㧔ୃᱜ㧕ୃᓧߔߴ߈⢻ജߩౝኈ㧔ୃᱜ㧕ୃᓧߔߴ߈⢻ജߩౝኈ㧝㧚⋴⼔߿ක≮ߦ㑐ߔࠆ୘ੱߩື

㧝㧚⋴⼔߿ක≮ߦ㑐ߔࠆኾ㐷⡯ߣቇࠍ⊒ዷߐߖ‫⼔⋴ޔ‬ታ〣ߦ⛔วߔߒߡߩືቇࠍ⊒ዷߐߖ‫⼔⋴ޔ‬ታ〣

ࠆ

ߦ⛔วߔࠆ

㧞㧚⋴⼔ቇࠍขࠅᏎߊ⺖㗴ߦߟ޿㧞㧚⋴⼔ቇࠍขࠅᏎߊ⺖㗴ߦߟ޿ߡߩᗵฃᕈࠍ⎇߉Ẵ߹ߒ‫ޔ‬ਥ૕ᕈߡߩᗵฃᕈࠍ㜞߼‫ޔ‬ਥ૕ᕈࠍᜬߞ

ࠍᜬߞߡᡷༀߔࠆ

ߡᡷༀߔࠆ㧟㧚⥄ಽ⥄りߣห௥ߩ↢ᶦቇ⠌ࠍ೥㒰㊀ⶄߒߡ޿ࠆߚ߼

㧠㧚ࠃࠅ⦟޿ࠤࠕࠍ᳿ቯߔࠆߚ߼

㧟㧚ࠃࠅ⦟޿ࠤࠕࠍ᳿ቯߔࠆߚ߼

ᢥ⸒ୃᱜ↢ᶦቇ⠌ߩࡠ࡯࡞ࡕ࠺࡞ߦߥࠆ

ߦᦨᣂߩ⍮⷗ࠍᓧߥ߇ࠄታ〣ߔ

ᄌᦝߥߒ

஻⠨
ᢥ⸒ୃᱜ

ᄌᦝߥߒ

ଦㅴߔࠆߚ߼‫߮ࠃ߅ޔ‬ታ〣ߦኾ㐷⊛⋴⼔ၮḰߣ⽿છࠍ⚵ߺㄟ߻ߚ߼ߩᣇ╷ࠍ⸳⸘ߔࠆ

ࠆࡕ࠺࡞ߦߥࠆ
㧡㧚ઁ⡯⒳ߦኻߒߡኾ㐷⡯ߢ޽ࠆ㧠㧚ኾ㐷⡯ߣߒߡ⋴⼔ⷰࠍ᣿⏕ߦ⋴⼔⡯ߩ߽ߩߩ⷗ᣇࠍ᣿⏕ߦ⴫

ߔࠆ

⃻ߔࠆ

－ 25 －

ᢥ⸒ୃᱜ ᢎ⢒ߦ㑐ߔࠆ⢻ജߦߟ޿ߡ
ᄢቇ㒮ୃੌᓟ‫⼔⋴ޔ‬ᢎ⢒⠪ߣߒߡߩᓎഀࠍᜂߞߡ޿ߊ႐ว߇޽ࠆ߇‫ޔ‬⢻ജߩⷞὐߣߒߡ
ᢎ⢒߇฽߹ࠇߡ޿ߥ߆ߞߚߎߣࠍ〯߹߃‫ߢ࡯ࡘࡆ࠲ࡦࠗࡊ࡯࡞ࠣޔ‬ᗧ⷗ࠍ⡞޿ߚ‫ޕ‬‫ޟ‬ᢎ⢒⊛
ߥ㑐ࠊࠅ‫ޔ‬ᢎ⢒⊛ߥⷞὐࠍ␜ߔ⢻ജ߇޽ߞߡ߽ࠃ޿‫ޟޠ‬ᢎ⢒⊛ⷞὐߢᜰዉജࠍ஻߃ߚੱߩ⢒ᚑࠍ฽߼ߡ߶ߒ޿‫ޠ‬‫߇࡞ࠠࠬ߁޿߁ߤޟ‬ᔅⷐ߆ߣ޿߁ࠃ߁ߥߎߣࠍี๧ߢ߈ࠆ⢻ജߣ߆‫ᦨޔ‬ૐ㒢ᔅⷐߥၮ␆⊛ߥᚻ⣨ࠍᜬߞߡ޿ࠆߣ߆ᄢ੐‫߁޿ߣޠ‬ᗧ⷗߇಴ߚ‫ޔߢߎߘޕ‬⢻ജ‫ޟ‬Ϊ㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆᢎ⢒ⅣႺߠߊࠅߦขࠅ⚵߻‫ߡߒߣޠ‬ᣂߒߊㅊടߒߚ‫ޕ‬ ߎߩ‫ޟ‬⢻ജ‫ୃޟޔߪࠈߎߣߔ␜߇ޠ‬჻⺖⒟ୃੌ↢ߪ‫⼔⋴ޔ‬ኾ㐷⡯ࠍ⢒ߡࠆߚ߼ߩᢎ⢒⊛ᕁ⠨ࠍ߽ߟߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬‫ޟޕߚߒߣޠ‬⢻ജߩౝኈ‫ޟޔߪߡߒߣޠ‬㧝㧚ቇ⠌⠪ߩ࠾࡯࠭ࠍᛠ
ីߒ‫ޔ‬ቇ⠌⠪ߦ޽ࠊߖߚᢎ⢒ᴺࠍℂ⸃ߔࠆ‫ޟޠ‬㧞㧚⋴⼔ቇߩ⸘↹⊛࡮ലᨐ⊛ߥᢎ⢒ᣇᴺࠍឭ
᩺ߔࠆ‫ޕߚߒߣޠ‬㧞㧕ߘߩઁߩᗧ⷗
㧔㧝㧕㜞ᐲታ〣ኅࠦ࡯ࠬ㧔CNS ࠦ࡯ࠬ㧕‫⺰ޔ‬ᢥࠦ࡯ࠬ㧔⎇ⓥ⠪ࠦ࡯ࠬ㧕౒ㅢߩ⢻ജߣߒߡᝒ
߃ࠆߎߣߦߟ޿ߡ
‫ୃޟ‬჻⺖⒟ߢ‫ޔ‬㜞ᐲታ〣⠪ࠍ⢒ߡࠆߩߣ‫ޔ‬ᢎ⢒⠪ࠍ⢒ߡࠆߩߪ㆑߁ߣᕁ߁‫ߩࠄࠇߎޟޠ‬⢻ജ߇‫ޔ‬ኾ㐷⋴⼔Ꮷࠦ࡯ࠬߛߌߢߥߊୃ჻ߩ⺰ᢥࠦ࡯ࠬ㧔⎇ⓥ⠪ࠦ࡯ࠬ㧕ߦ߽౒ㅢߔࠆ߽ߩ
ߣߔࠆߣ‫ࠍࠢ࡯ࡢࠬ࡯ࠦޔ‬⠨߃ߦߊߊߥࠆ‫ޟޠ‬㜞ᐲታ〣ኅࠦ࡯ࠬߣ⺰ᢥࠦ࡯ࠬߢߪ‫ޔ‬᳞߼ࠆ߽ߩߦᏅࠍߟߌߡ޿ࠆߩߦ‫ޔ‬᳞߼ࠆ⢻ജ߇หߓ‫߁޿ߣޔ‬ὐߦߪ⇼໧߇޽ࠆ‫ޔߦ߁ࠃ߁޿ߣޠ‬ኾ㐷⋴⼔Ꮷࠦ࡯ࠬߣ⎇ⓥ⠪ࠦ࡯ࠬߢߪ‫ޔ‬᳞߼ࠆ⢻ജߪ⇣ߥࠆߣ޿߁ᗧ⷗ߣ‫ࠢ࡯ࡢࠬ࡯ࠦޔ‬ࠍߤߩࠃ߁ߦ⚵ߺ┙ߡߡ޿ߞߚࠄࠃ޿ߩ߆㔍ߒ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬߹ߚ‫ߩࠬ࡯ࠦ⺰ୃޟޔ‬ቇ↢ߦ߽‫ⶄ“ޔ‬㔀ߥ⥃ᐥ⃻႐ߩ⁁ᴫࠍಽᨆߢ߈ࠆ”ߣ޿߁ߣߎࠈ߹ߢ
ߪ᳞߼ߚ޿߇‫“ޔ‬ථ⿧ߒߚᛛࠍ↪޿ߡ੺౉ߔࠆ”ߣ޿߁ߣߎࠈ߹ߢߪ᳞߼߈ࠇߥ޿‫ޠ‬‫ߢࠕࠦޟ‬
ߪᐢ޿ᗧ๧ߢߩታ〣ࠍ⠨߃ࠆᔅⷐ߇޽ࠆ‫ޟޠ‬ቇ↢ߩࠦ࡯ࠬߦࠃߞߡ 10 ߩ⢻ജߩ㊀ߺߠߌ߇޽ࠆߣࠃ޿‫ߩࠕࠦޔߦ߁ࠃ߁޿ߣޠ‬⢻ജߣߒߡߪᔅⷐߢ޽ࠆߣ⠨߃ࠆ߇‫ޔ‬หߓ࡟ࡌ࡞߹ߢ
ߪ᳞߼ࠆߎߣ߇㔍ߒ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬㧔㧞㧕‫ޟ‬⢻ജ‫⴫౏ߩޠ‬ᣇᴺߦߟ޿ߡ ౏⴫ᣇᴺߦߟ޿ߡ‫ޔ‬‫ޟ‬ᄢ㗄⋡ 10 ߪߔߏߊᄢ੐ߛߣᕁ߁߇‫߹߹ߩߘޔ‬಴ߔߣ‫⥃ޔ‬ᐥ⹏ଔߩ࠴ࠚ࠶ࠢ࡝ࠬ࠻ߩ᭽ߦᕁࠊࠇߡߒ߹߁‫ߡߒߣߩ߽ߥ޿ߚߺ”⺑⸃“ޕ‬಴ߒߚᣇ߇‫ޔ‬㧔ᢎ⢒㧕⃻႐߽⚛⋥ߦฃߌ౉ࠇࠄࠇࠆߣᕁ߁‫ߩࠄࠇߎޟޠ‬⢻ജߪ⹏ଔߦ߽ߥࠆߚ߼‫ߦ⴫౏ޔ‬㓙ߒߡߪᘕ㊀ߦߒߡ޿ߚߛ߈ߚ޿‫ޔߦ߁ࠃ߁޿ߣޠ‬⢻ജࠍ␜ߔߎߣ߇⹏ଔߦ߽ߟߥ߇ࠆߚ߼ߦᘕ㊀ߦߒߡ᰼ߒ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ᦠ⺑⸃ޟޔߚ߹ޕ‬㧔ᄢ㗄⋡ߩᗧ࿑ߔࠆߣߎࠈࠍ⸃⺑ߒߚ߽ߩ㧕ࠍߟߊࠆߣหᤨߦ‫ޔ‬ᣣᧄߩ⋴⼔ߩᢎ⢒࡮⎇ⓥ⠪ࠍߤߩࠃ߁ߦ⢒ߡߡⴕߊߩ߆‫ߣߎ߁޿ߣޔ‬߽৻✜ߦ૞ࠆᔅⷐ߇޽ࠆߣᕁ߁‫⃻ޔ⾰߿࡞ࡌ࡟ߩ⼔⋴ޟޠ‬႐ࠍ㐳ᦼ⊛ⷞὐߢߤߩࠃ߁ߦᄌ߃
ߡⴕߊߩ߆‫߁޿ߣޔ‬ὐ߽⷗ߔ߃ߡ⠨߃ߥ޿ߣ‫♽⼔⋴ޔ‬ᄢቇߦ߆ߥࠅߩᓇ㗀ࠍਈ߃ߡߒ߹߁
ߣᕁ߁‫⺖ߩ੹ޔߦ߁ࠃ߁޿ߣޠ‬㗴ࠍ᣿⏕ߦߒ‫੹ޔ‬ᓟߩߎߣ߽⠨߃ߡ⊒ାߒߡ޿ߊᔅⷐ߇޽
ࠆߣ޿߁ᗧ⷗߽಴ߚ‫ޕ‬－ 26 －

‫ޟ‬ᣣᧄߢᦨೋߦ಴ߔ߽ߩߣߒߡ‫ޔ‬77 㗄⋡ߣߎࠎߥߦ⹦⚦ߦឭ␜ߐࠇߡ߽‫ޔ‬ᢎ⢒ߔࠆᣇ߇ߘߩౝኈࠍⷡ߃ࠄࠇߥ޿ߣᕁ߁‫ޟޠ‬ℂᗐ⊛ߦၮḰߣ޿߁߽ߩߪᔅⷐߛ߇‫ᦨޔ‬ૐ㒢ᔅⷐߥ߽ߩ
ߪߎߎ‫߁޿ߣޔ‬ឭ␜ߦ⇐߼ߡ߽ࠄ޿ߚ޿‫ޔߦ߁ࠃ߁޿ߣޠ‬ᢎ⢒ߦߤߎ߹ߢ෻ᤋߐߖߡ޿ߌ
ࠆ߆ߣ޿߁⃻ታᕈ߽〯߹߃ߡ᰼ߒ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬㧔㧟㧕ඳ჻ᓟᦼ⺖⒟ߦ᳞߼ࠆ‫ޟ‬⢻ജ‫ߩߣޠ‬ᢛวᕈߦߟ޿ߡ
‫ޟ‬೨ᦼ⺖⒟ߢ᳞߼ࠆ⢻ജߪ‫ޔ‬ᓟᦼ⺖⒟ߩ⢻ജߣߒߡߤߎ߹ߢᜬߞߡ޿ߊߩ߆ߦࠃߞߡ߽
᳿߹ࠆߩߢ‫ޔ‬㧞ߟߩᢛวᕈࠍᜬߟߚ߼ߦ߽‫ޔ‬ਔᣇࠍ૞ߞߡ߆ࠄ⸛⼏ߔߴ߈‫ߩߎޟޠ‬ၮḰࠍ╷ቯߔࠆߦ޽ߚࠅ‫ޔ‬೨ᦼ⺖⒟㧔ୃ჻⺖⒟㧕ߣᓟᦼ⺖⒟㧔ඳ჻⺖⒟㧕ߩ㆑޿ࠍ‫ߩߤޔ‬ᨒ⚵ߺߢ૞ߞߚߩ߆‫ࠍޔ‬᣿␜ߒߡ᰼ߒ޿‫ޔߦ߁ࠃ߁޿ߣޠ‬ඳ჻ᓟᦼ⺖⒟ߣߩ㆑޿ߦ㑐ߔࠆᨒ⚵ߺࠍᜬߞߡᬌ⸛ߒߡ᰼ߒ޿ߣ޿߁ᗧ⷗߇಴ߚ‫ޕ‬㧔㧠㧕ࠦࠕߩ‫ޟ‬⢻ജ‫ࠍޠ‬⢒ᚑߔࠆߚ߼ߩᢎ⢒ߦߟ޿ߡ ࠦࠕߩ⢻ജࠍ⢒ᚑߔࠆߚ߼ߩᢎ⢒ߦ㑐ߒߡ‫ޔ‬‫ߩࠄࠇߎޟ‬⢻ജࠍᜬߜᓧࠆੱࠍ⢒ߡࠆߚ߼ߩ
ᢎ⢒ࠍ‫ߡߞ߿߁ߤޔ‬૞ߞߡⴕߊߩ߆‫ߦ߁ࠃߩߤޔ‬⠨߃ߡ޿ߌ߫޿޿߆‫ߩߣߎ߁޿ߣޔ‬ឭ␜߽ᔅⷐߣߥߞߡߊࠆߩߢߪߥ޿߆‫ޠ‬‫ޟ‬10 ߩ⢻ജߩୃᓧࠍߤߩࠃ߁ߦ଻㓚ߔࠆ߆‫ޠ‬‫ޟ‬10 ߩ⢻ജࠍ‫ᧄޔ‬ᒰߦ↢߈ߚౝኈߦߔࠆߚ߼ߩᚢ⇛㧔㧩ߎࠇࠄߩ⢻ജࠍᢎ⢒ߢ߈ࠆᢎ⢒⠪ࠍߤߩࠃ߁
ߦ⢒ߡߡ޿ߊ߆‫ߣߎ߁޿ߣޔ‬㧕‫ࠍࡓ࠹ࠬࠪޔ‬૞ߞߡ޿ߊᔅⷐ߇޽ࠆߣᕁ߁‫ޠ‬‫ߩࠄࠇߎޟ‬⢻ജࠍၮḰߣߒߡ‫“ޔ‬૗ߢ߽⋓ࠅㄟ߹ࠇߚᄢቇ㒮ᢎ⢒”ߦߪߥࠄߥ޿ࠃ߁ߦߒߡ޿ߚߛ߈ߚ޿‫ߣޠ‬޿߁ࠃ߁ߦ‫ߦ߁ࠃߩߤޔ‬ᢎ⢒ࠍ⠨߃ߡ޿ߌ߫ࠃ޿ߩ߆߹ߢ⠨߃ߡ᰼ߒ޿ߣ޿߁ᗧ⷗߽಴ߚ‫ޕ‬㧟㧚ୃᱜߒߚ೨ᦼ㧔ୃ჻㧕⺖⒟ୃੌ↢߇ୃᓧߔߴ߈ 10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬ ࡈࠜ࡯ࠞࠬࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯ߩ⚿ᨐߦၮߠ߈‫ୃޔ‬ᱜߒߚ 10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬40 㗄⋡ࠍએਅߦ␜ߔ‫ޕ‬I.

⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ࠍࠬࡦ࠺ࡆࠛޔ‬ᵴ↪ߔࠆୃ჻⺖⒟ୃੌ↢ߪ‫⼔⋴ޔ‬ታ〣߿ࠤࠕឭଏߩ႐ߦ߅޿ߡ‫⇼ޔ‬໧ࠍ߽ߜត᳞ߔࠆᘒᐲߢ‫ޔ‬⸃᳿ߔߴ߈⋴⼔ߩ⺖㗴ࠍ⷗಴ߔߎߣ‫ߦࠄߐޔ‬ᣢሽߩ᭽‫ࠍࠬࡦ࠺ࡆࠛߩ࡞ࡌ࡟ߥޘ‬෼㓸‫ޔ‬⛔วߒ‫⎇ࠍࠄࠇߘޔ‬ⓥ߿ታ〣ߦᵴ↪ߒ‫⺖ޔ‬㗴⸃᳿ߦ❬޿ߢ޿ߊߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬㧝㧚⋴⼔ታ〣ߢߩ໧㗴ࠍ⸃᳿ߔࠆߚ߼ߦ‫ޔ‬ᔅⷐߥࠛࡆ࠺ࡦࠬࠍត᳞ߔࠆ
㧞㧚ࠛࡆ࠺ࡦࠬ࡟ࡌ࡞ࠍᛕ್⊛ߦ⺒⸃ߒ‫⹏ޔ‬ଔߔࠆ
㧟㧚Evidence-based practice ࠍℂ⸃ߔࠆ㧠㧚ᣂߚߥ⍮⼂߿వㅴ⊛ߥᛛⴚࠍត⚝ߒ‫ޔ‬ᵴ↪ߔࠆ

II.

⋴⼔ߩኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ㧕ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆୃ჻⺖⒟ୃੌ↢ߪ‫ߦࠬࡦ࠺ࡆࠛޔ‬ၮߠ޿ߡᦨᣂߥࠄ߮ߦᦨༀߩࠤࠕࠍᄙ⡯⒳ߣද௛ߒ
ߥ߇ࠄឭଏߒ‫⥄ޔ‬り߇ⴕ߁⋴⼔ߦኻߒߡ⺑᣿ߢ߈ߥߌࠇ߫ߥࠄߥ޿‫∛ޔߦࠄߐޕ‬᳇߿∔－ 27 －

ᖚߩ⍮⼂ߦട߃‫∉ޔ‬ቇ⊛࠺࡯࠲߿␠ળ㨯ⅣႺ࠺࡯࠲߽↪޿ߥ߇ࠄ‫ޔ‬୘ੱ࡮ኅᣖߛߌߢߥߊ‫ޔ‬㓸࿅࡮࿾ၞߦ߽⋡ࠍ߻ߌߚ⋴⼔ࠍᬌ⸛ߔࠆ‫ୃޕ‬჻⺖⒟ୃੌ↢ߪ‫ޔ‬ஜᐽߣ޿߁᭎ᔨࠍ߭ࠈ
ߊᷓߊᝒ߃‫∔ޔ‬ᖚࠍᛴ߃ߚኻ⽎߳ߩ௛߈߆ߌ߆ࠄ‫ߩޘੱޔ‬ஜᐽߩ଻ᜬ࡮Ⴧㅴߦะߌߚข
ࠅ⚵ߺ߹ߢ‫ޔ‬ኻ⽎ߩ⁁ᘒߦᔕߓߚ⋴⼔ࠍᗧ࿑⊛ߦⴕ߁‫ୃߚ߹ޕ‬჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኻ⽎ߦᢎ⢒⊛ᡰេ߇ᔅⷐߥᤨߦߪ‫ޔ‬ℂ⺰߿ࠛࡆ࠺ࡦࠬߦၮߠ޿ߚ௛߈߆ߌࠍߔࠆߎߣ߇᳞߼ࠄ
ࠇࠆ‫ޕ‬㧝㧚ᦨᣂߩࠤࠕᛛⴚ߿ࠛࡆ࠺ࡦࠬߦၮߠ޿ߡ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆ㧞㧚ឭଏߐࠇߡ޿ࠆක≮ߩ୶ℂᕈࠍ್ᢿߒታ〣ߔࠆ
㧟㧚୶ℂ⊛ߦㆡᱜߥᖱႎᛛⴚߩ೑↪ࠍଦㅴߔࠆ
㧠㧚ᄙ⡯⒳ߣߣ߽ߦක≮ߩ቟ోᕈࠍ⏕⹺ߒ‫଻ޔ‬㓚ߔࠆ㧡㧚ኻ⽎ਛᔃߦ‫⼔⋴ޔ‬⡯߅ࠃ߮ᄙ⡯⒳ߣߩ⺞ᢛࠍⴕ޿‫ޔ‬ද௛ߒߡࠤࠕߔࠆ
㧢㧚⋴⼔ߦߟ޿ߡߩ⺑᣿ജࠍ߽ߜ‫ޔ‬ද௛ࠍផㅴߔࠆ
㧣㧚੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍㅢߓ‫ޔ‬ஜᐽࠍ଻ᜬჇㅴߔࠆ
㧤㧚⋴⼔ߩኻ⽎ߦኻߒߡ‫∉ޔ‬ቇ⊛ߥ⍮⼂ࠍᵴ↪ߒߡࡐࡇࡘ࡟࡯࡚ࠪࡦ࡮ࠕࡊࡠ࡯࠴ࠍታ〣
ߔࠆ

III.

⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡขࠅ⚵߻   ୃ჻⺖⒟ୃੌ↢ߪ‫ᦨޔ‬ᣂߩᖱႎࠍᵴ↪ߒߡ‫⼔⋴ޔ‬ታ〣߿ࠤࠕⅣႺࠍᡷༀߔࠆߎߣ߇
᳞߼ࠄࠇࠆ‫ޕ‬㧝㧚⾌↪ኻലᨐ‫᦭⊛❱⚵ޔ‬ലᕈߥߤߩⷰὐࠍ฽߼‫ޔ‬ኻ⽎ߦߣߞߡߩലᨐࠍ⹏ଔߔࠆ
㧞㧚ࠤࠕߩ⾰ࠍᡷༀߔࠆߚ߼ߦࠛࡆ࠺ࡦࠬࠍ↪޿ߡ⚵❱߿㓸࿅߳௛߈߆ߌࠆ
㧟㧚ᖱႎࠪࠬ࠹ࡓ‫∉ߣ⸘⛔ޔ‬ቇߩ⍮⼂ࠍ↪޿ߡ‫ߩࡓࠞ࠻࠙ࠕޔ‬ᡷༀ߿࡝ࠬࠢૐᷫߩߚ߼ߩ
ᚢ⇛ࠍ┙ߡࠆ
㧠㧚᡽╷⊛ߥⷰὐߢࠤࠕߩ⾰଻⸽߿࡝ࠬࠢࡑࡀࠫࡔࡦ࠻ࠍℂ⸃ߔࠆ

IV.

ࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ࠕࠤޔ‬ⅣႺࠍᡷༀߔࠆ   ୃ჻⺖⒟ୃੌ↢ߪ‫⺖ࠆ޿ߡߓ↢ߦ❱⚵ޔ‬㗴ࠍಽᨆߒ‫߇ࠕࠤ޿⦟ࠅࠃޔ‬ឭଏߐࠇࠆࠃ
߁ߦࠤࠕⅣႺࠍ⺞ᢛߔࠆߎߣ߿ᢎ⢒⊛ߦ௛߈߆ߌࠆߎߣ߇᳞߼ࠄࠇࠆ‫ࠕࠤޕ‬ⅣႺࠍᡷ
ༀߔࠆߦߪ቟ోߢ᦭ലߥࠤࠕᛛⴚ߿ᖱႎᛛⴚߩ೑↪ߦߟ޿ߡ‫ޔ‬ኾ㐷⡯ߦኻߒᢎ⢒⊛ߦ௛߈߆ߌࠆߎߣ߽฽߹ࠇࠆ‫ޕ‬㧝㧚୘ߣ⚵❱ߩਔ஥㕙߆ࠄ‫ࠆ߃ᝒߡߒߣࡓ࠹ࠬࠪࠍ⼔⋴ޔ‬㧞㧚ࠤࠕⅣႺߣߒߡߩ⚵❱ࠍಽᨆߒ‫⺖ޔ‬㗴⸃᳿ߩߚ߼ߩᣇ⇛ࠍឭ᩺ߔࠆ
㧟㧚ኻ⽎ਛᔃߩࠤࠕࠍታ〣ߔࠆߦᒰߚࠅ‫ޔ‬ᔅⷐߣߥࠆᄙ⡯⒳߿⾗ḮࠍᏎ߈ㄟߺߥ߇ࠄࠤࠕ
ⅣႺࠍᡷༀߔࠆ
㧠㧚⚵❱ߩ⺖㗴ߦߟ޿ߡᢎ⢒⊛ߦ௛߈߆ߌࠆ

－ 28 －

V.

ࠤࠕࠍផㅴߢ߈ࠆ႐߿ੱ⊛ⅣႺࠍᢛ߃ࠆߚ߼ߦ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆ  ୃ჻⺖⒟ୃੌ↢ߪ‫ߩࠕࠤޔ‬ᡷༀߦะߌߡ‫ޔ‬㓸࿅߿⚵❱ߦ௛߈߆ߌ‫ޔ‬ᄌൻࠍ⿠ߎߔᓎ
ഀࠍᜂ߁ߎߣ߇᳞߼ࠄࠇࠆ‫ޔߦ߼ߚߩߘޕ‬ᔅⷐߥ⍮⼂࡮ᛛⴚࠍᵴ↪ߒ‫࡞ࠞࠖ࠹࡝ࠢޔ‬ࠪࡦࠠࡦࠣ߿࡝ࡈ࡟࡚ࠢࠪࡦࠍขࠅ౉ࠇߡ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆߎߣ߇᳞߼ࠄ
ࠇࠆ‫ޕ‬㧝㧚ᣂߒ޿⍮⼂߿ࡕ࠺࡞ࠍታ〣ߦዉ౉ߔࠆߚ߼ߩᚻᴺࠍℂ⸃ߒ‫ߩߘޔ‬ታ⃻ߦะߌߡ࡝࡯࠳
࡯ࠪ࠶ࡊࠍ⊒ើߔࠆ㧞㧚㓸࿅߿⚵❱ߩ႐ߩ࠳ࠗ࠽ࡒ࠭ࡓࠍಽᨆߒ‫ޔ‬㓸࿅߿⚵❱ࠍേ߆ߔ㧟㧚ᦨༀߩක≮ࠨ࡯ࡆࠬࠍឭଏߔࠆߚ߼ߦࠤࠕߩᡷༀࠍਥዉߔࠆ

VI.

ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ   ୃ჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኾ㐷⡯㑆ߩലᨐ⊛ߥㅪ៤㑐ଥࠍଦߔߚ߼ߦ‫⋧ޔ‬੕ߦቇ⠌ߔࠆⅣႺ
ࠍ⺞ᢛߒߚࠅ‫⼔⋴ޔ‬⡯߿ᄙ⡯⒳߆ࠄߩ⋧⺣ߦᔕߓߚࠅߒߡ‫ޔ‬ᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫ޕ‬ߘߩ㓙ߦߪ‫ઁࠍ⼔⋴ޔ‬⡯⒳ߦ⺑᣿ߔࠆ⢻ജ߇᳞߼ࠄࠇࠆ‫ޕ‬㧝㧚ኾ㐷⡯㑆ߩലᨐ⊛ߥㅪ៤㑐ଥࠍ▽ߊߚ߼ߦ‫ޔ‬੕޿ࠍዅ㊀ߒߚࠦࡒࡘ࠾ࠤ࡯࡚ࠪࡦࠍߣࠆ
㧞㧚⋴⼔Ꮷ߿ઁ⡯⒳ߦኻߒߡ⋴⼔ߩᗧ࿑߿ᔅⷐᕈࠍ⺑᣿ߒ‫ޔ‬ද௛ߔࠆ㧟㧚ኻ⽎ߩ⺖㗴ࠍนⷞൻߒ‫ઁޔ‬⡯⒳ߣද௛ߒߡ⸃᳿ߦዉߊ
㧠㧚ࠦ࡯࠺ࠖࡀ࡯࠲࡯ߩᓎഀࠍᜂ޿‫ޔ‬ද௛ߩ౞Ṗൻࠍផㅴߔࠆ

VII. ⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ
ୃ჻⺖⒟ୃੌ↢ߪ‫ߩⴕ⃻ޔ‬ᴺᓞ㨯೙ᐲ࡮᡽╷߇ੱ‫ߩޘ‬ஜᐽ߿⋴⼔ߦߤߩࠃ߁ߥᓇ㗀ࠍ߽ߚࠄߒߡ޿ࠆ߆ࠍಽᨆߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫ߩߘޕ‬ಽᨆ⚿ᨐߦၮߠ߈‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ߇‫ߩߘޔ‬㓙ߦ⋴⼔ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯ⷰࠍ෻ᤋߒߚᣇ╷ࠍ⠨߃ࠆߎߣ߽
᳞߼ࠄࠇࠆ‫ޕ‬㧝㧚ක≮᡽╷߇୘‫ޔ‬㓸࿅‫ߔࠄߚ߽ߦ❱⚵ޔ‬ᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍ⠨᩺ߔࠆ㧞㧚⋴⼔ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯߇᡽╷ߦ෻ᤋߐࠇࠆࠃ߁ᣇ╷ࠍ⠨߃ࠆ㧟㧚⸻≮ႎ㈽߿੺⼔଻㒾ߥߤߩ᡽╷࡮೙ᐲ߇ࠤࠕឭଏᣇᴺ߿ࠕ࠙࠻ࠞࡓߦ෸߷ߔᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ᩺ࠍឭ᩺ߔࠆ
㧠㧚ੱ‫ߩޘ‬ஜᐽჇㅴߣ޿߁ⷞὐ߆ࠄ‫ߩ⼔⋴ޔ‬᡽╷ࠍឭ᩺ߔࠆ

VIII. ⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆᢎ⢒ⅣႺߠߊࠅߦขࠅ⚵߻ୃ჻⺖⒟ୃੌ↢ߪ‫⼔⋴ޔ‬ኾ㐷⡯ࠍ⢒ߡࠆߚ߼ߩᢎ⢒⊛ᕁ⠨ࠍ߽ߟߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬㧝㧚ቇ⠌⠪ߩ࠾࡯࠭ࠍᛠីߒ‫ޔ‬ቇ⠌⠪ߦ޽ࠊߖߚᢎ⢒ᴺࠍℂ⸃ߔࠆ㧞㧚⋴⼔ቇߩ⸘↹⊛࡮ലᨐ⊛ߥᢎ⢒ᣇᴺࠍឭ᩺ߔࠆ

－ 29 －

IX.

୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ
ୃ჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኻ⽎ࠍᠩ⼔ߔࠆߚ߼ߦ୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍ㜞߼ࠆߣߣ߽ߦ‫ޔ‬ࠤࠕᛛⴚ߿ᖱႎᛛⴚߩ૶↪ߦ㑐ߔࠆ୶ℂේೣ߿ၮḰࠍℂ⸃ߒߚ߁߃ߢታ〣ࠍⴕ޿‫ޔ‬ኾ㐷⡯ߣߒߡߩ୶ℂ⊛⽿ോࠍᨐߚߔߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬㧝㧚୘ੱ࡮ኅᣖ࡮㓸࿅ߩᜬߟᢥൻ߿⢛᥊ࠍᛠីߒ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆ㧞㧚ኻ⽎ߩᠩ⼔ߩ┙႐߆ࠄ‫ޔ‬቟ోߥࠤࠕⅣႺࠍଦㅴߒ‫୶ޔ‬ℂ⊛ታ〣ࠍ᥉෸ߔࠆ
㧟㧚୶ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆኻ⽎߿ኾ㐷⡯ࠍᡰេߔࠆߚ߼ߦ‫୶ޔ‬ℂߦ㑐ߔࠆℂ⺰ࠍᵴ↪
ߔࠆX.

⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ
ୃ჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኾ㐷⡯ߣߒߡߩືቇࠍ⊒ዷߐߖ‫ࠍⷰ⼔⋴ޔ‬᣿⏕ߦ⴫⃻ߒ‫⋴ޔ‬⼔ࠍታ〣ߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫↢ޔߦࠄߐޕ‬ᶦࠍㅢߓߡቇ⠌ߒߡ޿ߊᆫ൓ࠍ߽ߜ‫ᦨޔ‬ᣂߩ⍮⷗ࠍᓧߡ⋴⼔ߦᵴ↪ߔࠆദജࠍ⛯ߌ‫⼔⋴ߩઁޔ‬⡯ߩᓎഀࡕ࠺࡞ߣߥࠆߎߣ߽᳞߼ࠄࠇࠆ‫ޕ‬㧝㧚⋴⼔߿ක≮ߦ㑐ߔࠆኾ㐷⡯ߣߒߡߩືቇࠍ⊒ዷߐߖ‫⼔⋴ޔ‬ታ〣ߦ⛔วߔࠆ㧞㧚⋴⼔ቇࠍขࠅᏎߊ⺖㗴ߦߟ޿ߡߩᗵฃᕈࠍ㜞߼‫ޔ‬ਥ૕ᕈࠍᜬߞߡᡷༀߔࠆ
㧟㧚ࠃࠅ⦟޿ࠤࠕࠍ᳿ቯߔࠆߚ߼ߦᦨᣂߩ⍮⷗ࠍᓧߥ߇ࠄታ〣ߔࠆࡕ࠺࡞ߦߥࠆ
㧠㧚ኾ㐷⡯ߣߒߡ⋴⼔ⷰࠍ᣿⏕ߦߔࠆ－ 30 －╙  ┨ ࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯ෳട⠪ߦኻߔࠆ⾰໧⚕⺞ᩏ㧝㧚⺞ᩏᣇᴺ㧝㧕ኻ⽎ࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯⺞ᩏදജ⠪ߥࠄ߮ߦ㜞╬ᢎ⢒ⴕ᡽ኻ╷ᆔຬળᆔຬࠍኻ⽎ߣߒߚߚ߼‫ޔ‬47 ੱߦ⺞ᩏࠍታᣉߒߚ‫⾰ޕ‬໧⚕⺞ᩏߩ࿁╵߇ᓧࠄࠇߚߩߪ 33 ੱߢ޽ߞߚ‫ޕ‬㧞㧕࠺࡯࠲෼㓸ᣇᴺ ⾰໧⚕⺞ᩏߢⴕߞߚ㗄⋡㧔⾗ᢱ 3㧕ߪ╙ 2 ┨ߢࠗࡦ࠲ࡆࡘ࡯⺞ᩏ⚿ᨐࠍㅀߴߚ‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈⢻ജ‫ୃࠆߌ߅ޠ‬ᓧߔߴ߈ 10 ߩ‫ޟ‬⢻ജ‫ޟߩߘ߮ࠃ߅ޠ‬⢻ജߩౝኈ‫ޠ‬40 㗄⋡ߩ⴫⃻ߣౝኈߦ㑐ߒߡߩ⾰໧ࠍ‫ޟ‬หᗧߒߥ޿‫ޟޠ‬หᗧߔࠆ‫᧦ޟޠ‬ઙઃ߈ߢหᗧߔࠆ‫ޠ‬ߩ޿ߕࠇ߆৻ߟࠍㆬᛯߒ‫᧦ޟޔ‬ઙઃ߈ߢหᗧߔࠆ‫ࠍޠ‬ㆬᛯߒߚ㓙ߦߪ‫ߩߘޔ‬ℂ↱ߣୃᱜ᩺ࠍ
⸥ㅀߔࠆࠃ߁ଐ㗬ߒߚ‫ޕ‬㧟㧕࠺࡯࠲෼㓸ᦼ㑆⾰໧⚕ߪㇷㅍᴺߢታᣉߒ‫⾰ޔ‬໧⚕ߩ࿁෼ߪᐔᚑ 25 ᐕ 1 ᦬ 9 ᣣ߆ࠄ 1 ᦬ 28 ᣣ߹ߢⴕߞߚ‫ޕ‬㧠㧕ಽᨆᣇᴺ‫ޟ‬หᗧߒߥ޿‫ޠ‬‫ޟ‬หᗧߔࠆ‫ޠ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ߩޠ‬ᐲᢙಽᏓਗ߮ߦୃᱜ᩺ߩ⸥ㅀߦࠃࠅ‫ޔ‬ୃᓧߔߴ߈ 10 ߩ‫ޟ‬⢻ജ‫ޟ߮ࠃ߅ޠ‬⢻ജߩౝኈ‫ޠ‬40 㗄⋡ࠍᬌ⸛ߒߚ‫ޕ‬
㧡㧕୶ℂ⊛㈩ᘦ
ᧄ⺞ᩏߩ⾰໧⚕ߦ࿁╵ߒ‫ޔ‬㄰ାߩ޽ߞߚ߽ߩࠍ⺞ᩏߦหᗧ߇ᓧࠄࠇߚ߽ߩߣߒߚ‫⺞ޕ‬ᩏදജଐ㗬ᢥߦߪ‫⺞ޔ‬ᩏߦᔅⷐߥᤨ㑆ࠍឭ␜ߒߚ‫ޕ‬ၮᧄ⊛ߦή⸥ฬߦࠃࠆ⾰໧⚕⺞ᩏߢ޽ࠆ߇‫⸥ޔ‬タౝኈߩ⏕⹺ߩߚ߼ߦ‫ޔ‬࿁╵⠪⥄り߇ੌ⸃ߒߚ႐วߪ‫ޔ‬࿁╵⠪⥄ࠄ⾰໧⚕ߦ᳁ฬࠍ⸥タߔࠆࠃ߁ଐ㗬ߒߚ‫ޕ‬


㧞㧚⚿ᨐ
㧝㧕࿁╵⠪ߩ᭎ⷐ
ࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯⺞ᩏߦߡදജࠍᓧߚඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ࠍ᦭ߒߡ޿ࠆᄢቇ㒮ᢎ⢒ᜂᒰ⠪ߣ㜞╬ᢎ⢒ⴕ᡽ኻ╷ᆔຬળߩᆔຬࠍ฽߻ 47 ฬߦ⾰໧⚕ࠍㅍઃߒߚ‫ޕ‬㄰ㅍߐࠇߚ⾰໧⚕ᢙ 33 ㇱ㧔࿁෼₸ 70.2%㧕ࠍኻ⽎ߦ‫ߩࠄࠇߘޔ‬ౝኈࠍಽᨆߒߚ‫⺞ᧄޕ‬ᩏߢߪ‫ޔ‬ή࿁╵࡮ήല࿁╵ࠍ㒰޿ߚ᦭ല࿁╵ߩߺࠍ㓸⸘ߒ‫ޔ‬ಽᨆߒߚ‫ޕ‬એਅߩୃᓧߔߴ߈Σ㨪άߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ ߩޠ‬40 㗄⋡ࠍฦ⢻ജߦᴪߞߡ⚿ᨐࠍㅀߴࠆ‫ޕ‬
㧞㧕ୃᓧߔߴ߈Σ㨪άߩ⢻ജߦኻߔࠆหᗧߩ᭎ⷐ
ୃ჻ୃੌ↢ߩ߽ߟΣ߆ࠄάߩ‫ޟ‬⢻ജ‫ߦޠ‬ኻߒߡߪ‫ ⴫ޔ‬11 ߦ␜ߔࠃ߁ߦ‫ޟ‬หᗧߔࠆ‫᧦ޟߣޠ‬ઙઃ߈ߢหᗧߔࠆ‫ࠍޠ‬วࠊߖࠆߣ 30 ੱ㨪33 ੱ㧔93.8㧑㨪100㧑㧕߇‫ޟ‬หᗧߔࠆ‫ߣޠ‬࿁╵ߒߡ޿ߚ‫ޕ‬Σ㨪άߩ‫ޟ‬⢻ജ‫ߩޠ‬ਛߢ‫ޟ‬หᗧߔࠆ‫ߩޠ‬࿁╵߇ᦨ߽㜞߆ߞߚ 3 ߟߩ‫ޟ‬⢻ജ‫ޠ‬ኻߒߡߪ‫ޔ‬‫ޟ‬Σ㧚⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦត᳞ߒ‫ࠍࠬࡦ࠺ࡆࠛޔ‬ᵴ↪ߔࠆ‫ޠ‬33 ੱ‫ޟޔ‬Ψ㧚ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫ޠ‬31 ੱ‫ޔ‬‫ޟ‬Ϋ㧚୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞ
ߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ‫ޠ‬32 ੱߩ࿁╵⠪ߩోຬ߇‫ޟ‬หᗧߔࠆ‫ߣޠ‬࿁╵ߒߡ޿ߚ‫৻ޕ‬－ 31 －

ᣇ‫߿߿ޔ‬ૐ߆ߞߚ⢻ജߪ‫ޟޔ‬Ω㧚⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ‫ޠ‬30 ੱ㧔93.8㧑㧕ߢ޽ߞߚ‫ޕ‬એ਄ߩ⚿ᨐ߆ࠄ‫ޔ‬‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈⢻ജ‫ޔߪޠ‬10 ߩ‫ޟ‬⢻ജ‫ߡߴߔߪޠ‬ᔅⷐߢ޽ࠆߣ⠨߃ࠆ‫ޕ‬ᰴߦ‫ޔ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈ 10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬㧔40 㗄⋡㧕ߦ㑐ߔࠆ‫ޟ‬หᗧ‫⺞ߩߡ޿ߟߦޠ‬ᩏ⚿ᨐࠍએਅߦㅀߴࠆ‫ޕ‬㩷 ⴫ 11. ‫ޟ‬⢻ജ‫ߦޠ‬ኻߔࠆหᗧ㪈㪇 䈱⢻ജ㩷หᗧ䊶᧦ઙઃหᗧ㩷ੱᢙ䋨䋦䋩㩷

㸇䋮⋴⼔䈱⺖㗴䉕⑼ቇ⊛䈮ត᳞䈚䇮䉣䊎䊂䊮䉴䉕ᵴ↪䈜䉎㩷㧔㧕㪠㪠䋮⋴⼔䈱ኻ⽎䋨୘ੱ䊶ኅᣖ䊶㓸࿅䊶࿾ၞ䋩䈮ኻ䈚䈩䇮㜞ᐲ䈭⋴⼔䉕ታ〣䈜䉎㩷㧔㧕㸉䋮⋴⼔䈏ឭଏ䈘䉏䉎ኻ⽎䉇႐䈮ኻ䈚䇮⾰䈱ᡷༀ䈮ะ䈔䈩ข䉍⚵䉃㩷㧔㧕㸊䋮䉬䉝䈏ឭଏ䈘䉏䈩䈇䉎⚵❱䉇䉲䉴䊁䊛䉕ಽᨆ䈚䇮䉬䉝ⅣႺ䉕⺞ᢛ䈜䉎㩷㧔㧕㸋䋮䉬䉝䉕ផㅴ䈪䈐䉎႐䉇ੱ⊛ⅣႺ䉕ᢛ䈋䇮䊥䊷䉻䊷䉲䉾䊒䉕⊒ើ䈜䉎㩷㧔㧕㸌䋮ኾ㐷ᕈ䈱⋧㆑䉕ዅ㊀䈚䈢਄䈪ᄙ⡯⒳㑆䈱ද௛䉕ផㅴ䈜䉎㩷㧔㧕㸍䋮⃻ⴕ䈱ᴺᓞ䊶೙ᐲ䊶᡽╷䈏ஜᐽ䈫⋴⼔䈮ਈ䈋䉎ᓇ㗀䉕ಽᨆ䈚䇮⸃᳿╷䉕ឭ᩺䈜䉎㩷㧔㧕㸎䋮⋴⼔ቇ䈱⊒ዷ䈮ነਈ䈪䈐䉎ᢎ⢒ⅣႺ䈨䈒䉍䈮ข䉍⚵䉃㩷㧔㧕

㸏䋮୶ℂ⊛䊶ᢥൻ⊛ᗵฃᕈ䉕ᜬ䈦䈩ኾ㐷⡯䈫䈚䈩䈱⽿ോ䉕ᨐ䈢䈜㩷㧔㧕㸐䋮⋴⼔ቇ䈱⊒ዷ䈮ነਈ䈪䈐䉎䉝䉟䊂䊮䊁䉞䊁䉞䉕ᒻᚑ䈜䉎㩷㧔㧕㧖୯ߪ‫ޟ‬หᗧ‫᧦ޟߣޠ‬ઙઃ߈ߢหᗧ‫ߩޠ‬ว⸘ੱᢙߣഀวࠍ␜ߒߚ‫ޕ‬㩷㧟㧕ฦ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ߦޠ‬㑐ߔࠆᗧ⷗
㧔㧝㧕‫ޟ‬Σ㧚⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ࠍࠬࡦ࠺ࡆࠛޔ‬ᵴ↪ߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߦޠ‬ኻߔࠆหᗧ
ୃ჻ୃੌ↢ߩ߽ߟΣߩ‫ޟ‬⢻ജ‫ߦ⃻⴫ߩߡߒߣޠ‬ኻߒߡߩ࿁╵ߪ‫ޔ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬29 ੱ
㧔87.9㧑㧕ߣ‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ޠ‬4 ੱ㧔12.1 㧑㧕ࠍวࠊߖࠆߣోຬ㧔33 ੱ㧕߇หᗧߔࠆߣ࿁╵ߒߡ߅ࠅ‫ޟޔ‬หᗧߒߥ޿‫ߣޠ‬࿁╵ߒߚ⠪ߪోߊ޿ߥ߆ߞߚ㧔࿑ 1㧕‫ޕ‬ߚߛߒ‫ޔ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ߩޠ‬࿁╵ߦ㑐ߒߡߩᗧ⷗߿ୃᱜ᩺ߣߒߡߩ⢻ജߩ⴫⃻ᣇᴺࠍ‫ޔ‬‫ޟ‬Σ㧚⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫⺖ߩ⼔⋴ޔ‬㗴ࠍ⑼ቇ⊛ߦត᳞ߔࠆ‫ࠆߔߣޠ‬᩺߇⸥タߐࠇߡ޿ߚ‫ߩߘޕ‬ਛߢ߽‫ߦ⪲⸒ߩޠࠬࡦ࠺ࡆࠛޟߦ․ޔ‬ኻߔࠆਇ᣿⏕ߐ߇ᜰ៰ߐࠇߡ޿ߚ‫ޕ‬߹ߚ‫ߩ࡞ࡌ࡟ߩࠬࡦ࠺ࡆࠛޟޔ‬ቯ⟵‫౒ߪߡ޿ߟߦޠ‬ㅢ⸒⺆ߣߒߡ૶↪ߢ߈ࠆ࡟ࡌ࡞ߢߩឭ
␜ߣ⺑᣿ߩᔅⷐᕈ߇᳞߼ࠄࠇߡ޿ߚ‫ޕ‬એ਄ߩߎߣ߆ࠄ‫ޔ‬Σߩ‫ޟ‬⢻ജ‫ޔߪߡ޿ߟߦ⃻⴫ߩޠ‬ㅊട߿ୃᱜߪⴕࠊߥ߆ߞߚ߇‫᧦ޟޔ‬ઙઃ߈ߢหᗧߔࠆ‫⸥ߦޠ‬タߐࠇߡ޿ߚୃᱜ᩺ࠍෳ⠨ߦขࠅ౉ࠇ‫⺑ޔ‬᣿ᢥ㧔⾗ᢱ㧠㧕ߩਛߦ‫ޔ‬ࠛࡆ࠺ࡦࠬߩᗧ๧߿ࠛࡆ࠺ࡦࠬ࡟ࡌ࡞ߦߟ޿ߡߩౕ૕⊛ߥ⸃㉼ࠍ⾰໧⚕ߩᵈ㉼ߦ⸥タߔࠆߎߣߦߥߞߚ‫ޕ‬ԙ‫ޟ‬⢻ജߩౝኈ‫ޠ‬㧔4 㗄⋡㧕ኻߔࠆหᗧ
ᰴߦ‫ޟޔ‬⢻ജߩౝኈ‫ߡߴߔߩޠ‬㧔4 㗄⋡㧕ߦ߅޿ߡ 27 ੱ㨪29 ੱ㧔81.8%㨪87.9%㧕߇－ 32 －

‫ޟ‬หᗧߔࠆ‫ߣޠ‬࿁╵ߒߡ޿ߚ㧔࿑ 2㧕‫ޟޕ‬หᗧߔࠆ‫ޠ‬㨪‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ࠍޠ‬วࠊߖ
ࠆߣ 31 ੱ㨪32 ੱ㧔93.9㧑㨪97.0㧑㧕ߢ޽ߞߚ‫৻ޕ‬ᣇ‫ޟޔ‬หᗧߒߥ޿‫ߩߣޠ‬࿁╵߇ 4 㗄⋡ߢߪ 1㨪2 ੱ㧔3.0㧑㨪6.1%㧕޽ߞߚ㧔࿑ 2㧕‫ޕ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ޠ‬ℂ↱ߣୃᱜ᩺ߦߣߒߡߪ‫ޟޔ‬Σ㧙1 ⋴⼔ታ〣ߢߩ໧㗴ࠍ⸃᳿ߔࠆߚ߼ߦ‫ޔ‬ᔅⷐߥࠛࡆ࠺ࡦࠬࠍត᳞ߔࠆ‫ޠ‬3 ੱ㧔9.1㧑㧕ߦ㑐ߒߡߪ‫ୃߩ⃻⴫ޔ‬ᱜ᩺ߣߒߡ‫ࠍࠬࡦ࠺ࡆࠛޟ‬ᵴ↪ߔࠆ‫ߩ⪲⸒߁޿ߣޠࠬࡦ࠺ࡆࠛޟޔޠ‬ᗧ๧߿‫ޟ‬ត᳞ߔࠆ‫ߩޠ‬ᢥ⸒ࠍ‫ޟ‬តⓥߔࠆ‫ୃߦޠ‬ᱜࠍ᳞߼ࠆᗧ⷗߇޽ߞߚ‫ޟޔߚ߹ޕ‬Σ㧙2 ࠛࡆ࠺ࡦࠬ࡟ࡌ࡞ࠍᛕ
್⊛ߦ⺒⸃ߒ‫⹏ޔ‬ଔߔࠆ‫ޠ‬5 ੱ㧔15.2㧑㧕ߢߪ‫ޟ‬ᛕ್⊛‫ୃߦޠࠅࠃߦࠢ࡯ࠖ࠹࡝ࠢޟࠍޠ‬ᱜߔࠆߎߣ߿ᢥ⸒ࠍ‫ୃߦޠࠆ߈ߢ⸃⺒ޟ‬ᱜߔࠆߎߣࠍ᳞߼ࠆᗧ⷗߽޽ߞߚ‫ޕ‬ࠛࡆ࠺ࡦࠬ࡟ࡌ࡞ߩ‫ޟ‬⢻ജߩౝኈ‫ߦޠ‬㑐ߒߡߪ‫ߩ࡞ࡌ࡟ࠬࡦ࠺ࡆࠛޟޔ‬ᗧ๧߇ࠊ߆ࠅ
ߦߊ޿‫ߣޠ‬ਇ᣿⍎ߐࠍ␜ߔᗧ⷗߽⸥タߐࠇߡ޿ߚ‫ޕ‬ታ〣࡟ࡌ࡞ߦ߅޿ߡߪ‫ޔ‬ᔅⷐߥࠛࡆ
࠺ࡦࠬࠍត᳞ߔࠆߦߪ‫ޟ‬න⁛ߢߪ㔍ߒ޿ߩߢ‫߿ࡓ࡯࠴ޔ‬਄มߩഥ⸒ࠍฃߌߥ߇ࠄߢࠃ޿
ߩߢߪߥ޿߆‫ߩߣޠ‬࿁╵߽޽ߞߚ‫ޕ‬ታ〣‫ޟ‬Σ㧙3 Evidence-based practice ࠍℂ⸃ߔࠆ‫ޠ‬5ੱ㧔15.2㧑㧕ߦ߅޿ߡߪ‫ޟޔ‬Evidence-based practice ߪਇⷐߢߪߥ޿߆‫⸥⴫⺆⧷ޟޔޠ‬ߣࠞ࠲ࠞ࠽⴫⸥߇ᷙ࿷ߒߡ޿ࠆ‫ߩߣޠޕ‬ᗧ⷗߇⸥タߐࠇߡ޿ߚ‫ޟޕ‬Σ㧙4 ᣂߚߥ⍮⼂߿వㅴ⊛ߥᛛⴚࠍត⚝ߒ‫ޔ‬ᵴ↪ߔࠆ‫ޠ‬4 ੱ㧔12.1㧑㧕ߦߟ޿ߡߪ‫ޟߡߒߣ⃻⴫ޔ‬ᣂߚߥ⍮⼂߿వㅴ⊛ߥᛛⴚࠍត⚝ߔࠆ‫ߦޠ‬ᄌᦝࠍ᳞߼ࠆ࿁╵߇޽ߞߚ‫ୃޕ‬჻ߢୃᓧߔߴ߈ታ〣⢻ജߦ㑐ߒߡߪ‫ޟ‬ᵴ↪߹ߢߪ㔍ߒ޿‫ޟޔޠ‬න⁛ߢߪ㔍ߒ޿ߩߢߪߥ޿߆‫߿ࡓ࡯࠴ޔ‬਄มߩഥ⸒
ࠍฃߌߥ߇ࠄߢࠃ޿ߩߢߪߥ޿߆‫ߩߤߥޠޕ‬ᗧ⷗߇⸥タߐࠇߡ޿ߚ‫ޟޕ‬⢻ജߩౝኈ‫ߩޠ‬㊀ⶄߦߟ޿ߡߪ‫ޟ‬1㧙1࡮2 ߣ㘃ૃߒߡ޿ࠆߩߢ‫ޔ‬Σ㧙4 ߆Σ㧙1࡮2 ߩߤߜࠄ߆ߦߔࠆ‫ޠ‬╬ߩᗧ⷗߇⸥タߐࠇߡ޿ߚ‫ޕ‬એ਄ߦࠃࠅ‫ޔ‬೨ㅀߒߚࠃ߁ߦࠛࡆ࠺ࡦࠬߩቯ⟵߿ࠛࡆ࠺ࡦࠬࠍᵴ↪ߔࠆᣇᴺࠍ᣿⏕ߦߔࠆᔅⷐ߇ᒝߊ᳞߼ࠄࠇߚߩߢ‫⾰ޔ‬໧⚕㧔⾗ᢱ 4㧕ߦߪୃ჻⺖⒟ୃੌ↢ߦߪ᳞߼ࠄࠇࠆ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ߦ߁ࠃߩߤ߇ࠬࡦ࠺ࡆࠛޔߦޠ‬ዉ߈಴ߐࠇߡ޿ࠆ߆ࠍ⏕⹺ߒ‫ࡆࠛޔ‬࠺ࡦࠬߩᅷᒰᕈ߿ା㗬ᕈߩ⒟ᐲࠍ⹏ଔߔࠆߣߣ߽ߦ‫ߦ࡞ࡌ࡟ߩߘޔ‬ၮߠ߈ߤߩࠃ߁ߦ⎇ⓥ⚿ᨐࠍណ↪ߔࠆ߆್ᢿߔࠆᔅⷐᕈࠍㅊ⸥ߒߚ‫ޕ‬
࿑ 1㧚‫ޟ‬Σ㧚⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦត᳞ߒ‫ࠍࠬࡦ࠺ࡆࠛޔ‬ᵴ↪ߔࠆ‫ߦޠ‬ኻߔࠆหᗧ
㩷－ 33 －㩷࿑ 2㧚Σߩ‫ޟ‬⢻ജߩౝኈ‫ߦޠ‬ኻߔࠆหᗧ

㧔㧞㧕‫ޟ‬Τ⋴⼔ߩኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ㧕ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߦޠ‬ኻߔࠆหᗧ
ୃ჻ୃੌ↢ߩ߽ߟΤߩ‫ޟ‬⢻ജ‫ߦ⃻⴫ߩޠ‬ኻߒߡ‫ޔ‬࿁╵⠪ߩᄙߊ߇‫ޟ‬หᗧߔࠆ‫ޠ‬21 ੱ㧔63.6㧑㧕‫ޔ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ޠ‬11 ੱ㧔33.3㧑㧕ߣ࿁╵ߒ‫ޔ‬วࠊߖࠆߣ 32 ੱ㧔96.9㧑㧕߇หᗧߔࠆ
ߣ࿁╵ߒߡ߅ࠅ‫ޔ‬‫ޟ‬หᗧߒߥ޿‫ߣޠ‬࿁╵ߒߚ⠪ߪ‫ ߆ߕࠊޔ‬1 ੱߢ޽ߞߚ㧔3.0㧑㧕
㧔࿑ 3㧕
‫ߚޕ‬
ߛߒ‫ޔ‬
‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ޔޠ‬‫ޟ‬หᗧߒߥ޿‫ߩޠ‬࿁╵ߦ㑐ߒߡߩℂ↱߿ୃᱜ᩺ߣߒߡߪ‫ޔ‬‫ޟ‬Τ⋴⼔ߩኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ㧕ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆ‫ޟߩޠ‬㜞ᐲߥ⋴⼔‫ߩ⃻⴫ߩޠ‬ᗧ๧߇ਇ᣿⍎ߢ޽ࠅ‫ߩߘޔ‬ᗧ๧ࠍ᣿⏕ߦߔࠆୃᱜߩᗧ⷗߿⢻ജߩᅷᒰᕈߣߒ
ߡ‫ޟ‬ታ〣࡟ࡌ࡞ࠍ໧߁߆⇼໧‫ޟޔޠ‬CNS ࠦ࡯ࠬߩቇ↢ߦߪㆡᔕߔࠆ߇‫⺰ޔ‬ᢥࠦ࡯ࠬߩቇ↢ߦߪ㜞ᐲൻߪ㔍ߒ޿‫ޔߚߞ޿ߣޠ‬ኾ᡹ࠦ࡯ࠬߦ߅ߌࠆ೔㆐ᐲߩᏅ⇣߿඙೎ߩᔅⷐᕈ╬߇⸥タߐࠇߡ޿ߚ‫ޕ‬એ਄ߩᗧ⷗ࠍ߰߹߃‫ޟޔ‬㜞ᐲߥ⋴⼔‫ߩޠ‬ᗧ๧ࠍౕ૕⊛ߦ⺑᣿ߔࠆᔅⷐ߇޽ߞߚ‫ߎߘޕ‬ߢ‫⾰ޔ‬໧⚕㧔⾗ᢱ 4㧕ߩΤߩ‫ޟ‬⢻ജ‫ୃߦޠ‬჻ୃੌ↢ߦ᳞߼ࠆ㜞ᐲߥ⋴⼔ߩ⹦⚦ࠍ‫ޟ‬ㆡ⏕ߦᖱႎ್ᢿߒ‫߇ߣߎ߈ߴߔߥޔ‬ታ〣ߢ߈ࠆ‫⺑ߣߣߎޠ‬᣿ᢥߦട╩ߒߚ‫ޕ‬ԙ‫ޟ‬⢻ജߩౝኈ‫ޠ‬㧔8 㗄⋡㧕ߦኻߔࠆหᗧ
‫ޟ‬⢻ജߩౝኈ‫ ߩޠ‬8 㗄⋡ߩਛߢ‫ޟ‬หᗧߔࠆ‫ߩߣޠ‬࿁╵߇ 80%એ਄ࠍභ߼ߚ㗄⋡ߪ‫ޔ‬32 ੱਛ‫ޟ‬Τ㧙2 ឭଏߐࠇߡ޿ࠆක≮ߩ୶ℂᕈࠍ್ᢿߒታ〣ߔࠆ‫ޠ‬27 ੱ㧔84.4 㧑㧕‫ޟޔ‬Τ㧙4 ᄙ⡯⒳ߣߣ߽ߦක≮ߩ቟ోᕈࠍ⏕⹺ߒ‫଻ޔ‬㓚ߔࠆ‫ޠ‬27 ੱ㧔84.4 㧑㧕‫ޟޔ‬Τ㧙5 ኻ⽎ਛᔃߦ‫ޔ‬⋴⼔⡯߅ࠃ߮ᄙ⡯⒳ߣߩ⺞ᢛࠍⴕ޿‫ޔ‬ද௛ߒߡࠤࠕߔࠆ‫ޠ‬28 ੱ㧔87.5㧑㧕‫ޟޔ‬Τ㧙6 ⋴⼔

－ 34 －

ߦߟ޿ߡߩ⺑᣿ജࠍ߽ߜ‫ޔ‬ද௛ࠍផㅴߔࠆ‫ޠ‬27 ੱ㧔84.4㧑㧕‫ޟޔ‬Τ㧙7 ੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍㅢߓ‫ޔ‬ஜᐽࠍ଻ᜬჇㅴߔࠆ‫ޠ‬26 ੱ㧔81.3㧑㧕ߩ 5 㗄⋡ߢ޽ߞߚ‫ޕ‬70㧑એ਄ߩ㗄⋡ߪ‫ޟ‬Τ㧙1 ᦨᣂߩࠤࠕᛛⴚ߿ࠛࡆ࠺ࡦࠬߦၮߠ޿ߡ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆ‫ޠ‬24 ੱ㧔75.0%㧕‫ޟ‬Τ㧙3 ୶ℂ⊛ߦㆡᱜߥᖱႎᛛⴚߩ೑↪ࠍଦㅴߔࠆ‫ޠ‬25 ੱ㧔78.1㧑㧕‫ޟ‬Τ㧙8 ⋴⼔ߩኻ⽎ߦኻߒߡ‫∉ޔ‬ቇ⊛ߥ⍮⼂ࠍᵴ↪ߒߡࡐࡇࡘ࡟࡯࡚ࠪࡦ࡮ࠕࡊࡠ࡯࠴ࠍታ〣ߔࠆ‫ޠ‬23 ੱ
㧔71.9㧑㧕ߢ޽ߞߚ‫ޕ‬Τ㧙1 ߆ࠄΤ㧙8 㗄⋡ߩߔߴߡߩ㗄⋡߇‫ޟ‬หᗧߔࠆ‫ޠ‬㨪‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ࠍޠ‬วࠊߖࠆߣ 30 ੱ㨪31 ੱ㧔93.8㧑㨪96.9㧑㧕ߢ޽ߞߚ㧔࿑ 4㧕‫ޕ‬᧦ઙઃ߈ߢหᗧߔࠆℂ↱߿ୃᱜ᩺ߪ‫ޔ‬‫ޟ‬Τ㧙1 ᦨᣂߩࠤࠕᛛⴚ߿ࠛࡆ࠺ࡦࠬߦၮߠ޿ߡ‫ޔ‬⋴⼔ࠍታ〣ߔࠆ‫ޠ‬7 ੱ㧔21.9㧑㧕ߢߪ‫ޟ‬ታ⠌߇ߥ޿ᢎ⢒⺖⒟ߢታ〣ߔࠆߎߣ߹ߢน⢻ߥߩ߆⇼໧‫ࠕࠤޟޔޠ‬ᛛⴚࠍ⋴⼔ࠤࠕᛛⴚߦᄌᦝߔࠆ‫ୃࠍ⃻⴫ߣޠ‬ᱜ‫߮ࠃ߅ޔ‬ᢎ⢒⺖⒟ߩ⢻ജߦ㑐ߒߡ‫ޟޔ‬CNS ࠦ࡯ࠬߩቇ↢ߩߺ‫⺰ޕ‬ᢥࠦ࡯ࠬߩቇ↢㧔⃻ᓎߩቇㇱ↢㧕ߦߪ㔍ߒ޿‫ޔޠޕ‬‫ޟ‬CNS ╬ᢎ⢒⺖⒟ߦࠃߞߡ⇣ߥࠆ‫ߩ╬ޠ‬ᗧ⷗߇޽ߞߚ‫ޟޕ‬Τ㧙2 ឭଏߐࠇߡ޿ࠆක≮ߩ୶
ℂᕈࠍ್ᢿߒታ〣ߔࠆ‫ޠ‬4 ੱ㧔12.5㧑㧕ߟ޿ߡߪ‫୶“ޟޔ‬ℂᕈ”ߣ“୶ℂ”ᕈࠍߟߌߡ޽ࠆᗧ๧
߇ࠊ߆ࠇ߫⦟޿ߩߢߔ߇‫ޟޔޠ‬ឭଏߐࠇߡ޿ࠆᢥ⸒ࠍ೥㒰ߔࠆ‫ޟޔޠ‬CNS ࠦ࡯ࠬߩቇ↢ߩߺ‫⺰ޕ‬ᢥࠦ࡯ࠬߩቇ↢㧔⃻ᓎߩቇㇱ↢㧕ߦߪ㔍ߒ޿‫ޟޠ‬CNS ╬ᢎ⢒⺖⒟ߦࠃߞߡ⇣ߥࠆ‫ޔޠ‬‫୶ޟ‬ℂߣߒߡߩࠞ࡝ࠠࡘ࡜ࡓ߇⚵ߺㄟ߹ࠇߡ޿ߥ޿ߣ㔍ߒ޿‫ޔ߁޿ߣޠ‬ᢥ⸒߿ᢎ⢒ౝኈߩୃᱜ᩺߿ᗧ⷗߇ߺࠄࠇߚ‫ޟޕ‬Τ㧙3 ୶ℂ⊛ߦㆡᱜߥᖱႎᛛⴚߩ೑↪ࠍଦㅴߔࠆ‫ޠ‬㧔15.6㧑㧕
ߦߟ޿ߡߪ‫߿⃻⴫ޔ‬ኻ⽎ߦኻߔࠆᗧ⷗ߣߒߡ‫ߦ⺕ޟ‬ะߌߡ‫ޔ‬૗ߩߚ߼ߩᛛⴚߥߩ߆ߣߡ߽
ࠊ߆ࠅߦߊ޿‫߿ޠ‬ኾ᡹ࠦ࡯ࠬߦࠃࠆ⢻ജ߿ታ〣ജ߇㆑޿‫ޟޔ‬CNS ࠦ࡯ࠬߩቇ↢ߩߺ‫⺰ޕ‬ᢥࠦ࡯ࠬߩቇ↢㧔⃻ᓎߩቇㇱ↢㧕ߦߪ㔍ߒ޿‫ߩߤߥޠ‬ᗧ⷗߇޽ߞߚ‫ޟޕ‬Τ㧙4 ᄙ⡯⒳ߣߣ߽
ߦක≮ߩ቟ోᕈࠍ⏕⹺ߒ‫଻ޔ‬㓚ߔࠆ‫ޠ‬4 ੱ㧔12.5㧑㧕ߦߟ޿ߡߪ‫ޟޔ‬CNS ࠦ࡯ࠬߩቇ↢ߩߺߢ‫⺰ޔ‬ᢥࠦ࡯ࠬߩቇ↢㧔⃻ᓎߩቇㇱ↢㧕ߦߪ㔍ߒ޿‫ߩߣޠ‬ᗧ⷗߿ౝኈߩ㊀ⶄߣߒߡ‫ޟ‬ᄙ⡯⒳ߪΦߦ߹ߣ߼ࠆ‫ߩߤߥޠ‬࿁╵߇޽ߞߚ‫ޟޕ‬Τ㧙5 ኻ⽎ਛᔃߦ‫⼔⋴ޔ‬⡯߅ࠃ߮ᄙ⡯⒳ߣ
ߩ⺞ᢛࠍⴕ޿‫ޔ‬ද௛ߒߡࠤࠕߔࠆ‫ޠ‬2 ੱ㧔6.3㧑㧕ߦߟ޿ߡߪ‫ޟޔ‬CNS ࠦ࡯ࠬߩቇ↢ߩߺ‫ޕ‬⺰ᢥࠦ࡯ࠬߩቇ↢㧔⃻ᓎߩቇㇱ↢㧕ߦߪ㔍ߒ޿‫ߩߣޠ‬ᗧ⷗߇޽ࠅ‫ޟޔ‬Τ㧙6 ⋴⼔ߦߟ޿ߡߩ⺑᣿ജࠍ߽ߜ‫ޔ‬ද௛ࠍផㅴߔࠆ‫ޠ‬4 ੱ㧔12.5㧑㧕ߦߟ޿ߡߪ‫ޟ‬ᄙ⡯⒳‫ߩޠ‬ᢥ⸒ࠍᝌ౉ߒ‫ޔ‬‫⺑ߩߡ޿ߟߦ⼔⋴ޟ‬᣿ജࠍ߽ߜ‫ޔ‬ᄙ⡯⒳ߣද௛ߒߡផㅴߔࠆ‫ୃߦޠ‬ᱜߔࠆߣ޿߁ᗧ⷗ߩ⸥タ߇ߺࠄࠇߚ‫ޟޕ‬Τ㧙7 ੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍㅢߓ‫ޔ‬ஜᐽࠍ଻ᜬჇㅴߔࠆ‫ޠ‬5 ੱ
㧔15.6㧑㧕ߦߟ޿ߡߪ‫ޟߡߒߣ⃻⴫ޔ‬⍮⼂ࠍㅢߓ‫ޟࠄ߆ޠ‬⍮⼂ࠍ↪޿ߡ‫ୃࠍ⃻⴫ߦޠ‬ᱜߔࠆߎߣ߿‫ߪߦ↢ੌୃోޟ‬෸߫ߥ޿‫ߩߣޠ‬ᗧ⷗ߩ⸥タ߇޽ߞߚ‫ޟޕ‬Τ㧙8 ⋴⼔ߩኻ⽎ߦኻߒߡ‫ޔ‬∉ቇ⊛ߥ⍮⼂ࠍᵴ↪ߒߡࡐࡇࡘ࡟࡯࡚ࠪࡦ࡮ࠕࡊࡠ࡯࠴ࠍታ〣ߔࠆ‫ޠ‬8 ੱ㧔25.0㧑㧕ߩ㗄⋡ߦߟ޿ߡߪ‫ޔ‬⢻ജౝኈߩ㊀ⶄߩᜰ៰ߣߒߡ‫ޟ‬Τ㧙8 㗄⋡ߩߺߦ“⋴⼔ߩኻ⽎ߦኻߒߡ”ߣ⸥タߐࠇߡ޿ࠆ‫ߩઁޕ‬㗄⋡ߦ߽ౝኈ߇൮฽ߐࠇߡ޿ࠆ‫ߩߣޠ‬ᗧ⷗߇⸥タߐࠇߡ߅ࠅ‫ୃޔ‬ᱜ᩺ߣߒߡ‫ߩ⼔⋴ޟ‬ኻ⽎ߦኻߒߡߩᢥ⸒ࠍ೥㒰ߔࠆ‫ߪ࠴࡯ࡠࡊࠕ࡮ࡦ࡚ࠪ࡯࡟ࡘࡇࡐޟ߿ߣߎޠ‬ᔅୃߢߪߥ޿‫⸥ࠍߣߎޠ‬ㅀߐࠇߡ޿ߚ‫ߩઁޕ‬ᢥ⸒ߦߟ޿ߡߩᗧ⷗ߣߒߡߪ‫⴫ߩ࠽ࠞ࠲ࠞޟ‬⸥ߪㆱߌߚᣇ߇ᦸ߹ߒ޿‫⸥ࠍߣߎޠ‬タߐࠇߡ޿ߚ‫ޔߚ߹ޕ‬ኾ᡹⺖⒟ߦߟ޿ߡߪ‫ޟޔ‬ኾ᡹ಽ
㊁ߦࠃߞߡߪ᳞߼ߥ޿⢻ജ‫ޟޔޠ‬࿾ၞࠍㆬᛯቇ↢ߦߩߺㆡ↪ߔࠆ‫ࠍ⼔⋴↢ⴡⴐ౏ޟޔޠ‬ਛᔃߦหᗧߔࠆ‫ߪ࠴࡯ࡠࡊࠕ࡮ࡦ࡚ࠪ࡯࡟ࡘࡇࡐޟޠ‬ഥߌ߇ᔅⷐߥ႐ว߇޽ࠅ‫ޔ‬ᔅⷐߦᔕߓ
ߡഥߌࠍ᳞߼ߡታ〣ߔࠆ‫ߩߤߥޠ‬ᗧ⷗ߩ⸥タ߇ߺࠄࠇߚ‫ޕ‬એ਄ߩᗧ⷗ࠍ߰߹߃‫ޔ‬Τߩ‫ޟ‬⢻ജߩౝኈ‫ޟޔߪߡ޿߅ߦޠ‬㜞ᐲߥ⋴⼔‫߇ޠ‬ਇ᣿⏕ߣ޿߁－ 35 －

ᗧ⷗߇⸥タߐࠇߡ޿ߚߚ߼‫⺑ޔ‬᣿ࠍട߃ࠆᔅⷐ߇޽ࠆߣ⠨߃ߚ‫ޔߢߎߘޕ‬࿁╵⠪߇Τߩ‫ޟ‬⢻ജ‫ߩޠ‬ℂ⸃ࠍ᣿⏕ߦߔࠆߚ߼ߦ‫ୃޔ‬჻ୃੌ↢ߦ᳞߼ࠆ㜞ᐲߥ⋴⼔ߩ‫ޟ‬⢻ജ‫ޟޔߪߣޠ‬ㆡ⏕ߦᖱႎ್ᢿߒ‫ⴕࠍߣߎ߈ߴߔߥޔ‬േߢ߈ࠆߎߣ‫⾰ࠍޠ‬໧⚕ߩ⺑᣿ᢥߦㅊ⸥ߒߚ‫ޔߚ߹ޕ‬ΤɆ8㗄⋡ߦߟ޿ߡߪ‫ࠍ⃻⴫߁޿ߣޠ࠴࡯ࡠࡊࠕ࡮ࡦ࡚ࠪ࡯࡟ࡘࡇࡐޟޔ‬ᣣᧄ⺆ߦᄌᦝߒ‫⋴ޟޔ‬⼔ߩኻ⽎ߦኻߒߡ‫∉ޔ‬ቇ⊛ߥ⍮⼂ࠍᵴ↪ߒߡ‫੍ޔ‬㒐⊛ⷰὐࠍ〯߹߃ߡஜᐽߩ଻ᜬ࡮Ⴧㅴߦ
ขࠅ⚵߻‫ୃߦޠ‬ᱜߒߚ‫⸥↱⥄ޔߚ߹ޕ‬タߩਛߢ‫∔ޟ‬ᖚࠍᜬߟੱߛߌߢߥߊ‫ޔ‬㓚߇޿ࠍᜬߟ
ੱ߽⋴⼔ߩኻ⽎⠪ߩⷞ㊁ߦ౉ࠇ‫ࠬࠣࡦ࡟࠻ࠬޔ‬㧔ᒝߺ㧕ࠍᵴ߆ߒߚេഥࠍⴕ߁⢻ജࠍ౉ࠇߡ᰼ߒ޿‫߁޿ߣޠ‬ᗧ⷗ࠍ㗄⋡ߩਛߦ෻ᤋߐߖ‫ޟޔ‬ኻ⽎ߩᒝߺࠍᵴ߆ߔ‫ޟ߿ߣߎޠ‬ኻ⽎ߩᜬߟജ‫⾰ޔߡ޿ߟߦޠ‬໧⚕ߩ⺑᣿ᢥߩਛߦ⸃㉼ࠍട╩ߒߚ‫ߩߘޕ‬ౝኈߪ‫ୃޟޔ‬჻⺖⒟ୃੌ↢ߪ‫ޔ‬ஜᐽߣ޿߁᭎ᔨࠍ߭ࠈߊᷓߊᝒ߃‫∔ޔ‬ᖚ߿㓚⎹ࠍᛴ߃ߚኻ⽎߳ߩ௛߈߆ߌ߆ࠄ‫ޘੱޔ‬ߩஜᐽߩ଻ᜬ࡮Ⴧㅴߦะߌߚขࠅ⚵ߺ߹ߢ‫߇ࠅߣ߭ੱ৻ޔ‬ᜬߟജࠍᒁ߈಴ߒ‫ޔ‬ኻ⽎ߩ⁁ᘒߦᔕߓߚ⋴⼔ࠍᗧ࿑⊛ߦⴕ߁‫ޕࠆ޽ߢޠޕ‬࿑ 3㧚‫ޟ‬Τ⋴⼔ߩኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ㧕ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆ‫ߦޠ‬ኻߔࠆหᗧ

－ 36 －࿑ 4Τߩ‫ޟ‬⢻ജߩౝኈ‫ޠ‬㧔㧤㗄⋡㧕ߦኻߔࠆหᗧ

㧟㧕‫ޟ‬Υ㧚⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡขࠅ⚵߻‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߦޠ‬ኻߔࠆหᗧ
ୃ჻ୃੌ↢ߩ߽ߟΥߩ⢻ജߣߒߡߩ⴫⃻ߦኻߒߡ࿁╵⠪ߩᄙߊ߇‫ޟ‬หᗧߔࠆ‫ޠ‬28 ੱ
㧔84.9㧑㧕‫᧦ޟޔ‬ઙઃ߈ߢหᗧߔࠆ‫ޠ‬4 ੱ㧔12.1㧑㧕ߣ࿁╵ߒ‫ޟޔ‬หᗧߒߥ޿‫ߣޠ‬࿁╵ߒߚ⠪ߪ‫ ߆ߕࠊޔ‬1 ੱ㧔3.0㧑㧕ߢ޽ߞߚ㧔࿑ 5㧕‫᧦ޟޔߒߛߚޕ‬ઙઃ߈ߢหᗧߔࠆ‫ߩޠ‬࿁╵ߦ㑐ߒߡߩᗧ⷗߿ୃᱜ᩺ߣߒߡ‫⃻⴫ޔ‬ᣇᴺߣߒߡ‫ޟ‬Υ ⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡขࠅ⚵߻‫ޟߩޠ‬ขࠅ⚵߻ౝኈߩᗧ๧߇ࠊ߆ࠅߦߊ޿‫ޟ߿ޠ‬ขࠅ⚵߻‫ߪߚ߹ޔ‬ត᳞ߔࠆ‫ߦޠ‬ᢥ⸒ࠍୃᱜߒ‫ࠍ⼔⋴ޟޔ‬ឭଏߔࠆኻ⽎߿႐ߦኻߒ‫߿ࠕࠤ⼔⋴ޔ‬ⅣႺࠍᡷༀߔࠆ‫ޠ‬ߣ޿߁ୃᱜ᩺ߩ⸥タ߇ߺࠄࠇߚ‫ޟઁߩߘޕ‬ᚲዻߔࠆ႐ߩᡷༀࠍਛᔃߦߔࠆߣ޿߁ߎߣߢห
ᗧߔࠆ‫߁޿ߣޠ‬ᗧ⷗ߩ⸥タ߇ߺࠄࠇߚ‫ޕ‬એ਄ߦࠃࠅ‫ޔ‬Υߩ‫ޟ‬⢻ജ‫ߦޠ‬㑐ߒߡߪ‫ޟ‬⢻ജ‫ୃߩޠ‬ᱜߩᔅⷐߪߥ޿ߣ⠨߃ࠄࠇߚ‫ޕ‬－ 37 －

ԙ‫ޟ‬⢻ജߩౝኈ‫ޠ‬
㧔4 㗄⋡㧕ኻߔࠆหᗧ
‫ޟ‬⢻ജߩౝኈ‫ޠ‬
㧔4 㗄⋡㧕ߩਛߢ‫ޔ‬‫ޟ‬หᗧߔࠆ‫ޠ‬㨪‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ࠍޠ‬วࠊߖࠆߣߔ
ߴߡߩ㗄⋡߇ 30 ੱ㨪31 ੱ㧔90.9%㨪93. 8%㧕 ߢ޽ࠅ‫ߩߤࠎߣ߶ޔ‬࿁╵⠪߇ୃ჻⺖⒟ߩୃ
ੌ⠪߇ୃᓧߔߴ߈‫ޟ‬⢻ജߩౝኈ‫ߡߒߣޠ‬หᗧߒߡ޿ߚ㧔࿑ 6㧕‫ޕ‬Ύ1㨪Ύ4 㗄⋡ߩ‫ޟ‬⢻ജߩౝኈ‫ޟߦޠ‬หᗧߔࠆ‫ߣޠ‬࿁╵ߒߚߩߪ 24 ੱ㨪26 ੱ㧔72.7%㨪78.8㧑㧕ߢ޽ߞߚ‫ޕ‬‫ޟ‬⢻ജߩౝኈ‫ޟޔߡ޿߅ߦޠ‬Ύ1 ⾌↪ኻലᨐ‫᦭⊛❱⚵ޔ‬ലᕈߥߤߩⷰὐࠍ฽߼‫ޔ‬ኻ⽎ߦߣߞߡߩ
ലᨐࠍ⹏ଔߔࠆ‫ޠ‬7 ੱ(21.2%)ߩ᧦ઙઃ߈ℂ↱߿ୃᱜ᩺ߦߟ޿ߡߪ‫ޟޔ‬⢻ജ‫ߩޠ‬ᅷᒰᕈߣߒ
ߡ‫ޟ‬ኻ⽎ߦߣߞߡߩലᨐࠍ⹏ଔߪߢ߈ࠆߣᕁ߁߇‫↪⾌ޔ‬ኻലᨐߪ⚵❱⊛᦭ലᕈߦߥࠆߣ▤ℂߩⷰὐߩੱߪ⦟޿߇㔍ߒ޿‫ޟޠ‬CNS ߩቇ↢ߦ᳞߼ࠆ⢻ജߢ޽ࠆ‫ޟޔޠ‬㔍ߒߔ߉ࠆ‫ߩߣޠ‬ᗧ⷗߇޽ߞߚ‫ޕ‬ᢎ⢒ౝኈߣߒߡ‫ୃߩߢ߹੹ޟ‬჻⺖⒟ߩࠞ࡝ࠠࡘ࡜ࡓߢߪ޽߹ࠅ฽߹ࠇߡ޿
ߥ޿‫৻ޕ‬ㇱߩ㗔ၞߛߌߥߩߢ‫੹ޔ‬ᓟߎߩࠃ߁ߥⷞὐߪᄢಾ‫ߩߣޠ‬࿁╵߇ነߖࠄࠇߡ޿ߚ‫ޕ‬‫ޟ‬Υ㧙2 ࠤࠕߩ⾰ࠍᡷༀߔࠆߚ߼ߦࠛࡆ࠺ࡦࠬࠍ↪޿ߡ⚵❱߿㓸࿅߳௛߈߆ߌࠆ‫ޠ‬4 ੱ(12.1%)㗄⋡ߩ᧦ઙઃ߈ߩℂ↱ߪ‫ޔߪߡ޿ߟߦࠬࡦ࠺ࡆࠛޟޔ‬Σߩ⢻ജߦ฽߹ࠇࠆߩߢߪߥ
޿߆‫ߦ⾰ߩࠕࠤ⼔⋴ࠍ⾰ߩࠕࠤޟޠ‬ᢥ⸒ࠍୃᱜߔࠆ‫⸥ޠ‬タ߿‫ޟ‬CNS ⺖⒟ߩ㒮↢ߦ᳞߼ࠆ⢻ജߢߪߥ޿߆‫߁޿ߣߤߥޠ‬ᗧ⷗ߩ⸥タ߽ߐࠇߡ޿ߚ‫৻ޕ‬ᣇ‫ޔ‬Υ㧙2 ߩ㗄⋡ߦ‫ޟ‬หᗧߒߥ޿‫ޠ‬3 ੱ㧔9.1㧑㧕ߣߩ࿁╵ߩℂ↱ߣߒߡ‫ޟޔ‬⢻ജߩౝኈ‫ޟࠍޠ‬㊀ⶄߒߡ޿ࠆߚ߼ߦΣ࡮Τߦ㓸⚂ߔࠆ‫ߩߣޠ‬ᗧ⷗߇޽ߞߚ‫ޟޕ‬Υ㧙3 ᖱႎࠪࠬ࠹ࡓ‫∉ߣ⸘⛔ޔ‬ቇߩ⍮⼂ࠍ↪޿ߡ‫࠻࠙ࠕޔ‬ࠞࡓߩᡷༀ߿࡝ࠬࠢૐᷫߩߚ߼ߩᚢ⇛ࠍ┙ߡࠆ‫ޠ‬6 ੱ㧔18.2㧑㧕ߦ㑐ߒߡ‫᧦ޟޔ‬ઙߟ߈หᗧ
ߔࠆ‫ߩޠ‬࿁╵ߒߚ࿁╵⠪ߩᗧ⷗ߪ‫ޟޔ‬⢻ജ‫ߩޠ‬ᅷᒰᕈߣߒߡ‫ޟޔ‬೨ᦼ⺖⒟ߩోຬߪ㔍ߒ޿‫ޔޠ‬‫ޟ‬ᚢ⇛߹ߢน⢻ߣߪᕁ߃ߥ޿‫ޟޔޠ‬න⁛ߢߪ࿎㔍‫߿ࠬ࡯ࠤߥ⊛⥸৻ޕ‬੐⽎ߢ޽ࠇ߫⦟޿‫ޠ‬ߩ࿁╵߿ᢎ⢒ౝኈߦߟ޿ߡ‫ޟ‬චಽߥᢎ⢒ߦߪ෸߫ߥ޿‫ޔ‬CNS ⺖⒟ߩ㒮↢ߦ᳞߼ࠆ⢻ജߢ޽ࠆ‫ୃߩߢ߹੹ޟޔޠ‬჻⺖⒟ߩࠞ࡝ࠠࡘ࡜ࡓߢߪ޽߹ࠅ฽߹ࠇߡ޿ߥ޿‫৻ޕ‬ㇱߩ㗔ၞߛߌߥߩߢ‫੹ޔ‬ᓟߎߩࠃ߁ߥⷞὐߪᄢಾ‫ߩߤߥޠ‬ᗧ⷗߇⸥タߐࠇߡ޿ߚ‫ޟޕ‬Υ㧙4 ᡽╷⊛ߥⷰὐߢࠤࠕߩ⾰଻⸽߿࡝ࠬࠢࡑࡀࠫࡔࡦ࠻ࠍℂ⸃ߔࠆ‫ߪߢޠ‬㧔32 ੱਛ㧕6 ੱ㧔18.8㧑㧕߇‫ޔ‬‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈߩ⴫⃻ߣߒߡ‫ޟ‬ℂ⸃ߩ࡟ࡌ࡞ߛߌߢߪߥߊ‫ޔ‬ឭ᩺࡟ࡌ࡞ߣᕁ߁‫⷗ޟޔޠ‬಴ߒߦ⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡขࠅ⚵߻ߣߥߞߡ޿ࠆߩߢ‫ޔ‬ታⴕ࡟ࡌ࡞ߢ⴫⃻ߒߡ߽⦟޿ߣᕁ߁‫ߚߞ޿ߣޠ‬ᗧ⷗ࠍ⸥タߒ‫ୃޔ‬ᱜ᩺ߣߒߡ‫ޟ‬᡽╷⊛ߥⷰὐߢࠤࠕߩ⾰଻⸽߿࡝ࠬࠢࡑࡀࠫࡔࡦ࠻ࠍឭ᩺ߔࠆ‫⸥ߩߣޠ‬タ߇޽ߞߚ‫ߦ․ޕ‬ᢥ⸒ߩ⴫⃻ߣߒߡ‫߳ޠ⾰ߩࠕࠤ⼔⋴ࠍ⾰ߩࠕࠤޟޔ‬ᢥ⸒ߩୃᱜ߇᳞߼ࠄࠇߡ޿ߚ‫ޟޔߚ߹ޕ‬᡽╷⊛ߥⷰὐߢࠤࠕߩ⾰଻⸽߿࡝ࠬࠢࡑࡀࠫࡔࡦ࠻ࠍℂ⸃ߔࠆ‫ޟࠍޠ‬᡽╷⊛ߥⷰὐߢࠤࠕߩ⾰଻⸽߿࡝ࠬࠢࡑࡀࠫࡔࡦ࠻ߦߟ޿ߡ⷗⸃ࠍㅀߴࠆ‫ౕߤߥޠ‬૕⊛ߥ⴫⃻ᣇᴺࠍୃᱜߔࠆߥߤߣឭ᩺ߦ
㑐ߔࠆ⸥タ߇޽ߞߚ‫ޟޕ‬⢻ജߩౝኈ‫ޟޔߡߒߣޠ‬᡽╷⊛ⷞὐߦ┙ߟߎߣߪ‫⼔⋴ޔ‬᡽╷⺰߿⋴⼔▤ℂቇࠍቇ߱ᔅⷐ߇޽ࠆߩߢ‫ୃߩߡߴߔޔ‬჻⺖⒟ߢߪߘࠇࠄߩ⑼⋡߇↪ᗧߢ߈ࠆࠃ߁
ߦദജ⋡ᮡߣߥࠆ‫ޠ‬᩺߇⸥タߐࠇߡ޿ߚ‫ޔߦ․ޕ‬Υߩ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬㗅ᐨᕈߟ޿ߡ‫ޟޔ‬㧝㨪㧠ߩ⴫⸥ߩ㗅ࠍ⠨߃ࠆߣ‫“ޔ‬ℂ⸃ߔࠆ”ߣ޿߁ᦨೋߦᦠ߆ࠇߡ޿ࠆᣇ߇⦟޿ࠃ߁ߦᕁ߁߇‫ޔ‬޽ࠆ޿ߪΦߪ‫ޟ‬᡽╷⊛ߥⷰὐ‫ߦޠ‬ജὐ߇޽ࠆߩߢ޽ࠇ߫‫ޔ‬Ωߦ฽߼ࠆౝኈߢࠃ޿ߩ߆‫ࠤޕ‬ࠕߩ⾰଻⸽߿࡝ࠬࠢࡑࡀࠫࡔࡦ࠻ߩℂ⸃ߪ᡽╷⊛ߥⷰὐ߆ࠄߛߌ߆‫ߩߎޕ‬㗄⋡ߩ⌀ᗧ߇ߊߺߣࠅߦߊ޿‫ߩ╬ޠޕ‬ౝኈ߿㗅ᐨᕈߩᗧ⷗߇ߺࠄࠇߚ‫ޕ‬












－ 38 －

࿑ 5‫ޟ‬Υ㧚⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡขࠅ⚵߻‫ߦޠ‬ኻߔࠆหᗧ࿑ 6Υߩ‫ޟ‬⢻ജߩౝኈ‫ޠ‬㧔 㗄⋡㧕ߦኻߔࠆหᗧ

－ 39 －

㧠㧕‫ޟ‬Φ㧚ࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ࠕࠤޔ‬ⅣႺࠍᡷༀߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߦޠ‬ኻߔࠆหᗧ
ୃ჻ୃੌ↢ߩ߽ߟΦߩ‫ޟ‬⢻ജ‫ߦ⃻⴫ߩߡߒߣޠ‬ኻߒߡߩ࿁╵⠪ 33 ੱਛߩᄙߊ߇‫ޟ‬หᗧߔࠆ‫ޠ‬24 ੱ㧔72.7㧑㧕ߢ޽ࠅ‫ޔ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ޠ‬8 ੱ㧔24.2㧑㧕ߣ࿁╵ߒ‫ޟޔ‬หᗧߒߥ޿‫ߣޠ‬࿁╵ߒߚ⠪ߪ‫ ߆ߕࠊޔ‬1 ੱߢ޽ߞߚ㧔3.0㧑㧕㧔࿑ 7㧕‫ޔߒߛߚޕ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ޠ‬ߩ࿁╵ߩℂ↱߿ౕ૕⊛ߥୃᱜౝኈߩ᩺ߣߒߡ‫ޔ‬ᢥ┨⴫⃻߇‫ޟ‬ฃേᒻࠃࠅ⢻േᒻߩᣇ߇⴫⃻ߣߒߡㆡಾߣᕁ߁‫ߩߣޠ‬࿁╵߿ߘߩୃᱜ᩺ߣߒߡ‫߇ࠕࠤޟ‬ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓ‫ޠ‬ࠍ‫ࠍࠕࠤޟ‬ឭଏߒߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓߣߩ⺆የ߇หߓߢ޽ࠆߩߢ‫ࠅࠃޔ‬਄૏ߩ⴫⃻߇ࠃ޿‫ࠕࠤޟޔޠ‬ⅣႺࠍ⺞ᢛߔࠆ‫ޟޔޠ‬ᡷༀ߹ߚߪត᳞ߔࠆ‫⚻ޟޔޠ‬ᷣ⊛ߥಽᨆ߿ᡷༀߦෳട
ߢ߈ࠆ߆ߤ߁߆ ᔨߐࠇࠆߩߢ‫ޔ‬௛߈߆ߌࠆ‫ୃࠍ⃻⴫ߦޠ‬ᱜߔࠆߎߣࠍ⸥タߐࠇߡ޿ߚ‫ޕ‬․ߦ‫⃻⴫ޔ‬ᣇᴺࠍୃᱜߔࠆߎߣ‫߮ࠃ߅ޔ‬ᢥ⸒ߩ⴫⃻ᣇᴺߩ⛔৻ࠍ࿑ࠆߚ߼ߩᗧ⷗ߣߒߡ‫ޔ‬‫ޟ‬Υߩ‫ޟ‬⢻ജ‫ޔ⼔⋴ߪߢޠ‬Φߩ‫ޟ‬⢻ജ‫⸥ߣࠕࠤߪߢޠ‬タߐࠇߡ߅ࠅ‫ߚߒ৻⛔ߪ⃻⴫ޔ‬ᣇ߇⦟޿‫ߩߣࠆߔ৻⛔ߦޠࠕࠤ⼔⋴ޟࠍޠࠕࠤޟ߮ࠃ߅ޔߣߎޠ‬ᗧ⷗߇޽ߞߚ‫ޟߚ߹ޕ‬⢻ജ‫ޠ‬ߩᅷᒰᕈߣߒߡ‫ࠕࠤޟޔ‬ⅣႺߩᡷༀߦขࠅ⚵߻‫ࠕࠤޟޠ‬ⅣႺߩᡷༀ߹ߢߪ߻ߕ߆ߒ޿‫ߣޠ‬ߩᗧ⷗ߩ⸥タ߇ߺࠄࠇߚ‫ޕ‬ߎࠇࠄߩᗧ⷗ࠍᬌ⸛ߒߚ਄ߢ‫ߩޠࠕࠤ⼔⋴ޟߣޠࠕࠤޟޔ‬㆑޿ࠍ᣿⏕ߦ⺑᣿ߔࠆᔅⷐ߇
޽ߞߚ‫⾰ޔߡߞ߇ߚߒޕ‬໧⚕㧔⾗ᢱ 4㧕ߩᵈ㉼ߦ‫⼔⋴ߪޠࠕࠤޟ‬⡯߇ᄙ⡯⒳ߣද௛ߒߡⴕ߁
ታ〣‫⼔⋴ߪޠ⼔⋴ޟޔ‬⡯߇ⴕ߁ታ〣ߣߒߡឭ␜ߒߚ‫ޕ‬ԙ䇸⢻ജ䈱ౝኈ䇹䋨4 㗄⋡䋩䈮ኻ䈜䉎หᗧΦߩ‫ޟ‬⢻ജߩౝኈ‫ޟߡ޿ߟߦޠ‬หᗧߔࠆ‫ޠ‬㨪‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ࠍޠ‬วࠊߖࠆߣߔߴ
ߡߩ㗄⋡߇ 30 ੱ㨪31 ੱ㧔90.9㨪93.9㧑㧕ߢ޽ࠅ‫ޔ‬ᄙߊߩ࿁╵⠪߇ୃ჻⺖⒟ߩୃੌ⠪߇ୃᓧߔߴ߈‫ޟ‬⢻ജߩౝኈ‫ߡߒߣޠ‬หᗧߒߡ޿ߚ㧔࿑ 8㧕‫ޟޕ‬หᗧߔࠆ‫ߣޠ‬࿁╵ߒߚ 80㧑એ਄ߩ㗄⋡ߪ‫ޟ‬Φ㧙1 ୘ߣ⚵❱ߩਔ஥㕙߆ࠄ‫ޠࠆ߃ᝒߡߒߣࡓ࠹ࠬࠪࠍ⼔⋴ޔ‬29 ੱ㧔90.6㧑㧕߇㜞ߊ‫ޔ‬ᰴߦ‫ޟ‬Φ㧙2 ࠤࠕⅣႺߣߒߡߩ⚵❱ࠍಽᨆߒ‫⺖ޔ‬㗴⸃᳿ߩߚ߼ߩᣇ⇛ࠍឭ᩺ߔࠆ‫ޠ‬
27 ੱ㧔81.8㧑㧕ߩ 2 㗄⋡ߢ޽ߞߚ‫߽ᦨޕ‬ૐ߆ߞߚߩߪ‫ޟ‬Φ㧙3 ኻ⽎ਛᔃߩࠤࠕࠍታ〣ߔࠆߦᒰߚࠅ‫ޔ‬ᔅⷐߣߥࠆᄙ⡯⒳߿⾗ḮࠍᏎ߈ㄟߺߥ߇ࠄࠤࠕⅣႺࠍᡷༀߔࠆ‫ޠ‬22 ੱ㧔68.8㧑㧕ߢ޽ߞߚ‫ޟޕ‬Φ㧙1 ୘ߣ⚵❱ߩਔ஥㕙߆ࠄ‫᧦ࠆߌ߅ߦޠࠆ߃ᝒߡߒߣࡓ࠹ࠬࠪࠍ⼔⋴ޔ‬ઙઃ߈หᗧߪ 1 ੱ(3.1%)ߢ޽ࠅ‫ߩߘޔ‬ℂ↱ߣߒߡ‫ߩߎޟ‬⢻ജߪ⋴⼔Ꮷߩ⢻ജߢߪߥ޿߆‫ߩߣޠ‬⸥タ߇޽ߞߚ‫ޟޕ‬Φ㧙2 ࠤࠕⅣႺߣߒߡߩ⚵❱ࠍಽᨆߒ‫⺖ޔ‬㗴⸃᳿ߩߚ߼ߩᣇ⇛ࠍឭ᩺ߔࠆ‫ޠ‬4 ੱ㧔12.1㧑㧕ߩ‫ޟ‬⢻ജߩౝኈ‫ޠ‬ኻߔࠆ᧦ઙઃ߈ߩℂ↱ߣߒߡ‫ޟߩߎޔ‬⢻ജߩౝኈ‫ߪޠ‬‫ޟ‬CNS ⺖⒟ߩ㒮↢ߦ᳞߼ࠆ“⢻ജ”‫ߩߣޠ‬ᗧ⷗߇޽ߞߚ‫ޟޕ‬Φ㧙3 ኻ⽎ਛᔃߩࠤࠕࠍታ〣ߔࠆߦᒰߚࠅ‫ޔ‬ᔅⷐߣߥࠆᄙ⡯⒳߿⾗ḮࠍᏎ߈ㄟߺߥ߇ࠄࠤࠕⅣႺࠍᡷༀߔࠆ‫ޠ‬8 ੱ㧔25.0㧑㧕ߩ᧦ઙઃ߈ߩหᗧߩℂ↱ߣߒߡ‫⃻⴫ޔ‬ᣇᴺߦߟ޿ߡ‫“ޟ‬ᡷༀߦขࠅ⚵߻”ߣߔࠇ߫หᗧߢ߈ࠆ‫ޠ‬ߎߣ‫ޟޔ‬ᢥ┨߇㐳ߔ߉ࠆߚ߼‫ޔ‬૗߇ᔅⷐߥ⢻ജ߆ਇ᣿⍎‫ޟޔޠ‬ኻ⽎ਛᔃߩࠤࠕࠍታ〣ߔࠆߦᒰߚࠅߩ“ᒰߚࠅ”ࠍ೥㒰ߔࠆ‫ߩߣޠ‬ᗧ⷗߿‫ޟ‬ኻ⽎ਛᔃߩࠤࠕࠍታ〣ߔࠆ‫ࠍࠕࠤ⼔⋴ޟࠍޠ‬ታ〣ߔࠆߚ߼ߦ‫ୃߦޠ‬ᱜߔࠆߎߣ߿‫ޟ‬ᄙ⡯⒳ࠍᏎ߈ㄟ߻ߪ⋴⼔⡯߇ਛᔃߢ⚵❱߇ߔߴߡേ
ߊ⸶ߢߪߥ޿ߩߢද௛ߒߡ‫⾗ޔ‬Ḯࠍᵴ↪ߒߡⅣႺࠍᡷༀߔࠆ߇ᅷᒰߥ⴫⃻ࠍਈ߃ࠆ‫⾗ޟޔޠ‬Ḯ߇૗ࠍᗧ๧ߔࠆߩ߆ࠊ߆ࠅߦߊ޿‫߿ੱᧄޕ‬ኅᣖߥߩ߆‫ޔ‬਄มߣ߆▤ℂ⡯ߩᗧ߆‫ޔߤߥޠ‬޿ߊߟ߆ߩᗧ⷗߇⸥タߐࠇߡ޿ߚ‫ޟޔߚ߹ޕ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈߣߒߡ‫ޔ‬ౝኈ߇‫ޟ‬CNS－ 40 －

⺖⒟ߩ㒮↢ߦ᳞߼ࠆ⢻ജ‫⺖߁޿ߣޠ‬⒟ߦኻߔࠆ‫ޟ‬⢻ജ‫ߩ߳ޠ‬ᗧ⷗߇ㅀߴࠄࠇߡ޿ߚ‫ޟޕ‬Φ
㧙4 ⚵❱ߩ⺖㗴ߦߟ޿ߡᢎ⢒⊛ߦ௛߈߆ߌࠆ‫ޠ‬6 ੱ㧔18.2㧑㧕ߦߟ޿ߡߩ᧦ઙઃ߈ߩℂ↱ߣߒߡ‫ߡߒߣ⃻⴫ޔ‬ᢥ⸒ߦ‫“ޟ‬ᢎ⢒⊛ߦ”߇ߥߊߡ߽ࠃ޿ߩߢߪߥ޿߆‫߁޿ߣޠ‬ᗧ⷗߿‫ޟ‬⢻ജ‫ޠ‬ߩᅷᒰᕈߣߒߡ‫ޟ‬㜞ᐲߥታ〣ߛߣᕁ߁‫ޕ‬CNS ࠦ࡯ࠬߥࠄ㒮↢ߩ᳞߼ࠆ⢻ജߢ‫⎇ޔ‬ⓥࠦ࡯ࠬ
ߩ႐ว᳞߼ߥߊߡ߽ࠃ޿‫ౕޟޠࡓ࠹ࠬࠪ߿❱⚵ࠍ❱⚵ޟޠ‬૕⊛ߢߥ޿‫ߩߣޠ‬࿁╵߿‫ࠇߛޟ‬ߦᢎ⢒⊛ߦ௛߈߆ߌࠆߩ߆‫ޔ‬௛߈߆ߌࠆኻ⽎ߩ⸥ㅀ߇ᔅⷐ‫ߩߣޠ‬ᗧ⷗߇⸥タߐࠇߡ޿ߚ‫ޕ‬หᗧߒߥ޿ℂ↱ߣߒߡ‫ޟޔ‬૗ߩߎߣ߆ࠃߊࠊ߆ࠄߥ޿‫߁޿ߣޠ‬ౝኈߩਇ᣿⍎ߐߩᗧ⷗ߩ⸥タ߽ߺࠄࠇߚ‫ޕ‬એ਄ߦࠃࠅ‫ޔ‬Φߩ‫ޟ‬⢻ജߩౝኈ‫ޔߪߡ޿ߟߦޠ‬Φߩ‫ޟ‬⢻ജ‫ߣޠ‬Φ́㧟ߩ‫ޟ‬⢻ജߩౝኈ‫ޠ‬ߦ‫޿૶ߩ⪲⸒߁޿ߣࠕࠤޟ‬ᣇߩ⛔৻ߔࠆ‫ߩޠࠕࠤޟޔ߁޿ߣޠ‬ᗧ๧ࠍ᣿⏕ߦߔࠆᔅⷐ߇޽
ߞߚ‫ޕ‬ᬌ⸛ߩ⚿ᨐ‫ޔ‬Φߩ‫ޟ‬⢻ജߩౝኈ‫⺑ߩޠ‬᣿ᢥߩਛߦ‫ࠆ޿↪ࠍޠࠕࠤޟߣޠ⼔⋴ޟ‬㓙ߩᗧ๧ߩ㆑޿ࠍ᣿⏕ߦ␜ߔߚ߼‫⼔⋴ߪࠕࠤޟޔ‬⡯߇ᄙ⡯⒳ߣද௛ߒߡⴕ߁ታ〣‫⼔⋴ߪ⼔⋴ޔ‬⡯߇ⴕ߁ታ〣ߣߒߡឭ␜‫⸥ޠ‬タߔࠆߎߣߦߒߚ‫ޔߚ߹ޕ‬Φ㧙㧟ߩ‫ޟ‬⢻ജߩౝኈ‫ߡ޿ߟߦޠ‬ߪ‫ޟޔ‬ታ〣ߔࠆߦᒰߚࠅߣ޿߁ᢥ⸒ߩ⴫⃻߇ਇㆡᒰߢ޽ࠆ‫ߩߣޠ‬ᗧ⷗ߦኻߒߡ‫ޔ‬Φߩ‫ޟ‬⢻ജ‫ࠍࠕࠤޟࠍ⃻⴫ߩޠ‬ታ〣ߔࠆߚ߼ߦᔅⷐߣߥࠆᄙ⡯⒳߿⾗ḮࠍᏎ߈ㄟߺߥ߇ࠄ‫ࠕࠤޔ‬ⅣႺߩᡷༀߦขࠅ⚵߻‫ߦޠ‬ᄌᦝߔࠆߎߣߦߒߚ‫ޕ‬㧔⴫ 12㧕࿑ 7‫ޟ‬Φࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ࠕࠤޔ‬ⅣႺࠍᡷༀߔࠆ‫ߦޠ‬ኻߔࠆหᗧ

－ 41 －

࿑ 8Φߩ‫ޟ‬⢻ജߩౝኈ‫ޠ‬㧔 㗄⋡㧕ߦኻߔࠆหᗧ㧡㧕‫ޟ‬Χࠤࠕࠍផㅴߢ߈ࠆ႐߿ੱ⊛ⅣႺࠍᢛ߃ࠆߚ߼ߦ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߦޠ‬ኻߔࠆหᗧ
ୃ჻ୃੌ↢ߩ߽ߟΧߩ‫ޟ‬⢻ജ‫ߦ⃻⴫ߩߡߒߣޠ‬ኻߒߡ‫ޔ‬࿁╵⠪ᄙߊ߇‫ޟ‬หᗧߔࠆ‫ޠ‬28 ੱ
㧔84.8㧑㧕ߢ޽ࠅ‫ޔ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ޠ‬4 ੱ㧔12.1㧑㧕ߣ࿁╵ߒ‫ޔ‬‫ޟ‬หᗧߒߥ޿‫ߣޠ‬࿁╵ߒߚ⠪ߪ‫ ߆ߕࠊޔ‬1 ੱߢ޽ߞߚ㧔3.0㧑㧕㧔࿑ 9㧕‫ޔߒߛߚޕ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ߩޠ‬࿁╵ߩℂ↱ߣߒߡ‫ߦޠࠕࠤ⼔⋴ࠍࠕࠤޟࠍ⃻⴫ޔ‬ᢥ⸒ࠍୃᱜߔࠆឭ᩺߇޽ߞߚ‫ޕ‬ԙ‫ޟ‬⢻ജߩౝኈ‫ޠ‬㧔 㗄⋡㧕ߦኻߔࠆหᗧ Χߩ‫ޟ‬⢻ജߩౝኈ‫ޟߡ޿ߟߦޠ‬หᗧߔࠆ‫ޠ‬㨪‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ࠍޠ‬วࠊߖࠆߣΧ㧙1
߆ࠄΧ㧙3 ߩߔߴߡߩ‫ޟ‬⢻ജߩౝኈ‫ޠ‬3 㗄⋡߇ 30 ੱ㨪31 ੱ㧔90.9㨪93.9㧑㧕ߢ޽ࠅ‫ޔ‬ᄙߊߩ࿁╵⠪߇ୃ჻⺖⒟ߩୃੌ⠪߇ୃᓧߔߴ߈‫ޟ‬⢻ജߩౝኈ‫ߡߒߣޠ‬หᗧߒߚ㧔࿑ 10㧕‫ޕ‬80%એ
਄߇‫ޟ‬หᗧߔࠆ‫ߣޠ‬࿁╵ߒߚ㗄⋡ߪ‫ޔ‬‫ޟ‬Χ㧙1 ᣂߒ޿⍮⼂߿ࡕ࠺࡞ࠍታ〣ߦዉ౉ߔࠆߚ߼ߩ
ᚻᴺࠍℂ⸃ߒ‫ߩߘޔ‬ታ⃻ߦะߌߡ࡝࡯࠳࡯ࠪ࠶ࡊࠍ⊒ើߔࠆ‫ޠ‬28 ੱ㧔84.8%㧕ߣ‫ޔ‬‫ޟ‬Χ㧙3 ᦨༀߩක≮ࠨ࡯ࡆࠬࠍឭଏߔࠆߚ߼ߦࠤࠕߩᡷༀࠍਥዉߔࠆ‫ޠ‬28 ੱ㧔84.8%㧕ߩ 2 ߟߢ޽ߞߚ‫ޕ‬Χ㧙3 ߩ᧦ઙઃ߈หᗧߩℂ↱ߣߒߡ‫ޟޔ‬ਥዉߪ㔍ߒ޿ߩߢߪߥ޿߆‫ޠ‬‫⚛ߩߘޟޔ‬࿾ࠍ⢒ᚑߔࠆ‫ୃߦޠ‬ᱜߔࠆ᩺߇⸥タߐࠇߡ޿ߚ‫ޟޕ‬หᗧߔࠆ‫ߩߣޠ‬࿁╵߇ઁߩ㗄⋡ߣᲧߴ‫ޔ‬ૐ߆ߞߚ㗄⋡ߪ‫ޟޔ‬Χ㧙2 㓸࿅߿⚵❱ߩ႐ߩ࠳ࠗ࠽ࡒ࠭ࡓࠍಽᨆߒ‫ޔ‬㓸࿅߿⚵❱ࠍേ߆ߔ‫ޠ‬22 ੱ
㧔66.7㧑㧕ߢ޽ߞߚ‫ޕ‬‫᧦ޟ‬ઙઃ߈หᗧ‫ߣޠ‬࿁╵ߒߚ 8 ੱ㧔24.2%㧕ߪ‫⧷ࠍ̍ࡓ࠭ࡒ࠽ࠗ࠳̌ޟ‬⺆ߢߪߥߊ‫ޔ‬ᣣᧄ⺆ߦࠊ߆ࠅ߿ߔ޿⴫⃻‫ୃߦޠ‬ᱜߔࠆߎߣ‫߿❱⚵ࠍ”ࡓ࠭ࡒ࠽ࠗ࠳“ޟޔ‬㓸࿅ߦᓇ㗀ࠍ෸߷ߔߎߣ߆ࠄ“ജേ”ߣᣣᧄ⺆ߦ⴫⸥ߒ‫“ޔ‬㓸࿅߿⚵❱ߩ႐ߩജቇ⊛․ᕈࠍಽᨆߒ

－ 42 －

㓸࿅߿⚵❱ࠍേ߆ߔ”ߣߔࠆ‫ޠ‬᩺߿‫ޟ‬CNS ߦ㒢ߞߚ⢻ജߢࠃ޿ߣ⠨߃ࠆ‫ޠ‬‫ޔ‬‫ޟ‬േ߆ߔࠃ߁ߦ௛
߈߆ߌࠆ‫⚛ߩߘޟޔޠ‬࿾ࠍ⢒ᚑߔࠆ‫“ޟޔޠ‬㓸࿅߿⚵❱ࠍേ߆ߔ”ࠍ“㓸࿅߿⚵❱ߦ௛߈߆ߌߡᄌ
ൻࠍ⿠ߎߔ”ߥߤ߇᜼ߍࠄࠇߡ޿ߚ‫ޕ‬એ਄ߦࠃࠅ‫ޔ‬Χߩ‫ޟ‬⢻ജߩౝኈ‫ޔߪߡ޿ߟߦޠ‬Χ㧙㧞ߩ‫ޟ‬⢻ജߩౝኈ‫ޟߦޠ‬หᗧߔࠆ‫ޠ‬ഀว߇ૐߊ‫ޔࠍ⪲⸒߁޿ߣޠࡓ࠭ࡒ࠽ࠗ࠳ޟޔ‬ᣣᧄ⺆ߩജേߣୃᱜߒ‫ޟޔ‬㧞㧚㓸࿅߿⚵❱ߩ႐ߩജേࠍಽᨆߒ‫ޔ‬㓸࿅߿⚵❱ࠍേ߆ߔ‫ޕߚߒߦ⃻⴫ޔ߁޿ߣޠ‬࿑ 9㧚‫ޟ‬Χࠤࠕࠍផㅴߢ߈ࠆ႐߿ੱ⊛ⅣႺࠍᢛ߃ࠆߚ߼ߦ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆ‫ߦޠ‬ኻߔ
ࠆหᗧ




࿑ 10Χߩ‫ޟ‬⢻ജߩౝኈ‫ޠ‬㧔 㗄⋡㧕ߦኻߔࠆหᗧ

㧢㧕‫ޟ‬Ψኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߦޠ‬ኻߔࠆหᗧ
ୃ჻ୃੌ↢ߩ߽ߟΨߩ‫ޟ‬⢻ജ‫ߦޠ‬ኻߒߡ‫ޔ‬࿁╵⠪㧔31 ੱ㧕ߩᄙߊ߇‫ޟ‬หᗧߔࠆ‫ޠ‬27 ੱ㧔87.1㧑㧕‫ޔ‬－ 43 －

‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ޠ‬4 ੱ㧔12.9㧑㧕ߣ࿁╵ߒߡ޿ߚ㧔࿑ 11㧕‫᧦ޟޔߒߛߚޕ‬ઙઃ߈ߢห
ᗧߔࠆ‫ߩޠ‬࿁╵ߩℂ↱ߣߒߡ‫ޔ‬‫“ޟ‬ኾ㐷ᕈࠍዅ㊀ߔࠆ”ߪቇㇱࠍතᬺߒߚ⋴⼔Ꮷ߇ᒰὼᜬߞߡ
޿ࠆၮ␆⊛ߥ⢻ജߢ޽ࠅ‫ୃ߇⃻⴫ߥ߁ࠃߩߎޔ‬჻⺖⒟ୃੌ⠪࡟ࡌ࡞ߢ᳞߼ࠄࠇࠆ‫ޟ‬⢻ജ‫ޠ‬ߣ⴫⃻ߐࠇࠆߎߣߦ㆑๺ᗵࠍᜬߟ‫ޔߦࠄߐޕ‬ද௛ߦߪ‫“ޔ‬ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀”ߢߪߥߊ‫“ޔ‬ኾ㐷ᕈߩ․ᕈࠍℂ⸃”ߒߚᣇ߇ଦㅴߢ߈ࠆߣᕁ߁‫ޟ߿ޠ‬CNS ߩቇ↢ߩߺ‫ߦޠ‬ㆡ↪ߔࠆߥߤ‫ޟ‬⢻ജ‫ߩߡ޿ߟߦ࡞ࡌ࡟ߩޠ‬ᗧ⷗߇ߺࠄࠇߚ‫ޟޔߚ߹ޕ‬ฦኾ㐷⡯ߩ․ᕈࠍℂ⸃ߒߚ਄ߢ‫ޔ‬ᄙ⡯⒳㑆ߢዅ㊀ߒߚ㑐ଥࠍ߽ߜද௛ߢ߈ࠆᡰេࠍߔࠆ‫⃻⴫߿ޠ‬ᣇᴺߣߒߡ‫ޟ‬ၮᧄߣߥࠆ⢻ജࠍ⢒ߡࠆ‫ୃߩߤߥޠ‬ᱜ᩺ߩ⸥タ߇޽ߞߚ‫ޕ‬ԙ‫ޟ‬⢻ജߩౝኈ‫ޠ‬
㧔4 㗄⋡㧕ߦኻߔࠆหᗧ Ψߩ‫ޟ‬⢻ജߩౝኈ‫ޔߪߡ޿ߟߦޠ‬࿁╵⠪ 32 ੱਛ 31 ੱ㧔96.9%㧕߇‫ޟ‬หᗧߔࠆ‫ޠ‬㨪‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ޔࠅ޽ߢޠ‬ᄙߊߩ࿁╵⠪߇ୃ჻⺖⒟ߩୃੌ⠪߇ୃᓧߔߴ߈‫ޟ‬⢻ജߩౝኈ‫ޠ‬ߣߒߡหᗧߒߡ޿ߚ㧔࿑ 12㧕‫ޟޕ‬หᗧߔࠆ‫ߣޠ‬࿁╵ߒߚ 90%એ਄ߩ㗄⋡ߪ‫ޟޔ‬Ψ㧙1 ኾ㐷⡯㑆ߩലᨐ⊛ߥㅪ៤㑐ଥࠍ▽ߊߚ߼ߦ‫ޔ‬੕޿ࠍዅ㊀ߒߚࠦࡒࡘ࠾ࠤ࡯࡚ࠪࡦࠍߣࠆ‫ޠ‬29 ੱ
㧔90.6%㧕‫ޔ‬‫ޟ‬Ψ㧙2 ⋴⼔Ꮷ߿ઁ⡯⒳ߦኻߒߡ⋴⼔ߩᗧ࿑߿ᔅⷐᕈࠍ⺑᣿ߒ‫ޔ‬ද௛ߔࠆ‫ޠ‬30
ੱ㧔93.8%㧕ߢ޽ࠅ‫ ߩઁޔ‬2 㗄⋡ߪ‫ޟ‬Ψ㧙3 ኻ⽎ߩ⺖㗴ࠍนⷞൻߒ‫ઁޔ‬⡯⒳ߣද௛ߒߡ⸃᳿
ߦዉߊ‫ޠ‬25 ੱ㧔78.1㧑㧕‫ޔ‬‫ޟ‬Ψ㧙4 ࠦ࡯࠺ࠖࡀ࡯࠲࡯ߩᓎഀࠍᜂ޿‫ޔ‬ද௛ߩ౞Ṗൻࠍផㅴߔ
ࠆ‫ޠ‬24 ੱ㧔75.0㧑㧕ߣ߿߿ૐ߆ߞߚ‫ޕ‬ ᧦ઙઃ߈ߢหᗧߩℂ↱ߣୃᱜ᩺ߦߟ޿ߡ‫ޔ‬‫ޟ‬Ψ㧙1 ኾ㐷⡯㑆ߩലᨐ⊛ߥㅪ៤㑐ଥࠍ▽ߊߚ߼ߦ‫ޔ‬੕޿ࠍዅ㊀ߒߚࠦࡒࡘ࠾ࠤ࡯࡚ࠪࡦ ࠍߣࠆ‫ ߪߢޠ‬32 ੱਛ 2 ੱ㧔6.3㧑㧕߇‫⃻⴫ޔ‬ᣇ
ᴺߣߒߡ‫ୃޟ‬჻⺖⒟ୃੌ↢ࠍኻ⽎ߦߒߚᢥ┨⴫⃻ߣߥࠆᔅⷐ߇޽ࠅ‫“ޔ‬੕޿ࠍዅ㊀ߒߚࠦࡒࡘ࠾ࠤ࡯࡚ࠪࡦࠍߣࠆ”ߢߪ‫ޔ‬ቢోߦᢛวߒߥ޿‫߁޿ߣޠ‬࿁╵ࠍߒߡ߅ࠅ‫ߦࠇߘޔ‬ኻߔࠆ᩺ߣߒߡ‫ޟ‬ኾ㐷⡯㑆ߩലᨐ⊛ߥㅪ៤㑐ଥࠍ▽ߊߚ߼ߦ‫ޔ‬੕޿ࠍዅ㊀ߒߚࠦࡒࡘ࠾ࠤ࡯࡚ࠪࡦ
߇ߣࠇࠆᡰេࠍߔࠆ‫ޠ‬‫ޔ‬‫“ޟ‬ዅ㊀ߒߚࠦࡒࡘ࠾ࠤ࡯࡚ࠪࡦࠍߣࠆ”ࠍ“ዅ㊀ߒߡࠦࡒࡘ࠾ࠤ࡯ࠪ
࡚ࡦߔࠆ”‫ୃߦޠ‬ᱜߔࠆߎߣߩ⸥タ߇޽ߞߚ‫ޟߩߎޔߚ߹ޕ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈߣߒߡ‫“ޟ‬CNS
ߩቇ↢ߩߺ”‫ߩߣޠ‬࿁╵߇ߺࠄࠇߚ‫ޕ‬‫ޟ‬Ψ㧙2 ⋴⼔Ꮷ߿ઁ⡯⒳ߦኻߒߡ‫ߩ⼔⋴ޔ‬ᗧ࿑߿ᔅⷐᕈ
ࠍ⺑᣿ߒ‫ޔ‬ද௛ߔࠆ‫ޠ‬1 ੱ㧔3.1%㧕ߢ߽‫ޟ‬CNS ߩቇ↢ߩߺ‫ߩߣޠ‬ᗧ⷗߇޽ߞߚ‫ޔߚ߹ޕ‬‫ޟ‬Ψ
㧙3 ኻ⽎ߩ⺖㗴ࠍนⷞൻߒ‫ઁޔ‬⡯⒳ߣද௛ߒߡ⸃᳿ߦዉߊ‫ߩޠ‬㗄⋡ߢߪ‫ޔ‬6 ੱ㧔18.8㧑㧕߇᧦ઙઃ߈ߣߒ‫ޔ‬‫ޟ‬CNS ߩቇ↢ߩߺ‫ࠍޠ‬ኻ⽎ߣߔࠆ‫ޟ‬⢻ജ‫߿ߣߎࠆ޽ߢޠ‬ᢥ⸒ߩ⴫⃻ౝኈߩୃᱜߦ߅޿ߡ‫ޔ‬‫ޟ‬ዉߊߩߪ࡝࡯࠳࡯⊛ᓎഀࠍᕁࠊߖࠆߩߢ‫⸃ޔ‬᳿ߦߟߥߍࠆ‫ઁޟ߿ޠ‬⡯⒳ߪน
ⷞൻߢ߈ࠆߎߣ߇ᄙ޿ߣߒߡ߽‫߽ᦨߪ⼔⋴ޔ‬นⷞൻߢ߈ߥ޿⃻ታࠍᛒߞߡ޿ࠆࠃ߁ߦᕁ߃
ࠆ‫ޟޔޠ‬ዉߊࠃ߁௛߈߆ߌࠆ‫ߩ╬ޠ‬ᗧ⷗߇ነߖࠄࠇߚ‫ޟޕ‬Ψ㧙㧠ࠦ࡯࠺ࠖࡀ࡯࠲࡯ߩᓎഀࠍ
ᜂ޿‫ޔ‬ද௛ߩ౞Ṗൻࠍផㅴߔࠆ‫ޠ‬7 ੱ㧔21.9㧑㧕ߩ㗄⋡ߦߟ޿ߡߩ⴫⃻ࠍ‫ޟ‬ᄙ⡯⒳㑆ߩㅪ៤ߦ߅޿ߡࠦ࡯࠺ࠖࡀ࡯࠲࡯ߩᓎഀࠍᜂ޿‫ޔ‬ද௛ߩ౞Ṗൻࠍផㅴߔࠆ‫ޟޠ‬ද௛ߦߪ⍮⊛⋧੕૞↪ࠍଦㅴߔࠆࡈࠔࠪ࡝࠹࡯࠲࡯߇ᔅⷐߢ޽ࠆ‫ࠍ࡯࠲࡯࠹࡝ࠪࠔࡈߦ࡯࠲࡯ࡀࠖ࠺࡯ࠦޕ‬ട߃ࠆ‫ୃߩߤߥޠ‬ᱜ᩺߇⸥タߐࠇߡ޿ߚ‫ߦࠇߘޕ‬ട߃‫ޔ‬Ψ㧙4 ߦߟ޿ߡ߽‫ޔ‬‫ޟ‬CNS ኻ⽎ߣߒߚቇ↢ߩߺ‫߁޿ߣޠ‬ᗧ⷗߽⸥タߐࠇߡ޿ߚ‫ޕ‬એ਄ߦࠃࠅ‫ޔ‬Ψߩ‫ޟ‬⢻ജߩౝኈ‫ޔߪߡ޿ߟߦޠ‬Ψ㧙4 ߩ㗄⋡ߩ‫ޟ‬หᗧߔࠆ‫ߩޠ‬ഀว߇ૐߊ‫ޔ‬⴫⃻ࠍୃᱜߔࠆᔅⷐᕈ߇᳞߼ࠄࠇߡ޿ߚߩߢ‫ޔ‬ᰴߩ⺞ᩏ㗄⋡ߢߪ‫ޟ‬Ψ㧙4 ࠦ࡯࠺ࠖࡀ࡯࠲࡯
ߩᓎഀࠍᜂ޿‫ޔ‬ᄙ⡯⒳㑆ද௛ߩ౞Ṗൻࠍផㅴߔࠆ‫ߦޠ‬ᄌᦝߔࠆߎߣߣߒߚ‫ޕ‬－ 44 －


࿑ 11㧚‫ޟ‬Ψኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫ߦޠ‬ኻߔࠆหᗧ


࿑ 12Ψߩ‫ޟ‬⢻ജߩౝኈ‫ޠ‬㧔 㗄⋡㧕ߦኻߔࠆหᗧ㧣㧕‫ޟ‬Ω⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߦޠ‬ኻߔࠆหᗧ
Ωߩ‫ޟ‬⢻ജ‫ߦޠ‬ኻߒߡ‫ޔ‬࿁╵⠪㧔32 ੱ㧕ਛߩᄙߊ߇‫ޟ‬หᗧߔࠆ‫ޠ‬24 ੱ㧔75.0㧑㧕ߣ࿁╵ߒ‫ޔ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ޠ‬6 ੱ㧔18.8㧑㧕‫ޔ‬‫ޟ‬หᗧߒߥ޿‫ߣޠ‬࿁╵ߒߚ⠪ߪ 2 ੱ㧔6.3㧑㧕ߢ޽ߞߚ㧔࿑ 13㧕‫ޕ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ߩޠ‬࿁╵ߩℂ↱ߣߒߡ‫⃻⴫ޔ‬ᣇᴺ߇‫ޔ‬‫“ޟ‬ឭ᩺ߔࠆ”ߢߪਇචಽߢ‫ޔ‬‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬㗄⋡ߣห᭽ߥ⴫⃻ߦߥߞߡ޿ࠆ‫ߩߣޠ‬ᗧ⷗߇޽ߞߚ‫৻ޕ‬ᣇ‫ޔ‬‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈߣߒߡ‫“ޟ‬ឭ᩺ߢ߈ࠆ”߹ߢߦߪ⥋ࠄߥ޿‫ోޟ߿ޠ‬ຬ߇⸃᳿╷ߩឭ᩺ߪ㔍ߒ޿‫ޠ‬‫⸃ޟ‬᳿╷ࠍឭ᩺ߔࠆߣࠈߎࠈ߹ߢߪ᳞߼ߔ߉ߡ޿ߥ޿߆‫߁޿ߣޠ‬ᗧ⷗߇⸥タߐࠇߡ޿ߚ‫ޕ‬－ 45 －

ߘࠇߦട߃‫ޔ‬‫ޟ‬หᗧߒߥ޿‫ޠ‬2 ੱ㧔6.3㧑㧕ߩℂ↱ߣߒߡߪ‫⸃ޟޔ‬᳿╷ߩឭ᩺ߪ⋡ᮡߣߒߡ㜞ߔ߉ࠆ‫⸥ߣޠ‬タߐࠇߡ޿ߚ‫ޕ‬ԙ‫ޟ‬⢻ജߩౝኈ‫ޠ‬
㧔4 㗄⋡㧕ኻߔࠆหᗧ Ωߩ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬Ω㧙1 ߆ࠄΩ㧙4 ߦߟ޿ߡ‫ޔ‬33 ੱਛ 30 ੱ㨪31 ੱ㧔90.9㧑㨪93.9㧑㧕߇‫ޟ‬หᗧߔࠆ‫ޠ‬㨪‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ޔࠅ޽ߢޠ‬ᄙߊߩ࿁╵⠪߇ୃ჻⺖⒟ߩୃੌ⠪߇ୃᓧߔߴ߈‫ޟ‬⢻ജߩౝኈ‫ߡߒߣޠ‬หᗧߒߡ޿ߚ㧔࿑ 14㧕‫ޕ‬Ωߩ‫ޟ‬⢻ജߩౝኈ‫ޔߪޠ‬‫ޟ‬หᗧߔࠆ‫ޠ‬ߣߩ࿁╵߇ઁߩ‫ޟ‬⢻ജߩౝኈ‫ߣޠ‬Ყセߒߡ‫߿߿ޔ‬ૐ޿௑ะ߇ߺࠄࠇߚ‫ޕ‬4 㗄⋡ߩ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ਛߢ‫ޟ‬หᗧߔࠆ‫ߣޠ‬࿁╵ߒߚ 70%એ਄ߩ‫ޟ‬⢻ജߩౝኈ‫ޟߪޠ‬Ω㧙2 ⋴⼔ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯߇᡽╷ߦ෻ᤋߐࠇࠆࠃ߁ᣇ╷ࠍ⠨߃ࠆ‫ޠ‬25 ੱ㧔75.8㧑㧕ߩߺߢ޽ߞߚ‫ޕ‬ᰴ
ߩ 3 ߟߩ‫ޟ‬⢻ജߩౝኈ‫ޟߪޠ‬Ω㧙3 ⸻≮ႎ㈽߿੺⼔଻㒾ߥߤߩ᡽╷࡮೙ᐲ߇ࠤࠕឭଏᣇᴺ
߿ࠕ࠙࠻ࠞࡓߦ෸߷ߔᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ᩺ࠍឭ᩺ߔࠆ‫ޠ‬21 ੱ㧔63.6%㧕
‫ޟޔ‬Ω㧙1 ක≮᡽╷߇୘‫ޔ‬㓸࿅‫ߔࠄߚ߽ߦ❱⚵ޔ‬ᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍ⠨᩺ߔࠆ‫ޠ‬20 ੱ㧔60.6㧑㧕‫ޔ‬‫ޟ‬Ω㧙4ੱ‫ߩޘ‬ஜᐽჇㅴߣ޿߁ⷞὐ߆ࠄ‫ߩ⼔⋴ޔ‬᡽╷ࠍឭ᩺ߔࠆ‫ޠ‬19 ੱ㧔57.6㧑㧕㗅ߦૐ޿௑ะߢ
޽ߞߚ‫ޕ‬
᧦ઙઃ߈ߢหᗧߩℂ↱ߣߒߡ‫ޔ‬‫ޟ‬Ω㧙1 ක≮᡽╷߇୘‫ޔ‬㓸࿅‫ߔࠄߚ߽ߦ❱⚵ޔ‬ᓇ㗀ࠍಽᨆ‫ޟ‬೨ᦼ⺖⒟ߩߤߩ㗔ၞ‫ోޔ‬ຬߦߪ㔍ߒ޿‫ޔޠ‬ߒ‫ޔ‬ᡷༀ╷ࠍ⠨᩺ߔࠆ‫ޠ‬11 ੱ㧔33.3㧑㧕ߢߪ‫ޔ‬‫ޟ‬ኾ㐷ᕈ߇㜞޿ߚ߼‫ޔ‬ㆬᛯ⑼⋡ߣߒߡᔅⷐߥ㒮↢ߦኻߒߡ‫ߔࠄߚ߽ߦ❱⚵ޟޠ‬ᓇ㗀ࠍචಽ‫ޔ‬ಽᨆߒߡᡷༀ╷ࠍ⠨᩺ߢ߈ࠆ߆ߪ‫ޔ‬ቇ↢ߩ⢻ജߦࠃߞߡ⇣ߥࠆߩߢቇ↢ߦࠃߞߡߪദജ⋡ᮡߣߥࠆ‫ޠ‬‫ޟޔ‬ᓇ㗀ߩಽᨆ߹ߢߪน⢻ߢ޽ࠈ߁߇‫ޔ‬ᡷༀ╷߹ߢߪ㔍ߒߊߥ޿߆‫⺖ߩߤߥޠ‬⒟ߦ㑐ߔࠆᗧ⷗߿‫ޟޔ‬⠨᩺ߒߡߤ߁ߔࠆ‫“ޟ߿ޠ‬⠨᩺”ࠍ“ឭ᩺”ߦ⛔৻ߒߡߪߤ߁߆‫ޟޔޠ‬ක≮᡽╷߇୘‫ޔ‬㓸࿅‫ߔࠄߚ߽ߦ❱⚵ޔ‬ᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍ⠨᩺ߦขࠅ⚵߻‫ޟޔޠ‬ᬌ⸛ߔࠆߎߣ߇ߢ߈ࠆ‫ߩߤߥޠ‬ᢥ⸒ߩ⴫⃻ߩୃᱜ᩺߇⸥タߐࠇߡ޿ߚ‫ޟޔߚ߹ޕ‬Ω㧙2 ⋴⼔ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯߇᡽╷ߦ෻ᤋߐࠇࠆࠃ߁ᣇ╷ࠍ⠨߃ࠆ‫ޠ‬6 ੱ㧔18.2㧑㧕ߢߪ‫ޟࠍ⃻⴫ޔ‬⠨߃ࠆࠃࠅ߽‫৻ޔ‬ᱠㅴࠎߛ⴫⃻‫ୃߦޠ‬ᱜߒ‫⼔⋴ޟޔ‬ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯߇᡽╷ߦ෻ᤋߐࠇࠆࠃ߁ᣇ╷ࠍ┙ߡࠆ‫ࠆߔߣޠ‬ᗧ⷗߿‫ޟ‬ᬌ⸛ߔࠆߎߣ߇ߢ߈ࠆ‫⃻⴫ߦޠ‬ᣇᴺߩୃᱜࠍ᳞
߼ࠆᗧ⷗߽ߺࠄࠇߚ‫ޟޕ‬Ω㧙3 ⸻≮ႎ㈽߿੺⼔଻㒾ߥߤߩ᡽╷࡮೙ᐲ߇ࠤࠕឭଏᣇᴺ߿ࠕ
࠙࠻ࠞࡓߦ෸߷ߔᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ᩺ࠍឭ᩺ߔࠆ‫ޠ‬10 ੱ㧔30.3㧑㧕ߦߟ޿ߡߪ‫ޔ‬‫ޟ‬Ω㧙1ߣߩ⋧㆑߇ࠊ߆ࠅߦߊ޿‫ޔޠ‬‫ߦߎߤޟ‬ឭ᩺ߔࠆ߆‫ޟޔޠ‬೨ᦼ⺖⒟ߩߤߩ㗔ၞ‫ోޔ‬ຬߦߪ㔍ߒ޿‫ޠ‬‫ޟ‬ኾ㐷ᕈ߇㜞޿ߚ߼‫ޔ‬ㆬᛯ⑼⋡ߣߒߡᔅⷐߥ㒮↢ߦኻߒߡ‫ࠍࠬࡦ࠺ࡆࠛޔ‬૞ࠅ‫⹏ޔ‬ଔߒ‫ޔ‬ᡷༀ᩺ߩឭ␜ߢ߈ࠆ⢻ജߪ೔㆐ߦߪ㔍ߒߊ‫ޔ‬ඳ჻࡟ࡌ࡞߆߽ߒࠇߥ޿‫ޟߤߥޠ‬⢻ജߩౝኈ‫ޠ‬
ߩ㊀ⶄ߿ᅷᒰᕈߦ㑐ߔࠆᗧ⷗߇⸥タߐࠇߡ޿ߚ‫ޕ‬‫ޟ‬Ω㧙4 ੱ‫ߩޘ‬ஜᐽჇㅴߣ޿߁ⷞὐ߆ࠄ‫ޔ‬⋴⼔ߩ᡽╷ࠍឭ᩺ߔࠆ‫ޠ‬11 ੱ㧔33.3㧑㧕ߩ᧦ઙઃ߈หᗧߩℂ↱ߣߒߡ‫ߩߎޟޔ‬㗄⋡߇৻⇟਄ߦ߈ߚᣇ߇ࠃ޿‫߁޿ߣޠ‬㗅ᐨᕈߩᜰ៰߿‫ޟ‬ஜᐽჇㅴ‫ޟࠍޠ‬ஜᐽߩ⛽ᜬ࡮Ⴧㅴ‫ޠ‬෶ߪ‫ޟ‬QOL
ߩะ਄‫ߩޘੱޟޔޠ‬ஜᐽჇㅴ߅ࠃ߮↢ᵴߩ⾰ะ਄ߩⷞὐ߆ࠄ‫↢ߣޔ‬ᵴߩⷞὐࠍട߃ߡ߶ߒ
޿‫ୃߩ⃻⴫ߤߥޠ‬ᱜߩᗧ⷗߇⸥タߐࠇߡ޿ߚ‫ޕ‬Ωߩ‫ޟ‬⢻ജߩౝኈ‫ޔߪߡ޿ߟߦޠ‬Ω㧙㧞ࠍ㒰޿ߡ‫ޟ‬หᗧߔࠆ‫ߩޠ‬࿁╵߇߿߿ૐ޿௑ะ߇
޽ࠅ‫⃻⴫ޔ‬ౝኈࠍୃᱜߔࠆᔅⷐᕈ߇޽ࠆߣ⠨߃ࠄࠇߚ‫ޕ‬ട߃ߡ‫ޟޔ‬⢻ജߩౝኈ‫ߩޠ‬㗅ᐨᕈߦߟ޿ߡ߽ᬌ⸛ߒ‫ ⴫ޔ‬12 ߦ␜ߒߚࠃ߁ߦΏ㧠ࠍΩ-㧝ߦ➅ࠅ਄ߍ‫ᦨޔ‬ೋߩ㗄⋡ߩΩ-㧝㨪Ώ㧟ࠍ➅ࠅਅߍߚ‫ޟޕ‬⢻ജߩౝኈ‫ୃߩ⃻⴫ߩޠ‬ᱜࠍ߅ߎߥ޿‫ޔ‬Ω-㧝ߪ‫ߩޘੱޟ‬ஜᐽჇㅴ－ 46 －

ߣ޿߁ⷞὐࠍ฽߼‫ߩ⼔⋴ޔ‬᡽╷ࠍᬌ⸛ߔࠆ‫ߦޠ‬ᄌᦝߒߚ‫ޕ‬Ω-㧞ߪ‫ޟ‬ක≮଻ஜ⑔␩᡽╷߇୘‫ޔ‬㓸࿅‫ߔࠄߚ߽ߦ❱⚵ޔ‬ᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍ⠨᩺ߔࠆ‫ޔޠ‬Ώ㧟ߪ‫⼔⋴ޟ‬ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯߇᡽╷ߦ෻ᤋߐࠇࠆࠃ߁ᣇ╷ࠍ⠨߃ࠆ‫ߦޠ‬ᄌᦝߒߚ‫ޕ‬Ώ㧠ߪ‫≮⸻ޟ‬ႎ㈽߿
੺⼔଻㒾ߥߤߩ‫ࠍޠ‬೥㒰ߒ‫⚻ޟ‬ᷣ߿᡽╷࡮೙ᐲ߇ࠤࠕឭଏᣇᴺ߿ࠕ࠙࠻ࠞࡓߦ෸߷ߔᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍឭ᩺ߔࠆ‫ୃߦ⃻⴫ޔ߁޿ߣޠ‬ᱜߒߚ‫ޕ‬࿑ 13‫ޟ‬Ω⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ‫ޠ‬ኻߔࠆหᗧ࿑ 14Ωߩ‫ޟ‬⢻ജߩౝኈ‫ޠ‬㧔 㗄⋡㧕ߦኻߔࠆหᗧ

－ 47 －

㧕‫ޟ‬Ϊ⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆᢎ⢒ⅣႺߠߊࠅߦขࠅ⚵߻‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߦޠ‬ኻߔࠆหᗧ
ୃ჻ୃੌ↢ߩ߽ߟΪߩ‫ޟ‬⢻ജ‫ߦޠ‬ኻߒߡ‫ޔ‬࿁╵⠪㧔32 ੱ㧕ߩᄙߊ߇‫ޟ‬หᗧߔࠆ‫ޠ‬28 ੱ㧔87.5㧑㧕ߣ࿁╵ߒ‫ޔ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ޠ‬3 ੱ㧔9.4㧑㧕‫ޔ‬‫ޟ‬หᗧߒߥ޿‫ޠ‬1 ੱ㧔3.1㧑㧕
‫ߚߞ޽ߢޔ‬㧔࿑
15㧕‫᧦ޟޕ‬ઙઃ߈ߢหᗧߔࠆ‫ߩޠ‬ℂ↱ߣߒߡ‫⼔⋴ޟߡ޿ߟߦ⃻⴫ޔ‬ቇߩ⸘↹⊛࡮ലᨐ⊛ߥᢎ
⢒ᣇᴺࠍឭ᩺ߔࠆ‫ޟࠍޠ‬ขࠅ⚵߻߹ߚߪត᳞ߔࠆ‫ୃߦޠ‬ᱜߔࠆ᩺߿‫ޟ‬㨪ᢎ⢒ⅣႺߠߊࠅߦ
ขࠅ⚵ߺ‫ޔ‬ᢎ⢒⊛ᓎഀࠍᨐߚߔ‫ߦޠ‬᜛ᄢߔࠆ᩺߇⸥タߐࠇߡ޿ߚ‫ޕ‬ԙ‫ޟ‬⢻ജߩౝኈ‫ޠ‬㧔 㗄⋡㧕ߦኻߔࠆหᗧ Ϊߩ‫ޟ‬⢻ജߩౝኈ‫ޔߪߡ޿ߟߦޠ‬‫ޟ‬หᗧߔࠆ‫ޠ‬㨪‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ࠍޠ‬วࠊߖࠆߣ 33
ੱਛ 32 ੱ㧔93.9㧑㨪97.0㧑㧕ߣ‫ߩߤࠎߣ߶ޔ‬࿁╵⠪߇ୃ჻⺖⒟ߩୃੌ⠪߇ୃᓧߔߴ߈‫ޟ‬⢻ജߩౝኈ‫ߡߒߣޠ‬หᗧߒߡ޿ߚ㧔࿑ 16㧕‫ޕ‬‫ޟ‬หᗧߔࠆ‫ߩޠ‬㗄⋡ߢ 80%એ਄ߩ㗄⋡ߪ‫ޟ‬Ϊ㧙2 ⋴⼔ቇߩ⸘↹⊛࡮ലᨐ⊛ߥᢎ⢒ᣇᴺࠍឭ᩺ߔࠆ‫ޠ‬28 ੱ㧔84.8㧑㧕ߩ 1 㗄⋡ߢ޽ߞߚ‫ޕ‬ᰴߦ 70%એ਄ߩ㗄⋡ߪ‫ޟ‬Ϊ㧙1 ቇ⠌⠪ߩ࠾࡯࠭ࠍᛠីߒ‫ޔ‬ቇ⠌⠪ߦ޽ࠊߖߚᢎ⢒ᴺࠍℂ⸃ߔࠆ‫ޠ‬26
ੱ㧔78.8㧑㧕ߢ޽ߞߚ‫ޕ‬‫᧦ޟ‬ઙઃ߈ߩหᗧ‫ߩޠ‬ℂ↱ߣߒߡ‫ޟ‬Ϊ㧙1 ቇ⠌⠪ߩ࠾࡯࠭ࠍᛠីߒ‫ޔ‬ቇ⠌⠪ߦ޽ࠊߖߚᢎ
⢒ᴺࠍℂ⸃ߔࠆ‫ޠ‬6 ੱ㧔18.2㧑㧕ߪ‫⃻⴫ޔ‬ᣇᴺߣߒߡ‫ޟ‬ᄢቇ㒮ୃੌ↢ߥߩߢ‫ޔ‬
̌ℂ⸃”ࠃࠅ߽
“ㆡᔕ”ߩࠃ߁ߦታ〣࡟ࡌ࡞ߢ⸥タߒߚᣇ߇⦟޿‫ޟ߿ޠ‬ᢎ⢒ᴺࠍᢎ⢒ᣇᴺ‫ୃߦޠ‬ᱜߔࠆᗧ⷗߇⸥タߐࠇߡ޿ߚ‫ߦࠇߘޕ‬ኻߒߡߩୃᱜ᩺ߣߒߡ‫ޟޔ‬ቇ⠌⠪ߩ࠾࡯࠭ࠍᛠីߒ‫ޔ‬ቇ⠌⠪ߦ޽ࠊ
ߖߚᢎ⢒ᴺࠍឭ᩺ߔࠆ‫ࠆߔߣޠ‬ឭ᩺߇⸥タߐࠇߡ޿ߚ‫ޟߩߎޕ‬⢻ജߩౝኈ‫ޟߪޠ‬CNS ߩᢎ⢒ߦ౉ࠆߩ߆‫ޠ‬‫⼔⋴ޟޔ‬ᢎ⢒ቇ෶ߪᢎ⢒ᣇᴺ⺰ߩ⑼⋡ߩ⸳ቯ߇ᔅⷐ‫ޟ߁޿ߣߤߥޠ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈߦ㑐ߔࠆᗧ⷗ߩ⸥タ߇ߺࠄࠇߚ‫৻ޕ‬ᣇ‫ޔ‬‫ޟ‬Ϊ㧙2 ⋴⼔ቇߩ⸘↹⊛࡮ലᨐ⊛ߥᢎ
⢒ᣇᴺࠍឭ᩺ߔࠆ‫᧦ޟߩޠ‬ઙઃ߈หᗧ‫ߩޠ‬ℂ↱ߣߒߡ‫ޔ‬ឭ᩺వߟ޿ߡߪ‫ߦ⺕ޟ‬ឭ᩺ߔࠆߩ
߆‫ޠ‬‫⥄ޟ‬ಽߩኾ㐷㗔ၞߦ㒢ࠆ‫߁޿ߣޠ‬ᗧ⷗߇⸥タߐࠇߡ޿ߚ‫৻ޕ‬ᣇ‫ޔ‬‫ޟ‬หᗧߒߥ޿ℂ↱‫ޠ‬3 ੱ
㧔9.1㧑㧕ߣߒߡ‫ޟ‬ᢥ┨ߩᗧ๧߇ࠊ߆ࠅߦߊ޿‫ୃߩ⃻⴫ߣޠ‬ᱜߩᗧ⷗߇⸥タߐࠇߡ޿ߚ‫ޕ‬ ‫ޟ‬⢻ജ‫ୃߩ⃻⴫ޔߪߡ޿ߟߦޠ‬ᱜߣߒߡ‫ޟ‬ᢎ⢒ߩⅣႺߠߊࠅߢ޽ࠆ⋡ᮡߩᬌ⸛‫ޟ߿ޠ‬ኻ⽎ߩቇ⠌࠾࡯࠭ߦኻߔࠆᢎ⢒⊛߆߆ࠊࠅࠍⴕ߁‫߁޿ߣޠ‬ឭ᩺߇⸥タߐࠇߡ޿ߚ‫ޟޔߚ߹ޕ‬⢻ജߩౝኈ‫⥃ޟߡߒߣޠ‬ᐥታ⠌ߦ߅ߌࠆࠤࠕ⃻႐஥ߩਥߚࠆᜰዉ⠪ߣߒߡⅣႺᢛ஻ߣ‫࠲ࠬޔ‬࠶ࡈਗ߮ߦቇ↢ߩᜰዉࠍⴕ߁‫ޠ‬‫ޔ‬‫ޟ‬ਥ૕ᕈࠍ⢒߻ᢎ⢒⊛ኻᔕࠍᎿᄦߢ߈ࠆ‫ࡘࡒࠦޟޔ߿ߣߎޠ‬࠾ࠤ࡯࡚ࠪࡦ⢻ജࠍ㜞߼ࠆ‫ߩߡోޕ‬ၮ␆ߣߥࠆࠦࡒࡘ࠾ࠤ࡯࡚ࠪࡦ⢻ജߩૐਅ߇ᦨㄭߩቇ
ㇱ↢࡮㒮↢ߦߺࠄࠇࠆߚ߼ߦߎߩࠃ߁ߥ⢻ജ߇ᔅⷐߣ⠨߃ࠆ‫ߩߣޠ‬ᢎ⢒㕙ߦኻߔࠆ⢻ജߦߟ޿ߡ߽ឭ᩺ߐࠇߡ޿ߚ‫ޕ‬એ਄ߦࠃࠅ‫ޔ‬Ϊߩᢎ⢒ߦ㑐ߒߡߩ‫ޟ‬⢻ജߩౝኈ‫ޔߪߡ޿ߟߦޠ‬೨ㅀߒߚ࿁╵⠪ߩᗧ⷗ࠍ෻ᤋߒ‫ޔ‬‫ޟ‬Ϊ㧙㧟ቇ⠌⠪ߩ࠾࡯࠭ߦวߞߚᢎ⢒⊛㑐ࠊࠅࠍⴕ߁‫ޠ‬‫ޟޔ‬Ϊ㧙㧠ቇ⠌߇ଦㅴߔࠆࠃ
߁ߦ‫ޔ‬ᢎ⢒ⅣႺࠍᢛ߃ࠆ‫ ߩޠ‬2 㗄⋡ࠍㅊടߒߚ㧔⴫ 12㧕‫ޕ‬－ 48 －

3.1%
9.4%

หᗧ䈜䉎
᧦ઙઃ䈐䈪หᗧ䈜䉎
หᗧ䈚䈭䈇
87.5%

n=32


࿑ 15‫ޟ‬Ϊ⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆᢎ⢒ⅣႺߠߊࠅߦขࠅ⚵߻‫ߦޠ‬ኻߔࠆหᗧ



࿑ 16㧚Ϊߩ‫ޟ‬⢻ജߩౝኈ‫ޠ‬㧔 㗄⋡㧕ߦኻߔࠆหᗧ㧥㧕‫ޟ‬Ϋ୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߦޠ‬ኻߔࠆหᗧ
Ϋߩ‫ޟ‬⢻ജ‫ߦޠ‬ኻߒߡ‫ޔ‬࿁╵⠪㧔32 ੱ㧕ߩᄙߊ߇‫ޟ‬หᗧߔࠆ‫ޠ‬30 ੱ㧔93.7㧑㧕ߣ࿁╵ߒ‫ޔ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ߣޠ‬࿁╵ߒߡ޿ߚ⠪ߪ 2 ੱ㧔6.3㧑㧕ߢ޽ߞߚ㧔࿑ 17㧕‫ޕ‬‫᧦ޟ‬ઙઃ߈ߢ
หᗧߔࠆ‫ߩޠ‬࿁╵ߩℂ↱ߣߒߡ‫୶ޟޔ‬ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߟߎߣߪ‫ޔ‬ቇㇱතᬺᤨߦၮ⋚ߣߒߡᣢߦୃᓧߒߡ޿ࠆ⢻ജߢ޽ࠆ‫ޟߚߞ޿ߣޠ‬⢻ജ‫ߩޠ‬ᅷᒰᕈߦ㑐ߔࠆ⸥タ߿‫ୃޔ‬჻⺖⒟ߩୃੌ⠪߇ୃᓧߔߴ߈‫ޟ‬⢻ജ‫⸥ߩߣߎ޿ߥߪߢޠ‬タ߇޽ߞߚ‫ୃޔߚ߹ޕ‬ᱜ᩺ߣߒߡ‫୶ޟ‬ℂ⊛࡮ᢥൻ⊛ᗵฃᕈߦ㑐ߒߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ‫⽿ޟޔޠ‬છߦߟ޿ߡត᳞ߔࠆ‫ߣޠ‬ߩ⸥タ߇ߺࠄࠇߚ‫ޕ‬－ 49 －

ԙ‫ޟ‬⢻ജߩౝኈ‫ޠ‬㧔 㗄⋡㧕ኻߔࠆหᗧ
‫ޟ‬⢻ജߩౝኈ‫ޟޔߡ޿ߟߦޠ‬หᗧߔࠆ‫ޠ‬㨪‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ࠍޠ‬วࠊߖࠆߣ 28 ੱ㨪
31 ੱ㧔87.6㧑㨪96.9㧑㧕ߣ㜞޿௑ะߦ޽ࠅ‫ޔ‬ᄙߊߩ࿁╵⠪߇ୃ჻⺖⒟ߩୃੌ⠪߇ୃᓧߔߴ
߈‫ޟ‬⢻ജߩౝኈ‫ߡߒߣޠ‬หᗧߒߡ޿ߚ㧔࿑ 18㧕‫ޕ‬‫ޟ‬หᗧߔࠆ‫ߩߣޠ‬࿁╵ߪ‫ޔ‬‫ޟ‬Ϋ㧙1 ୘ੱ࡮ኅᣖ࡮㓸࿅ߩᜬߟᢥൻ߿⢛᥊ࠍᛠីߒ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆ‫ޠ‬32 ੱਛ 27 ੱ㧔84.4㧑㧕‫ޔ‬‫ޟ‬Ϋ㧙2 ኻ⽎ߩᠩ⼔ߩ┙႐߆ࠄ‫ޔ‬቟ోߥࠤࠕⅣႺࠍଦㅴߒ‫୶ޔ‬ℂ⊛ታ〣ࠍ᥉෸ߔࠆ‫ޠ‬32 ੱਛ 26 ੱ
㧔81.3%㧕‫ޟ‬Ϋ㧙3 ୶ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆኻ⽎߿ኾ㐷⡯ࠍᡰេߔࠆߚ߼ߦ‫୶ޔ‬ℂߦ㑐ߔࠆℂ⺰ࠍᵴ↪ߔࠆ‫ޠ‬33 ੱਛ 29 ੱ㧔87.9㧑㧕ߣ 3 㗄⋡ߩߔߴߡ߇ 80%એ਄ࠍ⿥߃ߡ޿ߚ‫ޕ‬‫᧦ޟ‬ઙઃ߈ߢหᗧ‫ߩޠ‬ℂ↱ߣߒߡ‫ޟ‬Ϋ㧙1 ୘ੱ࡮ኅᣖ࡮㓸࿅ߩᜬߟᢥൻ߿⢛᥊ࠍᛠីߒ‫ޔ‬⋴⼔ࠍታ〣ߔࠆ‫ޠ‬4 ੱ㧔12.5㧑㧕ߢߪ‫ޔ‬ቇㇱߣߩౝኈߩ඙೎߿㆑޿ߦࠍ᣿⏕ߦߔࠆᔅⷐᕈߦ
ߟ޿ߡ㑐⸥タߐࠇߡ޿ߚ‫୶ޟޔߚ߹ޕ‬ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߟߎߣ‫ޔߚ߹ޔ‬ᢥൻ߿⢛᥊ࠍᛠីߒ⋴⼔ߔࠆߎߣߪ‫ޔ‬ቇㇱߩතᬺᤨߦၮ⋚ߣߒߡᣢߦୃᓧߒߡ޿ࠆ⢻ജߢ޽ࠆ‫߆ߣߎޠ‬ࠄ‫ୃޔ‬ᱜ᩺ߣߒߡ‫⼔⋴ޟ‬Ꮷ߇ࠤࠕ࿎㔍ߣᝒ߃ࠆኻ⽎ߦኻߒߡ߽‫ޔ‬㜞޿୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍ߽ߞߡ⊛⏕ߦኻ⽎ࠍᝒ߃‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆ‫ߩޠ‬᩺߇⸥タߐࠇߡ޿ߚ‫ޔߚ߹ޕ‬‫ޟ‬⢻ജߩౝ
ኈ‫߇⃻⴫ߩޠ‬ਇ᣿⏕ߢ޽ࠆߚ߼‫⃻⴫ޔ‬ᣇᴺߩୃᱜ᩺ߣߒߡ‫ޟ‬୘೎࡮ኅᣖ࡮㓸࿅ߩᜬߟᢥൻ
߿⢛᥊ࠍᛠីߒ‫୶ޔ‬ℂ⊛⺖㗴ࠍ᣿⏕ߦߔࠆ‫⸥ߩߣޠ‬タ߽ߺࠄࠇߚ‫ޔߚ߹ޕ‬‫ޟ‬⢛᥊߆ࠄ↢ᵴ⢛᥊ߦ‫ߣޠ‬ᢥ⸒ߩ⴫⃻ࠍୃᱜߔࠆ߽᩺ߺࠄࠇߚ‫ޕ‬‫ޟ‬Ϋ㧙2 ኻ⽎ߩᠩ⼔ߩ┙႐߆ࠄ‫ޔ‬቟ోߥࠤࠕ
ⅣႺࠍଦㅴߒ‫୶ޔ‬ℂ⊛ታ〣ࠍ᥉෸ߔࠆ‫ޠ‬2 ੱ㧔6.3%㧕ߦߟ޿ߡߪ‫“ޟࠍ⃻⴫ޔ‬᥉෸ߔࠆ”ࠍ“᥉෸ߐߖࠆ”ߦ‫ޠ‬ᢥ⸒ࠍୃᱜߔࠆឭ᩺߿‫ޟޔ‬ᢥ┨߇㐳޿ߩߢ‫̌ޔ‬ኻ⽎ߩᠩ⼔ߩ┙႐߆ࠄ̍ࠍ೥㒰‫ޟ‬⢻ജߩౝኈ‫ޠ‬ߦ߅޿ߡ‫ޟ‬หᗧߒߥ޿‫ޠ‬4 ੱ
㧔12.5㧑㧕
ߔࠆᗧ⷗߇⸥タߐࠇߡ޿ߚ‫৻ޕ‬ᣇ‫ޔ‬Ϋ㧙2 ߩℂ↱ߣߒߡ‫ޔ‬‫ޟ‬ᢥ┨ߩᗧ๧߇ਇ᣿⏕‫ޠ‬‫“ޟ‬᥉෸ߔࠆ”ߩᢥ⸒߇૗ࠍߔࠆߎߣࠍᗧ๧ߔࠆߩ߆ਇ᣿
⏕‫ߩߤߥޠ‬࿁╵߽ߺࠄࠇߚ‫ޕ‬‫ޟ‬Ϋ㧙3 ୶ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆኻ⽎߿ኾ㐷⡯ࠍᡰេߔࠆߚ
߼ߦ‫୶ޔ‬ℂߦ㑐ߔࠆℂ⺰ࠍᵴ↪ߔࠆ‫ޠ‬2 ੱ㧔6.1㧑㧕ߩ‫᧦ޟ‬ઙߟ߈หᗧߩℂ↱‫ޔߪߡ޿ߟߦޠ‬‫୶ޟ‬ℂߦ㑐ߔࠆℂ⺰ࠍᵴ↪ߒߡ‫୶ޔ‬ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆኻ⽎߿ኾ㐷⡯ࠍᡰᜬߔࠆ‫ޔޠ‬‫ޟ‬ᢥ┨߇㐳ߊ‫୶ޔ‬ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆኻ⽎߿ኾ㐷⡯ࠍᡰេߔࠆߚ߼ߦ߹ߢߩᢥ┨ࠍ೥㒰ߔࠆ‫ߣޠ‬ᢥ┨⴫⃻ߩୃᱜ᩺߇⸥タߐࠇߡ޿ߚ‫ޕ‬એ਄ߦࠃࠅ‫ޔ‬Ϋߩ⢻ജౝኈߦߟ޿ߡߪ೨ㅀߩᗧ⷗ࠍ෻ᤋߐߖߚ਄ߢ‫ޔ‬‫ޟ‬⢻ജߩౝኈ‫⴫ߩޠ‬⃻ࠍୃᱜߔࠆᔅⷐ߇޽ߞߚ‫ޔߢߎߘޕ‬‫ޟ‬Ϋ㧙㧞ኻ⽎ߩᠩ⼔ߩ┙႐߆ࠄ‫ޟࠍޠ‬Ϋ㧙㧞ኻ⽎ࠍᠩ‫ޟ‬Ϋ㧙3 ୶ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆኻ⽎߿ኾ㐷⡯ࠍ⼔ߔࠆ┙႐߆ࠄ‫ߣ߳ޠ‬ਅ✢ㇱࠍᄌᦝߒ‫ޔ‬ᡰេߔࠆߚ߼ߦ‫୶ޔ‬ℂߦ㑐ߔࠆℂ⺰ࠍᵴ↪ߔࠆ‫ߩޠ‬ਅ✢ㇱࠍ೥㒰ߒ‫ޟޔ‬Ϋ㧙㧟୶ℂߦ㑐ߔࠆℂ⺰ࠍᵴ↪ߒߡ‫୶ޔ‬ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆኻ⽎߿ኾ㐷⡯ࠍᡰេߔࠆ‫⃻⴫ߦޠ‬ᣇᴺࠍୃᱜ
ߒߚ‫ޕ‬－ 50 －

6.3%

หᗧ䈜䉎᧦ઙઃ䈐䈪หᗧ䈜䉎
หᗧ䈚䈭䈇

n=32

93.7%


࿑ 17‫ޟ‬Ϋ୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ‫ޠ‬ኻߔࠆหᗧ


࿑ 18Ϋߩ‫ޟ‬⢻ജߩౝኈ‫ޠ‬㧔 㗄⋡㧕ߦኻߔࠆหᗧ

㧕‫ޟ‬ά⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߦޠ‬ኻߔࠆหᗧ
άߩ‫ޟ‬⢻ജ‫ߦޠ‬ኻߒߡ࿁╵⠪㧔33 ੱ㧕ߩᄙߊ߇‫ޟ‬หᗧߔࠆ‫ޠ‬31 ੱ㧔93.9㧑㧕ߣ࿁╵ߒ‫ޔ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ޠ‬1 ੱ㧔3.0㧑㧕‫ޔ‬‫ޟ‬หᗧߒߥ޿‫ޠ‬1 ੱ㧔3.0㧑㧕ߣ࿁╵ߒߡ޿ߚ㧔࿑ 19㧕‫ޕ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ߩޠ‬ℂ↱ߣୃᱜ᩺ߣߒߡ‫ޟޔ‬ኾ㐷⡯ߣߒߡߩືቇࠍㅊⓥߔࠆ‫⃻⴫ߣޠ‬－ 51 －

ࠍୃᱜߔࠆᗧ⷗߇⸥タߐࠇߡ޿ߚ‫৻ޕ‬ᣇ‫ޔ‬หᗧߔࠆ߇‫ߩࠖ࠹ࠖ࠹ࡦ࠺ࠗࠕߩߎޟޔ‬ᒻᚑߪ⢻ജߣ޿߁ࠃࠅߪ߻ߒࠈࠠࡖ࡝ࠕ⊒㆐⺖㗴ߩࠃ߁ߦ߽ᕁ߃ࠆ‫ߩߣޠ‬ᗧ⷗ߩ⸥タ߇ߺࠄࠇߚ‫ޕ‬ԙ‫ޟ‬⢻ജߩౝኈ‫ޠ‬
㧔3 㗄⋡㧕ߦኻߔࠆหᗧ
‫ޟ‬⢻ജߩౝኈ‫ޔߡ޿ߟߦޠ‬࿁╵⠪ߩ 30㨪31 ੱਛ‫ޟ‬หᗧߔࠆ‫ޠ‬㨪‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ޠ‬ࠍวࠊߖࠆߣ 29 ੱ㨪30 ੱ㧔93.5㧑㨪96.8㧑㧕ߣ㜞޿௑ะߦ޽ࠅ‫ޔ‬ᄙߊߩ࿁╵⠪߇ୃ჻⺖⒟ߩୃੌ⠪߇ୃᓧߔߴ߈⢻ജߩౝኈߣߒߡหᗧߒߡ޿ߚ㧔࿑ 20㧕‫ޕ‬‫ޟ‬หᗧߔࠆ‫ߩߣޠ‬࿁╵߇ 90㧑એ਄ࠍ⿥߃ߚ‫ޟ‬⢻ജߩౝኈ‫ޟޔߪޠ‬ά㧙2 ⋴⼔ቇࠍขࠅᏎߊ⺖㗴ߦߟ޿ߡߩᗵฃᕈࠍ㜞߼‫ޔ‬ਥ૕ᕈࠍᜬߞߡᡷༀߔࠆ‫ޠ‬28 ੱ㧔90.3㧑㧕ߣ‫ޟ‬ά㧙4 ኾ㐷⡯ߣߒߡ⋴⼔ⷰࠍ᣿⏕ߦߔࠆ‫ޠ‬
27 ੱ㧔90.0㧑㧕ߩ 2 㗄⋡ߢ޽ߞߚ‫ޕ‬80%એ਄ߩ㗄⋡ߪ‫ޔ‬‫ޟ‬ά㧙3 ࠃࠅ⦟޿ࠤࠕࠍ᳿ቯߔࠆߚ
߼ߦᦨᣂߩ⍮⷗ࠍᓧߥ߇ࠄታ〣ߔࠆࡕ࠺࡞ߦߥࠆ‫ޠ‬26 ੱ㧔83.9㧑㧕‫ޔ‬‫ޟ‬ά㧙1 ⋴⼔߿ක≮ߦ㑐ߔࠆኾ㐷⡯ߣߒߡߩືቇࠍ⊒ዷߐߖ‫⼔⋴ޔ‬ታ〣ߦ⛔วߔࠆ‫ޠ‬25 ੱ㧔80.6㧑㧕ߢ޽ߞߚ‫ޕ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ޠ‬ℂ↱ߣߒߡ‫ޔ‬‫ޟ‬ά㧙1 ⋴⼔߿ක≮ߦ㑐ߔࠆኾ㐷⡯ߣߒߡߩືቇࠍ
⊒ዷߐߖ‫⼔⋴ޔ‬ታ〣ߦ⛔วߔࠆ‫ޠ‬4 ੱ㧔12.9㧑㧕ߢߪ‫ޔ‬‫⼔⋴ޟ‬ታ〣ߦ⛔วߔࠆᗧ๧߇ਇ᣿⍎‫ޔޠ‬‫ືޟ‬ቇߣ޿߁․ቯߩቇ໧ࠍ␜ߔߎߣߢࠃ޿߆‫ࠅ޽ޕ‬ᣇ‫߈↢ޔ‬ᣇ‫ޔࠇࠄߍ޽߇ޠ‬‫ޟ‬⢻ജߩౝኈ‫ޠ‬ߣߒߡਇ᣿⏕ߣߐࠇߡ޿ߚ‫ޟޔߚ߹ޕ‬᛽⽎⊛⺖㗴ߢߎߎ߹ߢߪ᳞߼ࠄࠇߥ޿ߩߢߪߥ޿߆‫ޠ‬‫ޟ‬ά㧙2 ⋴⼔ቇࠍข‫⚛ޟ‬࿾ࠍ㙃߁‫ޟߤߥޠ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈߦ㑐ߔࠆ⸥タ߇ߺࠄࠇߚ‫ޕ‬ࠅᏎߊ⺖㗴ߦߟ޿ߡߩᗵฃᕈࠍ㜞߼‫ޔ‬ਥ૕ᕈࠍᜬߞߡᡷༀߔࠆ‫ޠ‬2 ੱ㧔6.5%㧕ߢߪ‫ޔ‬‫ޟ‬ᡷༀߔࠆߪ㜞ᐲߢ޽ࠆߩߢ‫ޔ‬ਥ૕ᕈࠍᜬߞߡ⠨߃ࠆ‫ޟ߿ޠ‬ਥ૕⊛ߦᡷༀߔࠆ‫ޟߩߤߥޠ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈߦ㑐ߔࠆᗧ⷗߇⸥タߐࠇߡ޿ߚ‫ޟޕ‬Ϋ㧙3 ୶ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆኻ⽎߿ኾ㐷⡯ࠍᡰេߔࠆߚ߼ߦ‫୶ޔ‬ℂߦ㑐ߔࠆℂ⺰ࠍᵴ↪ߔࠆ‫ޠ‬4 ੱ㧔12.9㧑㧕ߢߪ‫ࡕޟࠍ⃻⴫ޔ‬࠺࡞ࠍᓎഀࡕ࠺࡞‫ߣޠ‬ᄌᦝߔࠆ᩺߿‫⎇߁ࠃࠆߥߦ࡞࠺ࡕޟ‬㐘ߔࠆ‫ߩ╬ޠ‬᩺߇⸥タߐࠇߡ޿ߚ‫ޕ‬‫ޟ‬ά㧙4 ኾ㐷⡯ߣߒߡ⋴⼔ⷰࠍ᣿⏕ߦߔࠆ‫ޠ‬2 ੱ㧔6.7㧑㧕ߢߪ‫ޔ‬‫⊒“ޔߪⷰ⼔⋴ޟ‬ዷߒߡ޿ߊ․ᕈ”߽ߒߊߪ“ᷓ߹ߞߡ޿ߊ․ᕈ”߇޽ࠆߣᕁ߁‫ޔࠅ߹ߟޕ‬േ⊛࡮ㆊ⒟⊛ߥ⴫⃻ߦߒߚᣇ߇⦟޿‫ߚߞ޿ߣޠ‬ᗧ⷗߇ߺࠄࠇߚ‫ୃޕ‬ᱜ᩺ߣߒߡߪ‫ࠍⷰ⼔⋴“ޟ‬ᷓ߼ࠆ”߽ߒߊߪ“⋴⼔ⷰࠍ⢒߻”‫ࠍⷰ⼔⋴“ޔ‬⢒ᚑߔࠆ”߹ߚߪ“⋴⼔ⷰࠍត᳞ߒ⛯ߌࠆ”‫ࠍⷰ⼔⋴ޟ߮ࠃ߅ޔߣߎޠ‬᣿⏕ߦߔࠆ‫ࠍⷰ⼔⋴ޟࠍޠ‬ᗧ⼂ߒ‫⊒ߩߘޔ‬ዷߦะߌߡ⎇㐘ࠍ㊀ߨࠆ‫ߤߥޠ‬ᢥ⸒ࠍୃᱜߔࠆ᩺߇⸥タߐࠇߡ޿ߚ‫ޕ‬એ਄ߩߐ߹ߑ߹ߥᗧ⷗߇ߺࠄࠇߚ߇‫ޔ‬άߩ‫ޟ‬⢻ജ‫ޟ߮ࠃ߅ޠ‬⢻ജߩౝኈ‫ޔߪߡ޿߅ߦޠ‬‫ޟ‬หᗧߔࠆ‫ߩߣޠ‬࿁╵߇ᄙ߆ߞߚߚ߼‫ޔ‬ᬌ⸛ߩ⚿ᨐ‫ୃߩ╬⃻⴫ޔ‬ᱜߪട߃ߥ߆ߞߚ‫ޕ‬－ 52 －


࿑ 19㧚‫ޟ‬ά⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ‫ޠ‬ኻߔࠆหᗧ


M/ᮡḰ M/ᮡḰ M/ᮡḰ M/ᮡḰ M/ᮡḰ M/ᮡḰ
ά䋭1 ⋴⼔䉇ක≮䈮㑐䈜䉎ኾ㐷⡯䈫䈚䈩䈱ືቇ䉕⊒ዷ䈘䈞䇮⋴⼔ታ〣䈮⛔ว䈜䉎n=31

80.6%

12.9%

6.5%

ά䋭2 ⋴⼔ቇ䉕ข䉍Ꮞ䈒⺖㗴䈮䈧䈇䈩䈱ᗵฃᕈ䉕㜞䉄䇮ਥ૕ᕈ䉕ᜬ䈦䈩ᡷༀ䈜䉎 n=31

90.3%

6.5% 3.2%

ά䋭3 䉋䉍⦟䈇䉬䉝䉕᳿ቯ䈜䉎䈢䉄䈮ᦨᣂ䈱⍮⷗䉕ᓧ䈭䈏䉌ታ〣䈜䉎䊝䊂䊦䈮䈭䉎 n=31

83.9%

12.9% 3.2%

ά䋭4 ኾ㐷⡯䈫䈚䈩⋴⼔ⷰ䉕᣿⏕䈮䈜䉎

90.0%

6.7% 3.3%

n=30

หᗧ䈜䉎

᧦ઙઃ䈐䈪หᗧ䈜䉎หᗧ䈚䈭䈇࿑ 20㧚άߩ‫ޟ‬⢻ജߩౝኈ‫ޠ‬㧔 㗄⋡㧕ߦኻߔࠆหᗧ  ⥄↱⸥タ⥄↱⸥タߦߟ޿ߡߪ‫ޔ‬એਅߩౝኈ߇⸥タߐࠇߡ޿ߚ‫ޕ‬㧔㧝㧕 ೔㆐ᐲߩ㆑޿
‫⎇ޟ‬ⓥࠦ࡯ࠬ‫ޔ‬CNS ࠦ࡯ࠬߩ㆑޿ߦࠃߞߡߪ᳞߼ࠆౝኈ߇㆑߁‫ޔ߿ߣߎޠ‬Σ㧙Τߪ‫ޔ‬‫ޟ‬㜞ᐲߥታ〣ߪઁߩ‛߽‫ޔ‬൮᜝ߐࠇࠆߩߢߪߥ޿߆‫ߩߣޠ‬ᗧ⷗߿‫ޟ‬᳞߼ࠆ࡟ࡌ࡞߇ᛠី
ߒߦߊ޿‫ޠ‬‫ߩߟ৻ޟޔ‬ౝኈߦ‫ޔ‬ੑߟߩ⢻ജ߇฽߹ࠇߡ޿ࠆ⴫⃻߇ᄙ޿‫ޠ‬㊀ⶄߒߚౝኈࠍᢛ

－ 53 －

ℂߔࠆߣ޿߁ᗧ⷗ߩ⸥タ߇ߺࠄࠇߚ‫ޕ‬㧔㧞㧕⴫⃻
‫߇⺆↪߁޿ߣࠬࡦ࠺ࡆࠛޟ‬ᄙㆊ߉ࠆߩߢ‫▸ߩߤࠍࠬࡦ࠺ࡆࠛޔ‬࿐ߢ↪޿ࠆ߆ߣ⛔৻ߔࠆ‫ߩߣߎޠ‬ᗧ⷗߿‫ޟޔ‬̌⋴⼔̍ߣ̌ࠤࠕ̍ߩ⴫⃻߇ᷙ࿷ߒߡ޿ࠆߩߢ‫⋴̌ࠍ̍ࠕࠤ⼔⋴̌ޔ‬⼔ߩࠤࠕ̍ߩߺߣߒ‫ޔ‬ක≮ో૕ߩࠤࠕߪ̌ࠤࠕ̍ߣߔࠆߣߒߡᗧ๧ࠍ⛔৻ߔࠆ‫ߣࠕࠤޠ‬⋴⼔ߩᗧ๧ࠍ᣿⏕ߦߔࠆᗧ⷗߽⸥タߐࠇߡ޿ߚ‫ޕ‬㧔㧟㧕‫ޟ‬⢻ജ‫ߦޠ‬ኻߔࠆ㗄⋡‫ޟ‬㗄⋡ᢙࠍ 77 㗄⋡߆ࠄ 40 㗄⋡ߦߒߚߚ߼ߦ᛽⽎ᐲ߇Ⴧߒ‫ޔ‬ਇ᣿⍎ߣߥߞߚ‫ߩߣޠ‬ᗧ⷗߿‫ޔ‬‫ୃޟ‬჻⺖⒟߇‫ޔ‬⢒ᚑߔࠆੱ᧚௝߇޿ߊߟ߆ᗐቯߐࠇࠆߩߢ‫౒ߦߡߴߔޔ‬ㅢߐߖࠆߥࠄ
߫‫ޔ‬㗄⋡ᢙࠍ೥ᷫߔࠆ‫ߩߣޠ‬ᗧ⷗߽޽ߞߚ‫ޔߚ߹ޕ‬Ωߩࡄࡉ࡝࠶ࠢࡋ࡞ࠬߩⷰὐࠍ᳞߼
ࠆ‫ޟ‬⢻ജ‫ߩߡ޿ߟߦޠ‬ᬌ⸛߽⸥タߐࠇߡ޿ߚ‫∔ޟޔߚ߹ޕ‬ᖚࠍ߽ߟੱߛߌߥߊ‫ޔ‬㓚⎹ࠍᜬߟੱ߽⋴⼔ߩኻ⽎⠪ߩⷞ㊁ߦ౉ࠇ‫ࠬࠣࡦ࡟࠻ࠬޔ‬㧔ᒝߺ㧕ࠍᵴ߆ߒߚេഥࠍⴕ߁ߣ޿߁
‫ޟ‬⢻ജ‫ࠍޠ‬ㅊ⸥ߔࠆᗧ⷗߽⸥タߐࠇߡ޿ߚ‫ޕ‬㧔㧠㧕ᢎ⢒ᣇᴺ࡮ౝኈߩᬌ⸛
ୃ჻೨ᦼ⺖⒟ߩᢎ⢒ߢୃᓧࠍ⋡ᜰߔߚ߼ߩᢎ⢒ᣇᴺ߿ౝኈߦߟ޿ߡߪ‫ޔ‬‫ߩⴕ⃻ޟ‬ኾ㐷ಽ
㊁ߩᢎ⢒ౝኈߦਇ⿷ߔࠆ߽ߩ߇ᄙߊ‫੹ޔ‬ᓟߦᬌ⸛ߩᔅⷐᕈ߇޽ࠆ‫⸥߇ߣߎޠ‬タߐࠇߡ޿ߚ‫ޕ‬㧔㧡㧕ᗵᗐ
‫ޟ‬⢻ജ‫ޟߪߡ޿ߟߦޠ‬ታ〣࡟ࡌ࡞ߢ޽ࠅ‫ޔ‬㜞ᐲኾ㐷⡯ᬺੱ㙃ᚑߦ஍ߞߡ޿ࠆߩߢ‫ޔ‬ត᳞ߔࠆ߇޽ߞߡ߽⦟޿‫ߩߣޠ‬ᗧ⷗߇޽ߞߚ‫ࠍ࠼࡯࠳ࡦ࠲ࠬ࡞ࡃ࡯ࡠࠣޔߚ߹ޕ‬᣿⏕ൻߔࠆߎߣߪ‫⼔⋴ޔ‬ቇߩ⊒ዷߦਇนᰳߩ⷗⼂ߣ⹺⼂ߒ‫ߩ࠼࡯࠳ࡦ࠲ࠬޔ‬ሽ࿷ߦࠃࠅ‫ޔ‬ᣣᧄߩ⋴⼔ቇߦ߅ߌࠆᄢቇ㒮ᢎ⢒ߩ⊒ዷ߿ඳ჻ᓟᦼ⺖⒟ߣߩ㑐ଥࠍ඙೎ߒߡᬌ⸛ߔࠆߎߣߩᔅⷐᕈߦ
ߟ޿ߡߩᗧ⷗߽⸥タߐࠇߡ޿ߚ‫ޕ‬㧟㧚⠨ኤᦨ⚳⾰໧⚕⺞ᩏࠍታᣉߔࠆߦ޽ߚࠅ‫⎇ᧄޔ‬ⓥࡊࡠࠫࠚࠢ࠻ᆔຬߦࠃࠆળ⼏ࠍ㐿௅ߒ‫ޔ‬ᬌ⸛ࠍⴕߞߚ‫੹ޕ‬࿁ߩ⾰໧⚕⺞ᩏߩ⚿ᨐߢߪ‫ޔ‬10 ߩ‫ޟ‬⢻ജ‫߷߶߈ߟߦޠ‬หᗧ߇ᓧࠄࠇߚߎ
ߣࠍ⏕⹺ߒߚ‫ޕ‬‫ޟ‬หᗧߔࠆ‫ߩޠ‬㗄⋡߇ 70㧑એਅߩ㗄⋡ߦ㑐ߒߡߪㅊട࡮ୃᱜߩౝኈࠍᬌ⸛
ߒߚ‫⾰ޕ‬໧⚕ߩ࿁╵ߦ߅޿ߡ‫ޟޔ‬หᗧߔࠆ‫ ߇ޠ‬80㧑એ਄ࠍ⿥߃ߚ‫ޟ‬⢻ജߩౝኈ‫ୃߪޠ‬ᱜ߿೥㒰ߪၮᧄ⊛ߦߪⴕߥࠊߕ‫⾰ߩ⚳ᦨޔ‬໧⚕⺞ᩏߢᗧ⷗ࠍ໧߁ߎߣߦߒߚ‫ޕ‬Σ㨪άߩ‫ޟ‬⢻ജ‫ޔߪߡ޿ߟߦޠ‬࿁╵⠪ߩ 9 ഀએ਄߇‫ޟ‬หᗧ‫⚿ߚ޿ߡߒޠ‬ᨐ߆ࠄ‫ୃޔ‬჻ୃੌ↢ߩ߽ߟ‫ޟ‬⢻ജ‫ߒߣޠ‬㊀ⷐߥ‫ޟ‬⢻ജ‫ߣࠆ޽ߢޠ‬⠨߃ߚ‫⾰ߩ⚳ᦨޔߡߞ߇ߚߒޕ‬໧⚕
⺞ᩏߦ߅޿ߡ‫ୃߩ⃻⴫ޔ‬ᱜߪⴕࠊߥ޿ߢᗧ⷗ࠍ໧߁ߎߣߦߒߚ‫ޕ‬‫ޟ‬⢻ജߩౝኈ‫⃻⴫ޔߪߡ޿߅ߦޠ‬ᣇᴺ߿‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈ߿㗅ᐨᕈߦߟ޿ߡߩᜰ៰߇ᄙߊ⸥タߐࠇߡ޿ߚ‫ޕ‬ฦ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬㗄⋡ߦߟ޿ߡߩ‫᧦ޟ‬ઙઃ߈หᗧ‫ߩޠ‬ᗧ⷗ࠍෳ⠨ߣߒߡ‫ޔ‬ౝኈ߿⴫⃻ࠍౣᐲᬌ⸛ߒߚ߁߃ߢୃᱜࠍߒߚ㧔⴫ 12㧕‫ޕ‬Σߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫߿⃻⴫ߩޠࠬࡦ࠺ࡆࠛޟࠆߌ߅ߦޠ‬ᗧ๧ߩਇ᣿⏕ߐߦߟ޿ߡᜰ៰߇ᄙߊ⸥ㅀ߇ߺࠄࠇ‫ޔ‬࿁╵⠪߇ℂ⸃ߢ߈ࠆ᣿⏕ߥ⴫⃻ౝኈߩ⺑᣿ࠍട╩ߔࠆᔅⷐ߇↢ߓߚ‫ߩ⚳ᦨޔߡߞ߇ߚߒޕ‬⾰໧⚕⺞ᩏߢߪ⺑᣿ᢥߣᵈ㉼ߦࠛࡆ࠺ࡦࠬߩౝኈ߿࡟ࡌ࡞ߦߟ޿ߡߩ⸃㉼ࠍㅊ⸥ߔࠆߎ
ߣߦߒߚ‫ޕ‬Τߩ‫ޟ‬⢻ജߩౝኈ‫ޔߪߡ޿ߟߦޠ‬‫ޟ‬㜞ᐲߥ⋴⼔‫ޟߩޠ‬⢻ജߩౝኈ‫߇ޠ‬ਇ᣿⏕ߢ

－ 54 －

޽ࠆߣ޿߁ᗧ⷗߇ᄙᢙ޽ࠅ‫ୃޔ‬ᱜࠍ᳞߼ࠄࠇߡ޿ߚ‫ޟߩߘޔߡߞࠃޕ‬⢻ജߩౝኈ‫⺑ߩޠ‬᣿ߩᔅⷐ߇޽ࠆߣ⠨߃ࠄࠇߚ‫ޔߢߎߘޕ‬࿁╵⠪߇‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᗧ๧ࠍ᣿⏕ߦߔࠆߚ߼ߦ‫ޔ‬⺑᣿ᢥߩਛߦୃ჻ୃੌ↢ߦ᳞߼ࠆ㜞ᐲߥ⋴⼔ߩ‫ޟ‬⢻ജ‫ޟޔߪߣޠ‬ㆡ⏕ߦᖱႎ್ᢿߒ‫ߔߥޔ‬ߴ߈ߎߣࠍⴕേߢ߈ࠆߎߣ‫ࠍޠ‬ㅊ⸥ߒߚ‫ޔߚ߹ޕ‬Τ̆8 ߩ‫ޟ‬⢻ജߩౝኈ‫ޔߪߡ޿ߟߦޠ‬‫ࡐޟ‬ࡇࡘ࡟࡯࡚ࠪࡦ࡮ࠕࡊࡠ࡯࠴‫ߦ⃻⴫߁޿ߣޠ‬ኻߒߡߩᗧ⷗߇⸥タߐࠇߡ޿ߚߩߢୃᱜߔࠆ
ᔅⷐ߇޽ߞߚ‫੍ޟࠍ⪲⸒߁޿ߣޠ࠴࡯ࡠࡊࠕ࡮ࡦ࡚ࠪ࡯࡟ࡘࡇࡐޟޔߢߎߘޕ‬㒐⊛ߥⷰὐࠍ〯߹߃ߡ‫ࠍ⃻⴫ߦޠ‬ᄌᦝߒߚ‫ޕ‬Φߩ‫ޟ‬⢻ജ‫ߡ޿ߟߦޠ‬㗄⋡ߪ‫ޔ‬Φߩ⢻ജߣΦ́㧟ߩ㗄⋡ߦ‫޿૶ߩ⪲⸒߁޿ߣޠࠕࠤޟ‬ᣇߩ⛔৻ᕈࠍ࿑ࠆᔅⷐᕈࠍ᳞߼ࠄࠇߡ߅ࠅ‫ޔ‬Φߩ‫ޟ‬⢻ജ‫ߩޠ‬⺑᣿ᢥߩਛߦ‫ޔ‬‫ࠆ޿↪ࠍޠࠕࠤޟߣޠ⼔⋴ޟ‬㓙ߩᗧ๧ߩ㆑޿ࠍ᣿⏕ߦ⸥タߔࠆߎߣߦߣߒ
ߚ‫ޕ‬Χ㧙㧞ߩ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬㗄⋡ߢߪ‫ޟ‬หᗧߔࠆ‫߁޿ߣޠ‬ഀว߇ૐߊ‫ޔ‬‫ޠࡓ࠭ࡒ࠽ࠗ࠳ޟ‬ߣ޿߁⸒⪲ߪ‫ޔ‬ᣣᧄ⺆ߣߒߡ⴫⃻߇ਇ᣿⍎ߢ޽ߞߚߣߩᗧ⷗߽ߺࠄࠇ‫ୃޔ‬ᱜߩᔅⷐᕈ߇↢ߓߚߚ߼‫ޔ‬‫ޟ‬ജേ‫ޔߚ߹ޕߚߒ⸥⴫ߣޠ‬‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬㗅ᐨᕈߟ޿ߡ⠨߃ࠆߣ‫ޔ‬Ωߩ‫ޟ‬⢻ജߩౝኈ‫ߩߡߴߔߩޠ‬㗄⋡ߩౝኈ߆ࠄ⠨ᘦߔࠆߣ㗄⋡ߩ㗅ᐨࠍᄌᦝߔࠆᔅⷐᕈࠍ↢ߓ‫⴫ޔ‬ߦ␜ߒߚࠃ߁ߦΏ㧠ߩ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬㗄⋡ࠍΩ㧝ߦ➅ࠅ਄ߍ‫ᦨޔ‬ೋߩΩ㧝㨪Ώ㧟ߩ㗄⋡ࠍ➅ࠅਅߍߡ‫ߩ⃻⴫ޔ‬ᣇᴺ߽ୃᱜߒߚ‫ޕ‬Ϊߩ‫ޟ‬⢻ജߩౝኈ‫ୃޔߪߡ޿ߟߦޠ‬჻⺖⒟ࠍୃੌߦኻߒߡߩ‫ޟ‬⢻ജ‫⥃ߪߦޠ‬ᐥߩታ〣ജߪ߽ߣࠃࠅ‫ޔ‬ᢎ⢒ߩ‫ޟ‬⢻ജ‫߽ޠ‬ᔅⷐߣߐࠇࠆ‫ޕ‬ߒߚ߇ߞߡ‫੹ޔ‬࿁ߩ⺞ᩏߢߪߘࠇࠍḩߚߔ‫ޟ‬⢻ജߩౝኈ‫߇ޠ‬ਇචಽߢ޽ߞߚߚ߼‫⺞⚳ᦨޔ‬ᩏߦ߅޿ߡߪ‫ޟ‬ᢎ⢒⊛㑐ࠊࠅ‫ޟ߿ޠ‬ᢎ⢒ⅣႺ‫ߩޠ‬ౝኈࠍㅊടߒ‫ޔ‬㗄⋡ᢙࠍ 40 㗄⋡߆ࠄ 42㗄⋡ߣჇടߒߚ‫⎇ޔߚ߹ޕ‬ⓥࠦ࡯ࠬߣ㧯㧺㧿ߩࠦ࡯ࠬߦߟ޿ߡߪ‫ޟ‬⢻ജߩౝኈ‫ࠍޠ‬඙೎ߔࠆᔅⷐ߇޽ࠅ‫੹ޔ‬ᓟߦ⺖㗴ߣߒߡ‫ޔ‬චಽᬌ⸛ߔࠆᔅⷐ߇޽ࠆߣ⠨߃ࠆ‫ޕ‬੹࿁ߩ⾰໧⚕ߩୃᱜ೨ߣୃᱜᓟߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ࠍޠ‬એਅߦ␜ߒߚ㧔⴫ 12㧕‫ޕ‬⴫ 12㧚ୃᱜ೨࡮ୃᱜᓟߩ 10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬ୃᱜ೨ 㪈㪇 䈱䇸⢻ജ䇹䈫䇸⢻ജ䈱ౝኈ䇹䋨㪋㪇 㗄⋡䋩㩷ୃᱜᓟ㩷 㪈㪇 䈱䇸⢻ജ䇹䈫䇸⢻ജ䈱ౝኈ䇹䋨䋴䋲㗄⋡䋩㩷㩷㩷㩷㸇䋮⋴⼔䈱⺖㗴䉕⑼ቇ⊛䈮តⓥ䈚䇮䉣䊎䊂䊮䉴䉕㩷ᵴ↪䈜䉎㩷䋱䋮⋴⼔ታ〣䈪䈱໧㗴䉕⸃᳿䈜䉎䈢䉄䈮䇮ᔅⷐ䈭㩷䉣䊎䊂䊮䉴䉕ត᳞䈜䉎㩷䋲䋮㩷 䉣䊎䊂䊮䉴䊧䊔䊦䉕ᛕ್⊛䈮⺒⸃䈚䇮⹏ଔ䈜䉎㩷䋳䋮㩷 㪜㫍㫀㪻㪼㫅㪺㪼㪄㪹㪸㫊㪼㪻㩷㫇㫉㪸㪺㫋㫀㪺㪼 䉕ℂ⸃䈜䉎㩷䋴䋮㩷 ᣂ䈢䈭⍮⼂䉇వㅴ⊛䈭ᛛⴚ䉕ត⚝䈚䇮ᵴ↪䈜䉎㩷㩷㩷Τ㧚⋴⼔ߩኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ㧕ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆ䋱䋮ᦨᣂ䈱䉬䉝ᛛⴚ䉇䉣䊎䊂䊮䉴䈮ၮ䈨䈇䈩䇮⋴⼔䉕ታ〣䈜䉎㩷䋲䋮ឭଏ䈘䉏䈩䈇䉎ක≮䈱୶ℂᕈ䉕್ᢿ䈚ታ〣䈜䉎㩷㸇䋮⋴⼔䈱⺖㗴䉕⑼ቇ⊛䈮តⓥ䈚䇮䉣䊎䊂䊮䉴䉕㩷ᵴ↪䈜䉎㩷䋱䋮⋴⼔ታ〣䈪䈱໧㗴䉕⸃᳿䈜䉎䈢䉄䈮䇮ᔅⷐ䈭㩷䉣䊎䊂䊮䉴䉕ត᳞䈜䉎㩷䋲䋮䉣䊎䊂䊮䉴䊧䊔䊦䉕ᛕ್⊛䈮⺒⸃䈚䇮⹏ଔ䈜䉎㩷䋳䋮㪜㫍㫀㪻㪼㫅㪺㪼㪄㪹㪸㫊㪼㪻㩷㫇㫉㪸㪺㫋㫀㪺㪼 䉕ℂ⸃䈜䉎㩷䋴䋮ᣂ䈢䈭⍮⼂䉇వㅴ⊛䈭ᛛⴚ䉕ត⚝䈚䇮ᵴ↪䈜䉎㩷㩷㸈䋮⋴⼔䈱ኻ⽎䋨୘ੱ䊶ኅᣖ䊶㓸࿅䊶࿾ၞ䋩䈮ኻ䈚䈩䇮㩷㜞ᐲ䈭⋴⼔䉕ታ〣䈜䉎㩷䋱䋮ᦨᣂ䈱䉬䉝ᛛⴚ䉇䉣䊎䊂䊮䉴䈮ၮ䈨䈇䈩䇮⋴⼔䉕ታ〣䈜䉎㩷䋲䋮ឭଏ䈘䉏䈩䈇䉎ක≮䈱୶ℂᕈ䉕್ᢿ䈚ታ〣䈜䉎㩷
䋳䋮୶ℂ⊛䈮ㆡᱜ䈭ᖱႎᛛⴚ䈱೑↪䉕䈲䈎䉍䇮ଦㅴ㩷䈜䉎㩷䋴䋮ᄙ⡯⒳䈫䈫䉅䈮ක≮䈱቟ోᕈ䉕⏕⹺䈚䇮଻㓚䈜䉎㩷䋵䋮ኻ⽎ਛᔃ䈮䇮⋴⼔⡯䈍䉋䈶ᄙ⡯⒳䈫䈱⺞ᢛ䉕㩷ⴕ䈇䇮ද௛䈚䈩䉬䉝䈜䉎㩷䋶䋮⋴⼔䈮䈧䈇䈩䈱⺑᣿ജ䉕䉅䈤䇮ද௛䉕ផㅴ䈜䉎㩷㩷䋳䋮୶ℂ⊛䈮ㆡᱜ䈭ᖱႎᛛⴚ䈱೑↪䉕ଦㅴ䈜䉎㩷䋴䋮ᄙ⡯⒳䈫䈫䉅䈮ක≮䈱቟ోᕈ䉕⏕⹺䈚䇮଻㓚䈜䉎㩷䋵䋮ኻ⽎ਛᔃ䈮䇮⋴⼔⡯䈍䉋䈶ᄙ⡯⒳䈫䈱⺞ᢛ䉕㩷ⴕ䈇䇮ද௛䈚䈩䉬䉝䈜䉎㩷䋶䋮⋴⼔䈮䈧䈇䈩䈱⺑᣿ജ䉕䉅䈤䇮ද௛䉕ផㅴ䈜䉎㩷－ 55 －

䋷䋮੐଀ಽᨆ䈫⛔⸘ಽᨆ䈱⍮⼂䉕ㅢ䈛䇮ஜᐽ䉕଻ᜬ㩷Ⴧㅴ䈜䉎㩷䋸䋮⋴⼔䈱ኻ⽎䈮ኻ䈚䈩䇮∉ቇ⊛䈭⍮⼂䉕ᵴ↪䈚䈩㩷䊘䊏䊠䊧䊷䉲䊢䊮䊶䉝䊒䊨䊷䉼䉕ታ〣䈜䉎㩷㩷㩷㸉䋮⋴⼔䈏ឭଏ䈘䉏䉎ኻ⽎䉇႐䈮ኻ䈚䇮⾰䈱ᡷༀ䈮㩷ะ䈔䈩ข䉍⚵䉃㩷䋱䋮⾌↪ኻലᨐ䇮⚵❱⊛᦭ലᕈ䈭䈬䈱ⷰὐ䉕฽䉄䇮㩷ኻ⽎䈮䈫䈦䈩䈱ലᨐ䉕⹏ଔ䈜䉎㩷䋲䋮䉬䉝䈱⾰䉕ᡷༀ䈜䉎䈢䉄䈮䉣䊎䊂䊮䉴䉕↪䈇䈩⚵㩷❱䉇㓸࿅䈻௛䈐䈎䈔䉎㩷䋳䋮ᖱႎ䉲䉴䊁䊛䇮⛔⸘䈫∉ቇ䈱⍮⼂䉕↪䈇䈩䇮䉝䉡㩷䊃䉦䊛䈱ᡷༀ䉇䊥䉴䉪ૐᷫ䈱䈢䉄䈱ᚢ⇛䉕┙䈩䉎㩷䋴䋮᡽╷⊛䈭ⷰὐ䈪䉬䉝䈱⾰଻⸽䉇䊥䉴䉪䊙䊈䉳㩷䊜䊮䊃䉕ℂ⸃䈜䉎㩷㩷㸊㩷 䉬䉝䈏ឭଏ䈘䉏䈩䈇䉎⚵❱䉇䉲䉴䊁䊛䉕ಽᨆ䈚䇮䉬䉝ⅣႺ䉕ᡷༀ䈜䉎㩷䋱䋮୘䈫⚵❱䈱ਔ஥㕙䈎䉌䇮⋴⼔䉕䉲䉴䊁䊛䈫䈚䈩ᝒ㩷䈋䉎㩷䋲㪅㩷 䉬䉝ⅣႺ䈫䈚䈩䈱⚵❱䉕ಽᨆ䈚䇮⺖㗴⸃᳿䈱㩷䈢䉄䈱ᣇ⇛䉕ឭ᩺䈜䉎㩷䋳䋮ኻ⽎ਛᔃ䈱䉬䉝䉕ታ〣䈜䉎䈮ᒰ䈢䉍䇮ᔅⷐ䈫䈭䉎ᄙ⡯⒳䉇⾗Ḯ䉕Ꮞ䈐ㄟ䉂䈭䈏䉌䉬䉝ⅣႺ䉕ᡷༀ䈜䉎㩷䋴䋮⚵❱䈱⺖㗴䈮䈧䈇䈩ᢎ⢒⊛䈮௛䈐䈎䈔䉎㩷㩷㩷㸋䋮䉬䉝䉕ផㅴ䈪䈐䉎႐䉇ੱ⊛ⅣႺ䉕ᢛ䈋䉎䈢䉄䈮䇮䊥䊷䉻䊷䉲䉾䊒䉕⊒ើ䈜䉎㩷䋱䋮ᣂ䈚䈇⍮⼂䉇䊝䊂䊦䉕ታ〣䈮ዉ౉䈜䉎䈢䉄䈱ᚻ㩷
ᴺ䉕ℂ⸃䈚䇮䈠䈱ታ⃻䈮ะ䈔䈩䊥䊷䉻䊷䉲䉾䊒䉕⊒ើ䈜䉎㩷䋲䋮㓸࿅䉇⚵❱䈱႐䈱䉻䉟䊅䊚䉵䊛䉕ಽᨆ䈚䇮㓸࿅䉇⚵❱䉕േ䈎䈜㩷
䋳䋮ᦨༀ䈱ක≮䉰䊷䊎䉴䉕ឭଏ䈜䉎䈢䉄䈮䉬䉝䈱ᡷ㩷ༀ䉕ਥዉ䈜䉎㩷
㩷㩷㸌䋮ኾ㐷ᕈ䈱⋧㆑䉕ዅ㊀䈚䈢਄䈪ᄙ⡯⒳㑆䈱ද௛㩷㩷 㩷 䉕ផㅴ䈜䉎㩷㪈㪅 ኾ㐷⡯㑆䈱ലᨐ⊛䈭ㅪ៤㑐ଥ䉕▽䈒䈢䉄䈮䇮੕䈇㩷䉕ዅ㊀䈚䈢䉮䊚䊠䊆䉬䊷䉲䊢䊮䉕䈫䉎㩷䋲㪅㩷㩷⋴⼔Ꮷ䉇ઁ⡯⒳䈮ኻ䈚䈩⋴⼔䈱ᗧ࿑䉇ᔅⷐᕈ䉕㩷⺑᣿䈚䇮ද௛䈜䉎㩷䋴䋮ኻ⽎䈱⺖㗴䉕นⷞൻ䈚䇮ઁ⡯⒳䈫ද௛䈚䈩⸃᳿䈮㩷ዉ䈒㩷䋴䋮㩷 䉮䊷䊂䉞䊈䊷䉺䊷䈱ᓎഀ䉕ᜂ䈇䇮ද௛䈱౞Ṗൻ䉕ផㅴ䈜䉎㩷㩷㩷㸍䋮⃻ⴕ䈱ᴺᓞ䊶೙ᐲ䊶᡽╷䈏ஜᐽ䈫⋴⼔䈮ਈ䈋䉎㩷ᓇ㗀䉕ಽᨆ䈚䇮⸃᳿╷䉕ឭ᩺䈜䉎㩷䋱䋮ක≮᡽╷䈏୘䇮㓸࿅䇮⚵❱䈮䉅䈢䉌䈜ᓇ㗀䉕ಽᨆ䈚䇮ᡷༀ╷䉕⠨᩺䈜䉎㩷䋳䋮⋴⼔ኾ㐷⡯䈫䈚䈩䈱⠨䈋䉇ଔ୯䈏᡽╷䈮෻ᤋ䈘䉏䉎䉋䈉ᣇ╷䉕⠨䈋䉎㩷㩷

－ 56 －

䋷䋮੐଀ಽᨆ䈫⛔⸘ಽᨆ䈱⍮⼂䉕ㅢ䈛䇮ஜᐽ䉕଻ᜬ㩷Ⴧㅴ䈜䉎㩷䋸䋮⋴⼔䈱ኻ⽎䈮ኻ䈚䈩䇮∉ቇ⊛䈭⍮⼂䉕ᵴ↪䈚䇮੍㒐⊛䈭ⷰὐ䉕〯䉁䈋䈩ஜᐽ䈱଻ᜬ䊶Ⴧㅴ䈮ข䉍⚵䉃㩷㧖⴫⃻ࠍᣣᧄ⺆ߦୃᱜ㸉䋮⋴⼔䈏ឭଏ䈘䉏䉎ኻ⽎䉇႐䈮ኻ䈚䇮⾰䈱ᡷༀ䈮ะ䈔䈩ข䉍⚵䉃㩷䋱䋮㩷 ⾌↪ኻലᨐ䇮⚵❱⊛᦭ലᕈ䈭䈬䈱ⷰὐ䉕฽䉄䇮ኻ⽎䈮䈫䈦䈩䈱ലᨐ䉕⹏ଔ䈜䉎䇯㩷䋲䋮䉬䉝䈱⾰䉕ᡷༀ䈜䉎䈢䉄䈮䉣䊎䊂䊮䉴䉕↪䈇䈩⚵❱䉇㓸࿅䈻௛䈐䈎䈔䉎㩷䋳䋮ᖱႎ䉲䉴䊁䊛䇮⛔⸘䈫∉ቇ䈱⍮⼂䉕↪䈇䈩䇮䉝䉡䊃䉦䊛䈱ᡷༀ䉇䊥䉴䉪ૐᷫ䈱䈢䉄䈱ᚢ⇛䉕┙䈩䉎㩷䋴䋮᡽╷⊛䈭ⷰὐ䈪䈱䉬䉝䈱⾰଻⸽䉇䊥䉴䉪䊙䊈䉳䊜
䊮䊃䉕ℂ⸃䈜䉎㩷
㩷㸊䋮䉬䉝䈏ឭଏ䈘䉏䈩䈇䉎⚵❱䉇䉲䉴䊁䊛䉕ಽᨆ䈚䇮
䉬䉝ⅣႺ䉕⺞ᢛ䈜䉎㩷䋱䋮୘䈫⚵❱䈱ਔ஥㕙䈎䉌䇮⋴⼔䉕䉲䉴䊁䊛䈫䈚䈩ᝒ㩷䈋䉎㩷䋲䋮䉬䉝ⅣႺ䈫䈚䈩䈱⚵❱䉕ಽᨆ䈚䇮⺖㗴✭๺䋨⸃㩷᳿䋩䈱䈢䉄䈱ᣇ⇛䉕ឭ᩺䈜䉎㩷䋳䋮䉬䉝䉕ታ〣䈜䉎䈢䉄䈮ᔅⷐ䈫䈭䉎ᄙ⡯⒳䉇⾗Ḯ䉕Ꮞ䈐ㄟ䉂䈭䈏䉌䇮䉬䉝ⅣႺ䉕ᡷༀ䈜䉎㩷䋴䋮⚵❱䈱⺖㗴䈮䈧䈇䈩ᢎ⢒⊛䈮௛䈐䈎䈔䉎㩷㩷㸋䋮䉬䉝䉕ផㅴ䈪䈐䉎႐䉇ੱ⊛ⅣႺ䉕ᢛ䈋䇮䊥䊷䉻䊷䉲䉾䊒䉕⊒ើ䈜䉎㩷䋱䋮ᣂ䈚䈇⍮⼂䉇䊝䊂䊦䉕ታ〣䈮ዉ౉䈜䉎䈢䉄䈱ᚻ
ᴺ䉕ℂ⸃䈚䇮䈠䈱ታ⃻䈮ะ䈔䈩䊥䊷䉻䊷䉲䉾䊒䉕⊒ើ䈜䉎㩷䋲䋮㓸࿅䉇⚵❱䈱႐䈱ജേ䉕ಽᨆ䈚䇮㓸࿅䉇⚵❱䉕㩷േ䈎䈜㩷䋳䋮ᦨༀ䈱ක≮䉰䊷䊎䉴䉕ឭଏ䈜䉎䈢䉄䈮䉬䉝䈱ᡷༀ䉕ਥዉ䈜䉎㩷
㧖ᣣᧄ⺆ߦ⴫⃻ࠍୃᱜ㸌䋮ኾ㐷ᕈ䈱⋧㆑䉕ዅ㊀䈚䈢਄䈪ᄙ⡯⒳㑆䈱ද௛䉕ផㅴ䈜䉎㩷䋱䋮ኾ㐷⡯㑆䈱ലᨐ⊛䈭ㅪ៤㑐ଥ䉕▽䈒䈢䉄䈮䇮੕䈇䉕ዅ㊀䈚䈢䉮䊚䊠䊆䉬䊷䉲䊢䊮䉕䈫䉎㩷䋲䋮⋴⼔Ꮷ䉇ઁ⡯⒳䈮ኻ䈚䈩⋴⼔䈱ᗧ࿑䉇ᔅⷐᕈ䉕⺑᣿䈚䇮ද௛䈜䉎㩷䋳䋮ኻ⽎䈱⺖㗴䉕นⷞൻ䈚䇮ઁ⡯⒳䈫ද௛䈚䈩⸃᳿䈮ዉ䈒㩷䋴䋮䉮䊷䊂䉞䊈䊷䉺䊷䈱ᓎഀ䉕ᜂ䈇䇮ᄙ⡯⒳㑆ද௛䈱౞Ṗൻ䉕ផㅴ䈜䉎㩷㩷㸍䋮⃻ⴕ䈱ᴺᓞ䊶೙ᐲ䊶᡽╷䈏ஜᐽ䈫⋴⼔䈮ਈ䈋䉎㩷ᓇ㗀䉕ಽᨆ䈚䇮⸃᳿╷䉕ឭ᩺䈜䉎㩷䋱䋮ੱ䇱䈱ஜᐽჇㅴ䈫䈇䈉ⷞὐ䉕฽䉄䇮⋴⼔䈱᡽╷䉕ᬌ⸛䈜䉎㩷 㩷䋲䋮ක≮଻ஜ⑔␩᡽╷䈏୘䇮㓸࿅䇮⚵❱䈮䉅䈢䉌䈜㩷ᓇ㗀䉕ಽᨆ䈚䇮ᡷༀ╷䉕⠨᩺䈜䉎㩷㩷䋳䋮㩷⸻≮ႎ㈽䉇੺⼔଻㒾䈭䈬䈱᡽╷䊶೙ᐲ䈏䉬䉝ឭଏ
ᣇᴺ䉇䉝䉡䊃䉦䊛䈮෸䈿䈜ᓇ㗀䉕ಽᨆ䈚䇮ᡷༀ᩺䉕ឭ᩺䈜䉎㩷䋴䋮㩷 ੱ䇱䈱ஜᐽჇㅴ䈫䈇䈉ⷞὐ䈎䉌䇮⋴⼔䈱᡽╷䉕ឭ᩺䈜䉎㩷㸎䋮⋴⼔ቇ䈱⊒ዷ䈮ነਈ䈪䈐䉎ᢎ⢒ⅣႺ䈨䈒䉍䈮ข䉍⚵䉃㩷䋱㪅 ቇ⠌⠪䈱䊆䊷䉵䉕ᛠី䈚䇮ቇ⠌⠪䈮䈅䉒䈞䈢㩷ᢎ⢒ᴺ䉕ℂ⸃䈜䉎㩷䋲㪅㩷⋴⼔ቇ䈱⸘↹⊛䊶ലᨐ⊛䈭ᢎ⢒ᣇᴺ䉕ឭ᩺䈜䉎㩷
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㸏䋮୶ℂ⊛䊶ᢥൻ⊛ᗵฃᕈ䉕ᜬ䈦䈩ኾ㐷⡯䈫䈚䈩䈱㩷⽿ോ䉕ᨐ䈢䈜㩷䋱㪅 ୘ੱ䊶ኅᣖ䊶㓸࿅䈱ᜬ䈧ᢥൻ䉇⢛᥊䉕ᛠី䈚䇮⋴㩷⼔䉕ታ〣䈜䉎㩷䋲㪅 ኻ⽎䈱ᠩ⼔䈱┙႐䈎䉌䇮቟ో䈭䉬䉝ⅣႺ䉕ଦㅴ䈚䇮୶ℂ⊛ታ〣䉕᥉෸䈜䉎㩷㪊㪅㩷㩷 ୶ℂ⊛໧㗴䈮⋥㕙䈚䈩䈇䉎ኻ⽎䉇ኾ㐷⡯䉕ᡰេ䈜䉎䈢䉄䈮䇮୶ℂ䈮㑐䈜䉎ℂ⺰䉕ᵴ↪䈜䉎㩷㩷㩷㸐䋮⋴⼔ቇ䈱⊒ዷ䈮ነਈ䈪䈐䉎䉝䉟䊂䊮䊁䉞䊁䉞䉕ᒻᚑ䈜䉎㩷䋱䋮⋴⼔䉇ක≮䈮㑐䈜䉎ኾ㐷⡯䈫䈚䈩䈱ືቇ䉕⊒ዷ㩷䈘䈞䇮⋴⼔ታ〣䈮⛔ว䈜䉎㩷䋲䋮㩷 ⋴⼔ቇ䉕ข䉍Ꮞ䈒⺖㗴䈮䈧䈇䈩䈱ᗵฃᕈ䉕㜞䉄䇮ਥ૕ᕈ䉕ᜬ䈦䈩ᡷༀ䈜䉎㩷䋳䋮㩷 䉋䉍⦟䈇䉬䉝䉕᳿ቯ䈜䉎䈢䉄䈮ᦨᣂ䈱⍮⷗䉕ᓧ䈭䈏䉌ታ〣䈜䉎䊝䊂䊦䈮䈭䉎㩷䋴䋮㩷 ኾ㐷⡯䈫䈚䈩⋴⼔ⷰ䉕᣿⏕䈮䈜䉎㩷㩷 㩷䋳䋮⋴⼔ኾ㐷⡯䈫䈚䈩䈱⠨䈋䉇ଔ୯䈏᡽╷䈮෻ᤋ䈘䉏䉎䉋䈉ᣇ╷䉕⠨䈋䉎㩷䋴䋮⚻ᷣ䉇᡽╷䊶೙ᐲ䈏䉬䉝ឭଏᣇᴺ䉇䉝䉡䊃䉦䊛䈮෸䈿䈜ᓇ㗀䉕ಽᨆ䈚䇮ᡷༀ╷䉕ឭ᩺䈜䉎㩷㩷 㧖㗅ᐨࠍᄌᦝߣ⴫⃻ࠍୃᱜ㧖㗄⋡  ࠍ  ߦ‫߳  ࠍ ޔ ࠍ ޔ‬㗅ᐨࠍᄌᦝ
㸎䋮⋴⼔ቇ䈱⊒ዷ䈮ነਈ䈪䈐䉎ᢎ⢒ⅣႺ䈨䈒䉍䈮ข䉍⚵䉃㩷䋱䋮ቇ⠌⠪䈱䊆䊷䉵䉕ᛠី䈚䇮ቇ⠌⠪䈮ว䉒䈞䈢㩷ᢎ⢒ᴺ䉕ℂ⸃䈜䉎䇯㩷䋲䋮⋴⼔ቇ䈱⸘↹⊛䊶ലᨐ⊛䈭ᢎ⢒ᣇᴺ䉕ឭ᩺䈜䉎㩷䋳䋮ቇ⠌⠪䈱䊆䊷䉵䈮ว䈦䈢ᢎ⢒⊛㑐䉒䉍䉕ⴕ䈉㩷䋴䋮ቇ⠌䈏ଦㅴ䈜䉎䉋䈉䈮ᢎ⢒ⅣႺ䉕ᢛ䈋䉎㩷㧖ౝኈߦ  㗄⋡ࠍㅊട㩷㸏䋮୶ℂ⊛䊶ᢥൻ⊛ᗵฃᕈ䉕ᜬ䈦䈩ኾ㐷⡯䈫䈚䈩䈱㩷⽿ോ䉕ᨐ䈢䈜㩷
䋱䋮୘ੱ䊶ኅᣖ䊶㓸࿅䈱ᜬ䈧ᢥൻ䉇⢛᥊䉕ᛠី䈚䇮⋴⼔䉕ታ〣䈜䉎㩷
䋲䋮ኻ⽎䉕ᠩ⼔䈜䉎┙႐䈎䉌䇮቟ో䈭䉬䉝ⅣႺ䉕ଦㅴ䈚䇮୶ℂ⊛ታ〣䉕᥉෸䈜䉎㩷
䋳䋮୶ℂ䈮㑐䈜䉎ℂ⺰䉕ᵴ↪䈚䈩䇮୶ℂ⊛໧㗴䈮⋥㕙䈚䈩䈇䉎ኻ⽎䉇ኾ㐷⡯䉕ᡰេ䈜䉎㩷㩷㸐䋮⋴⼔ቇ䈱⊒ዷ䈮ነਈ䈪䈐䉎䉝䉟䊂䊮䊁䉞䊁䉞䉕ᒻᚑ䈜䉎㩷䋱䋮⋴⼔䉇ක≮䈮㑐䈜䉎ኾ㐷⡯䈫䈚䈩䈱ືቇ䉕⊒ዷ㩷䈘䈞䇮⋴⼔ታ〣䈮⛔ว䈜䉎㩷䋲䋮⋴⼔ቇ䉕ข䉍Ꮞ䈒⺖㗴䈮䈧䈇䈩䈱ᗵฃᕈ䉕㜞䉄䇮ਥ૕ᕈ䉕ᜬ䈦䈩ᡷༀ䈜䉎㩷䋳䋮䉋䉍⦟䈇䉬䉝䉕᳿ቯ䈜䉎䈢䉄䈮ᦨᣂ䈱⍮⷗䉕ᓧ䈭䈏䉌ታ〣䈜䉎䊝䊂䊦䈮䈭䉎㩷䋴䋮ኾ㐷⡯䈫䈚䈩⋴⼔ⷰ䉕᣿⏕䈮䈜䉎㩷㩷㩷㧖ୃᱜ೨࡮ୃᱜᓟߩΣ㨪άߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬















－ 57 －

㧠㧚ୃᱜߒߚ೨ᦼ㧔ୃ჻㧕⺖⒟ୃੌ↢߇ୃᓧߔߴ߈  ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬⾰໧⚕⺞ᩏߩ⚿ᨐߦၮߠ߈‫ୃޔ‬ᱜਅ 10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬42 㗄⋡ࠍએਅߦ␜ߒߚ‫ޕ‬Σ㧚⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ࠍࠬࡦ࠺ࡆࠛޔ‬ᵴ↪ߔࠆୃ჻⺖⒟ୃੌ↢ߪ‫⼔⋴ޔ‬ታ〣߿ࠤࠕ  ឭଏߩ႐ߦ߅޿ߡ‫⇼ޔ‬໧ࠍ߽ߜត᳞ߔࠆᘒᐲߢ‫ޔ‬⸃᳿ߔߴ߈⋴⼔ߩ⺖㗴ࠍ⷗಴ߔߎߣ‫ߦࠄߐޔ‬ᣢሽߩ᭽‫ࠍࠬࡦ࠺ࡆࠛߩ࡞ࡌ࡟ߥޘ‬෼㓸‫ޔ‬⛔วߒ‫⎇ࠍࠄࠇߘޔ‬ⓥ߿ታ〣ߦᵴ↪ߒ‫⺖ޔ‬㗴⸃᳿ߦ❬޿ߢ޿ߊߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬㧝㧚⋴⼔ታ〣ߢߩ໧㗴ࠍ⸃᳿ߔࠆߚ߼ߦ‫ޔ‬ᔅⷐߥࠛࡆ࠺ࡦࠬࠍត᳞ߔࠆ‫ޕ‬㧞㧚ࠛࡆ࠺ࡦࠬ࡟ࡌ࡞ࠍᛕ್⊛ߦ⺒⸃ߒ‫⹏ޔ‬ଔߔࠆ‫ޕ‬
㧟㧚Evidence-based practice ࠍℂ⸃ߔࠆ‫ޕ‬㧠㧚ᣂߚߥ⍮⼂߿వㅴ⊛ߥᛛⴚࠍត⚝ߒ‫ޔ‬ᵴ↪ߔࠆΤ㧚⋴⼔ߩኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ㧕ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆୃ჻ୃੌ↢ߦ᳞߼ࠆ㜞ᐲߥ⋴⼔ߣߪ‫ޔ‬‫ޟ‬ㆡ⏕ߦᖱႎ್ᢿߒ‫߇ߣߎ߈ߴߔߥޔ‬ታ〣ߢ߈ࠆ‫ޠ‬ߣ޿߁ߎߣߢ޽ࠆ‫ߩࠄࠇߎޕ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆߦ޽ߚࠅ‫ୃޔ‬჻⺖⒟ୃੌ↢ߪ‫ࡆࠛޔ‬࠺ࡦࠬߦၮߠ޿ߡᦨᣂߥࠄ߮ߦᦨༀߩࠤࠕࠍᄙ⡯⒳ߣද௛ߒߥ߇ࠄឭଏߒ‫⥄ޔ‬り߇ⴕ߁⋴⼔ߦኻߒߡ⺑᣿ߢ߈ߥߌࠇ߫ߥࠄߥ޿‫∛ޔߦࠄߐޕ‬᳇߿∔ᖚߩ⍮⼂ߦട߃‫∉ޔ‬ቇ⊛࠺࡯࠲߿␠ળ㨯ⅣႺ࠺࡯࠲߽↪޿ߥ߇ࠄ‫ޔ‬୘ੱ࡮ኅᣖߛߌߢߥߊ‫ޔ‬㓸࿅࡮࿾ၞߦ߽⋡ࠍ߻ߌߚ⋴⼔ࠍᬌ⸛ߔࠆ‫ୃޕ‬჻⺖⒟ୃੌ↢ߪ‫ޔ‬ஜᐽߣ޿߁᭎ᔨࠍ߭ࠈߊᷓߊᝒ߃‫∔ޔ‬ᖚ߿㓚⎹ࠍᛴ߃ߚኻ⽎߳ߩ௛߈߆ߌ߆ࠄ‫ߩޘੱޔ‬ஜᐽߩ଻ᜬ࡮Ⴧㅴߦะߌߚขࠅ⚵ߺ߹ߢ‫ੱ৻ޔ‬߭ߣࠅ߇ᜬߟജࠍᒁ߈಴ߒ‫ޔ‬ኻ⽎ߩ⁁ᘒߦᔕߓߚ⋴⼔ࠍᗧ࿑⊛ߦⴕ߁‫ୃߚ߹ޕ‬჻⺖⒟ୃ
ੌ↢ߪ‫ޔ‬ኻ⽎ߦᢎ⢒⊛ᡰេ߇ᔅⷐߥᤨߦߪ‫ޔ‬ℂ⺰߿ࠛࡆ࠺ࡦࠬߦၮߠ޿ߚ௛߈߆ߌࠍߔ
ࠆߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬㧝㧚ᦨᣂߩࠤࠕᛛⴚ߿ࠛࡆ࠺ࡦࠬߦၮߠ޿ߡ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆ㧞㧚ឭଏߐࠇߡ޿ࠆක≮ߩ୶ℂᕈࠍ್ᢿߒታ〣ߔࠆ
㧟㧚୶ℂ⊛ߦㆡᱜߥᖱႎᛛⴚߩ೑↪ࠍߪ߆ࠅ‫ޔ‬ଦㅴߔࠆ
㧠㧚ᄙ⡯⒳ߣߣ߽ߦක≮ߩ቟ోᕈࠍ⏕⹺ߒ‫଻ޔ‬㓚ߔࠆ㧡㧚ኻ⽎ਛᔃߦ‫⼔⋴ޔ‬⡯߅ࠃ߮ᄙ⡯⒳ߣߩ⺞ᢛࠍⴕ޿‫ޔ‬ද௛ߒߡࠤࠕߔࠆ
1‫⼔⋴ߪޠࠕࠤޟ‬⡯߇ᄙ⡯⒳ߣද௛ߒߡⴕ߁ታ〣‫⼔⋴ߪޠ⼔⋴ޟޔ‬⡯߇ⴕ߁ታ〣ߣߒߡឭ␜ߒߡ޿߹ߔ‫ޕ‬2ࠛࡆ࠺ࡦࠬ‫⑼ࠅ߹ߟޔ‬ቇ⊛ߦታ⸽ߐࠇߚᩮ᜚㧔⑼ቇ⊛ᩮ᜚㧕㧙ታ㛎߿⺞ᩏߥߤ⾰⊛⎇ⓥ߽฽߼ߚ⎇ⓥ⚿ᨐ߆ࠄዉ߆ࠇߚ

‫ⵣޟ‬ઃߌ‫ޠ‬㧙ߦၮߠ޿ߡ⋴⼔ታ〣߿ࠤࠕឭଏࠍⴕ߁ߎߣ߇᳞߼ࠄࠇߡ޿ࠆ‫ࠍࠬࡦ࠺ࡆࠛޕ‬ᵴ↪ߔࠆߦߪ‫ޔ‬ᓧߚࠛࡆ࠺ࡦ
ࠬ߇ᅷᒰߢା㗬ߢ߈ࠆ߽ߩ߆ߤ߁߆ࠍ⷗ᭂ߼ࠆߎߣ߇ᔅⷐߢ޽ࠅ‫⎇ߥ߁ࠃߩߤޔ‬ⓥᣇᴺࠍ↪޿ߡ޿ࠆ߆‫ࠆ޿ߡ޿↪ޔ‬ᣇᴺ߆ࠄ↢ߓࠆࡃࠗࠕࠬ㧔ㆬᛯࡃࠗࠕࠬ‫ޔ‬ᖱႎࡃࠗࠕࠬ‫ޔ‬੤⛊ࡃࠗࠕࠬߥߤ㧕ࠍߤߩࠃ߁ߦ೙ᓮߒߡ޿ࠆ߆ߥߤ‫ࠛߩߘޔ‬ࡆ࠺ࡦࠬ߇ߤߩࠃ߁ߦዉ߈಴ߐࠇߡ޿ࠆ߆ࠍ⏕⹺ߒ‫ߩࠬࡦ࠺ࡆࠛޔ‬ᅷᒰᕈ߿ା㗬ᕈߩ⒟ᐲࠍ⹏ଔߔࠆߣߣ߽ߦ‫࡟ߩߘޔ‬ࡌ࡞ߦၮߠ߈ߤߩࠃ߁ߦ⎇ⓥ⚿ᨐࠍណ↪ߔࠆ߆್ᢿߔࠆᔅⷐ߇޽ࠆ‫৻ࠄࠇߎޕ‬ㅪߩࠛࡆ࠺ࡦࠬߩ⠨߃ᣇࠍℂ⸃ߒߡ‫⋴ޔ‬⼔ߦᵴ↪ߔࠆࠛࡆ࠺ࡦࠬࠍត⚝࡮តⓥߒ⹏ଔߢ߈ࠆߎߣ߇ୃ჻⺖⒟ୃੌ↢ߦߪ᳞߼ࠄࠇࠆ‫ޕ‬－ 58 －

㧢㧚⋴⼔ߦߟ޿ߡߩ⺑᣿ജࠍ߽ߜ‫ޔ‬ද௛ࠍផㅴߔࠆ
㧣㧚੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍㅢߓ‫ޔ‬ஜᐽࠍ଻ᜬჇㅴߔࠆ
㧤㧚⋴⼔ߩኻ⽎ߦኻߒߡ‫∉ޔ‬ቇ⊛ߥ⍮⼂ࠍᵴ↪ߒ‫੍ޔ‬㒐⊛ߥⷰὐࠍ〯߹߃ߡஜᐽߩ଻ᜬ࡮
Ⴧㅴߦขࠅ⚵߻Υ㧚⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡขࠅ⚵߻ୃ჻⺖⒟ୃੌ↢ߪ‫ᦨޔ‬ᣂߩᖱႎࠍᵴ↪ߒߡ‫⼔⋴ޔ‬ታ〣߿ࠤࠕⅣႺࠍᡷༀߔࠆߎߣ߇᳞
߼ࠄࠇࠆ‫ޕ‬㧝㧚⾌↪ኻലᨐ‫᦭⊛❱⚵ޔ‬ലᕈߥߤߩⷰὐࠍ฽߼‫ޔ‬ኻ⽎ߦߣߞߡߩലᨐࠍ⹏ଔߔࠆ‫ޕ‬㧞㧚ࠤࠕߩ⾰ࠍᡷༀߔࠆߚ߼ߦࠛࡆ࠺ࡦࠬࠍ↪޿ߡ⚵❱߿㓸࿅߳௛߈߆ߌࠆ
㧟㧚ᖱႎࠪࠬ࠹ࡓ‫∉ߣ⸘⛔ޔ‬ቇߩ⍮⼂ࠍ↪޿ߡ‫ߩࡓࠞ࠻࠙ࠕޔ‬ᡷༀ߿࡝ࠬࠢૐᷫߩߚ߼ߩ
ᚢ⇛ࠍ┙ߡࠆ
㧠㧚᡽╷⊛ߥⷰὐߢߩࠤࠕߩ⾰଻⸽߿࡝ࠬࠢࡑࡀࠫࡔࡦ࠻ࠍℂ⸃ߔࠆΦ㧚ࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ࠕࠤޔ‬ⅣႺࠍ⺞ᢛߔࠆ  ୃ჻⺖⒟ୃੌ↢ߪ‫⺖ࠆ޿ߡߓ↢ߦ❱⚵ޔ‬㗴ࠍಽᨆߒ‫߇ࠕࠤ޿⦟ࠅࠃޔ‬ឭଏߐࠇࠆࠃ߁
ߦࠤࠕⅣႺࠍ⺞ᢛߔࠆߎߣ߿ᢎ⢒⊛ߦ௛߈߆ߌࠆߎߣ߇᳞߼ࠄࠇࠆ‫ࠕࠤޕ‬ⅣႺࠍᡷༀߔ
ࠆߦߪ቟ోߢ᦭ലߥࠤࠕᛛⴚ߿ᖱႎᛛⴚߩ೑↪ߦߟ޿ߡ‫ޔ‬ኾ㐷⡯ߦኻߒᢎ⢒⊛ߦ௛߈߆ߌࠆߎߣ߽฽߹ࠇࠆ‫ޕ‬㧝㧚୘ߣ⚵❱ߩਔ஥㕙߆ࠄ‫ޕࠆ߃ᝒߡߒߣࡓ࠹ࠬࠪࠍ⼔⋴ޔ‬㧞㧚ࠤࠕⅣႺߣߒߡߩ⚵❱ࠍಽᨆߒ‫⺖ޔ‬㗴✭๺㧔⸃᳿㧕ߩߚ߼ߩᣇ⇛ࠍឭ᩺ߔࠆ
㧟㧚ࠤࠕࠍታ〣ߔࠆߚ߼ߦᔅⷐߣߥࠆᄙ⡯⒳߿⾗ḮࠍᏎ߈ㄟߺߥ߇ࠄ‫ࠕࠤޔ‬ⅣႺࠍᡷༀߔ
ࠆ㧠㧚⚵❱ߩ⺖㗴ߦߟ޿ߡᢎ⢒⊛ߦ௛߈߆ߌࠆ‫ޕ‬Χ㧚ࠤࠕࠍផㅴߢ߈ࠆ႐߿ੱ⊛ⅣႺࠍᢛ߃‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆୃ჻⺖⒟ୃੌ↢ߪ‫ߩࠕࠤޔ‬ᡷༀߦะߌߡ‫ޔ‬㓸࿅߿⚵❱ߦ௛߈߆ߌ‫ޔ‬ᄌൻࠍ⿠ߎߔᓎഀ
ࠍᜂ߁ߎߣ߇᳞߼ࠄࠇࠆ‫ޔߦ߼ߚߩߘޕ‬ᔅⷐߥ⍮⼂࡮ᛛⴚࠍᵴ↪ߒ‫ࡦࠪ࡞ࠞࠖ࠹࡝ࠢޔ‬ࠠࡦࠣ߿࡝ࡈ࡟࡚ࠢࠪࡦࠍขࠅ౉ࠇߡ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬㧝㧚ᣂߒ޿⍮⼂߿ࡕ࠺࡞ࠍታ〣ߦዉ౉ߔࠆߚ߼ߩᚻᴺࠍℂ⸃ߒ‫ߩߘޔ‬ታ⃻ߦะߌߡ࡝࡯࠳
࡯ࠪ࠶ࡊࠍ⊒ើߔࠆ㧞㧚㓸࿅߿⚵❱ߩ႐ߩജേࠍಽᨆߒ‫ޔ‬㓸࿅߿⚵❱ࠍേ߆ߔ
㧟㧚ᦨༀߩක≮ࠨ࡯ࡆࠬࠍឭଏߔࠆߚ߼ߦࠤࠕߩᡷༀࠍਥዉߔࠆ
Ψ㧚ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ  ୃ჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኾ㐷⡯㑆ߩലᨐ⊛ߥㅪ៤㑐ଥࠍଦߔߚ߼ߦ‫⋧ޔ‬੕ߦቇ⠌ߔࠆⅣႺ
ࠍ⺞ᢛߒߚࠅ‫⼔⋴ޔ‬⡯߿ᄙ⡯⒳߆ࠄߩ⋧⺣ߦᔕߓߚࠅߒߡ‫ޔ‬ᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫ޕ‬－ 59 －

ߘߩ㓙ߦߪ‫ઁࠍ⼔⋴ޔ‬⡯⒳ߦ⺑᣿ߔࠆ⢻ജ߇᳞߼ࠄࠇࠆ‫ޕ‬㧝㧚ኾ㐷⡯㑆ߩലᨐ⊛ߥㅪ៤㑐ଥࠍ▽ߊߚ߼ߦ‫ޔ‬੕޿ࠍዅ㊀ߒߚࠦࡒࡘ࠾ࠤ࡯࡚ࠪࡦࠍߣࠆ
㧞㧚⋴⼔Ꮷ߿ઁ⡯⒳ߦኻߒߡ⋴⼔ߩᗧ࿑߿ᔅⷐᕈࠍ⺑᣿ߒ‫ޔ‬ද௛ߔࠆ
㧟㧚ኻ⽎ߩ⺖㗴ࠍนⷞൻߒ‫ઁޔ‬⡯⒳ߣද௛ߒߡ⸃᳿ߦዉߊ
㧠㧚ࠦ࡯࠺ࠖࡀ࡯࠲࡯ߩᓎഀࠍᜂ޿‫ޔ‬ᄙ⡯⒳㑆ද௛ߩ౞Ṗൻࠍផㅴߔࠆ
Ω㧚⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ  ୃ჻⺖⒟ୃੌ↢ߪ‫ߩⴕ⃻ޔ‬ᴺᓞ㨯೙ᐲ࡮᡽╷߇ੱ‫ߩޘ‬ஜᐽ߿⋴⼔ߦߤߩࠃ߁ߥᓇ㗀ࠍ߽ߚࠄߒߡ޿ࠆ߆ࠍಽᨆߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫ߩߘޕ‬ಽᨆ⚿ᨐߦၮߠ߈‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ߇‫ߩߘޔ‬㓙ߦ⋴⼔ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯ⷰࠍ෻ᤋߒߚᣇ╷ࠍ⠨߃ࠆߎߣ߽᳞߼ࠄ
ࠇࠆ‫ޕ‬
㧝㧚ੱ‫ߩޘ‬ஜᐽჇㅴߣ޿߁ⷞὐࠍ฽߼‫ߩ⼔⋴ޔ‬᡽╷ࠍᬌ⸛ߔࠆ
㧞㧚ක≮଻ஜ⑔␩᡽╷߇୘‫ޔ‬㓸࿅‫ߔࠄߚ߽ߦ❱⚵ޔ‬ᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍ⠨᩺ߔࠆ㧟㧚⋴⼔ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯߇᡽╷ߦ෻ᤋߐࠇࠆࠃ߁ᣇ╷ࠍ⠨߃ࠆ㧠㧚⚻ᷣ߿᡽╷࡮೙ᐲ߇ࠤࠕឭଏᣇᴺ߿ࠕ࠙࠻ࠞࡓߦ෸߷ߔᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍឭ᩺ߔࠆ㩷Ϊ㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆᢎ⢒ⅣႺߠߊࠅߦขࠅ⚵߻  ୃ჻⺖⒟ୃੌ↢ߪ‫⼔⋴ޔ‬ኾ㐷⡯ࠍ⢒ߡࠆߚ߼ߩᢎ⢒⊛ᕁ⠨ࠍ߽ߟߎߣ߇ᔅⷐߢ޽ࠆ‫ޕ‬㧝㧚ቇ⠌⠪ߩ࠾࡯࠭ࠍᛠីߒ‫ޔ‬ቇ⠌⠪ߦวࠊߖߚᢎ⢒ᴺࠍℂ⸃ߔࠆ‫ޕ‬㧞㧚⋴⼔ቇߩ⸘↹⊛࡮ലᨐ⊛ߥᢎ⢒ᣇᴺࠍឭ᩺ߔࠆ
㧟㧚ቇ⠌⠪ߩ࠾࡯࠭ߦวߞߚᢎ⢒⊛㑐ࠊࠅࠍⴕ߁
㧠㧚ቇ⠌߇ଦㅴߔࠆࠃ߁ߦᢎ⢒ⅣႺࠍᢛ߃ࠆ
Ϋ㧚୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ
ୃ჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኻ⽎ࠍᠩ⼔ߔࠆߚ߼ߦ୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍ㜞߼ࠆߣߣ߽ߦ‫ޔ‬ࠤࠕᛛⴚ߿ᖱႎᛛⴚߩ૶↪ߦ㑐ߔࠆ୶ℂේೣ߿ၮḰࠍℂ⸃ߒߚ߁߃ߢታ〣ࠍⴕ޿‫ޔ‬ኾ㐷⡯ߣߒߡߩ୶ℂ⊛⽿ോࠍᨐߚߔߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬㧝㧚୘ੱ࡮ኅᣖ࡮㓸࿅ߩᜬߟᢥൻ߿⢛᥊ࠍᛠីߒ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆ㧞㧚ኻ⽎ࠍᠩ⼔ߔࠆ┙႐߆ࠄ‫ޔ‬቟ోߥࠤࠕⅣႺࠍଦㅴߒ‫୶ޔ‬ℂ⊛ታ〣ࠍ᥉෸ߔࠆ
㧟㧚୶ℂߦ㑐ߔࠆℂ⺰ࠍᵴ↪ߒߡ‫୶ޔ‬ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆኻ⽎߿ኾ㐷⡯ࠍᡰេߔࠆ
㩷ά㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ  ୃ჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኾ㐷⡯ߣߒߡߩືቇࠍ⊒ዷߐߖ‫ࠍⷰ⼔⋴ޔ‬᣿⏕ߦ⴫⃻ߒ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫↢ޔߦࠄߐޕ‬ᶦࠍㅢߓߡቇ⠌ߒߡ޿ߊᆫ൓ࠍ߽ߜ‫ᦨޔ‬ᣂߩ⍮⷗ࠍᓧߡ⋴⼔ߦᵴ↪ߔࠆദജࠍ⛯ߌ‫⼔⋴ߩઁޔ‬⡯ߩᓎഀࡕ࠺࡞ߣߥࠆߎߣ߽᳞߼ࠄࠇࠆ‫ޕ‬－ 60 －

㧝㧚⋴⼔߿ක≮ߦ㑐ߔࠆኾ㐷⡯ߣߒߡߩືቇࠍ⊒ዷߐߖ‫⼔⋴ޔ‬ታ〣ߦ⛔วߔࠆ㧞㧚⋴⼔ቇࠍขࠅᏎߊ⺖㗴ߦߟ޿ߡߩᗵฃᕈࠍ㜞߼‫ޔ‬ਥ૕ᕈࠍᜬߞߡᡷༀߔࠆ
㧟㧚ࠃࠅ⦟޿ࠤࠕࠍ᳿ቯߔࠆߚ߼ߦᦨᣂߩ⍮⷗ࠍᓧߥ߇ࠄታ〣ߔࠆࡕ࠺࡞ߦߥࠆ
㧠㧚ኾ㐷⡯ߣߒߡ⋴⼔ⷰࠍ᣿⏕ߦߔࠆ－ 61 －

╙㧠┨ ⋴⼔♽ᄢቇද⼏ળળຬᩞߦኻߔࠆ⾰໧⚕⺞ᩏ㧝⺞ᩏᣇᴺ㧝㧕ኻ⽎৻⥸␠࿅ᴺੱᣣᧄ⋴⼔♽ᄢቇද⼏ળߩળຬᩞߢ‫♽⼔⋴ޔ‬ᄢቇ㒮ߩ⎇ⓥ⑼㐳‫ޔ‬ᄢቇ㒮⸳⟎ࠍḰ஻ߒߡ޿ࠆቇㇱ㐳╬ࠍኻ⽎ߣߒߚ‫ޕ‬⾰໧⚕⺞ᩏߩ࿁╵߇ᓧࠄࠇߚߩߪ 122 ੱߢ޽ߞߚ‫ޕ‬㧞㧕࠺࡯࠲෼㓸ᣇᴺࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯ෳട⠪ߦኻߔࠆ⾰໧⚕⺞ᩏߩ⚿ᨐࠃࠅ‫ޔ‬‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢ
ୃᓧߔߴ߈⢻ജ‫ ࠆߌ߅ߦޠ‬10 ߩ⢻ജߣߘߩౝኈࠍ␜ߔ 42 㗄⋡ࠍౣᐲୃᱜߒ‫⾗ޔ‬ᢱ㧠ߦ␜ߒߚ⾰໧⚕ࠍ૞ᚑߒߚ‫ޟߩߘޔߡߒߘޕ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ߦ߮ࠄߥ⃻⴫ߩޠ‬ౝኈߦ㑐ߒߡ‫ޔ‬‫ޟ‬หᗧߒߥ޿‫ޠ‬‫ޟ‬หᗧߔࠆ‫ࠍߟ৻߆ࠇߕ޿ߩޠ‬ㆬᛯߒ‫ޟޔ‬หᗧߒߥ޿‫ࠍޠ‬ㆬᛯߒߚ㓙ߦߪ‫ߩߘޔ‬ℂ↱ࠍ⸥ㅀߔࠆࠃ߁ଐ㗬ߒ‫ޔ‬਄⸥ኻ⽎⠪ߦ⸘ 209 ㇱㅍઃߒߚ‫ޕ‬㧟㧕࠺࡯࠲෼㓸ᦼ㑆⾰໧⚕ߪㇷㅍᴺߢታᣉߒ‫⾰ޔ‬໧⚕ߩ࿁෼ߪᐔᚑ 25 ᐕ 2 ᦬ 18 ᣣ߆ࠄ 3 ᦬ 7 ᣣ߹ߢⴕߞߚ‫ޕ‬㧠㧕ಽᨆᣇᴺ‫ޟ‬หᗧߒߥ޿‫ޔޠ‬‫ޟ‬หᗧߔࠆ‫ߩޠ‬ᐲᢙಽᏓਗ߮ߦ‫ޟ‬หᗧߒߥ޿‫ޠ‬ℂ↱ߩ⸥ㅀߦࠃࠅ‫ୃޔ‬ᓧ
ߔߴ߈ 10 ߩ⢻ജ߅ࠃ߮ߘߩ⢻ജߩౝኈ 42 㗄⋡ࠍᬌ⸛ߒߚ‫ޕ‬
㧡㧕୶ℂ⊛㈩ᘦ
⾰໧⚕ߦ࿁╵ߒ‫ޔ‬㄰ାߩ޽ߞߚ߽ߩࠍᧄ⺞ᩏߩදജ⠪ߣߒߚ‫⺞ޕ‬ᩏදജଐ㗬ᢥߦߪ‫⺞ޔ‬ᩏߦᔅⷐߥᤨ㑆ࠍឭ␜ߒ‫ޔ‬ή⸥ฬߦࠃࠆ⾰໧⚕⺞ᩏߣߒߚ‫ޕ‬㧞⚿ᨐㅍઃߒߚ 209 ㇱߩ߁ߜ‫ޔ‬㄰ㅍߐࠇߚ 122 ㇱ㧔࿁෼₸ 58.4%㧕ࠍኻ⽎ߦ‫ޔ‬‫ޟ‬หᗧߒߥ޿‫ޔޠ‬‫ޟ‬หᗧߔࠆ‫ߩޠ‬ᐲᢙಽᏓਗ߮ߦ‫ޟ‬หᗧߒߥ޿‫ޠ‬ℂ↱ߩ⸥ㅀࠍಽᨆߒ‫ୃޔ‬ᓧߔߴ߈ 10 ߩ‫ޟ‬⢻ജ‫ޟߩߘ߮ࠃ߅ޠ‬⢻ജߩౝኈ‫ޠ‬42 㗄⋡ࠍᬌ⸛ߒߚ‫ޕ‬ ߥ߅‫⺞ᧄޔ‬ᩏߪ‫ޔ‬ή࿁╵࡮ήല࿁╵ࠍ㒰޿ߚ᦭ല࿁╵ᢙߩߺࠍ㓸⸘ߒ‫ޔ‬‫ޟ‬หᗧߔࠆ‫ޟߣޠ‬หᗧߒߥ޿‫ߩޠ‬ਛ㑆ࠍㆬᛯߒߡ޿ߚ႐วߪ‫ޔ‬ήല࿁╵ߣߒߡ࠺࡯࠲ಣℂࠍⴕ޿‫ޔ‬ಽᨆߒߚ‫ޕ‬㧝㧕࿁╵⠪ߩ᭎ⷐ ࿁╵⠪߇ᚲዻߒߡ޿ࠆᄢቇߩ⸳⟎ᒻᘒߪ‫┙⑳ޔ‬ᄢቇ߇ᦨ߽ᄙߊ 53 ᩞ㧔43.4%㧕
‫ߡ޿⛯ޔ‬࿖┙ᄢቇᴺੱ߇ 39 ᩞ㧔32.0%㧕
‫┙౏ޔ‬ᄢቇ࡮౏┙ᄢቇᴺੱ߇ 30 ᩞ㧔24.6%㧕ߢ޽ߞߚ㧔࿑ 21㧕‫ޕ‬‫ޔ‬ ߹ߚ‫ޔ‬ᚲዻᄢቇߢⴕߞߡ޿ࠆ⋴⼔ቇߩᄢቇ㒮ᢎ⢒ߪ‫ޔ‬ᄢቇ㒮ୃ჻⺖⒟ᢎ⢒߇ 47 ᩞ
㧔39.8㧑㧕
ᄢቇ㒮ඳ჻⺖⒟㧨೨ᦼ࡮ᓟᦼ㧪ᢎ⢒߇ 45 ᩞ㧔38.1㧑㧕‫ޔ‬ᄢቇ㒮ᢎ⢒⸳⟎Ḱ஻ਛ߇ 26 ᩞ
㧔22.0%㧕ߢ޽ߞߚ㧔࿑ 22㧕
‫ޕ‬－ 62 －

ᄢቇ㒮ᢎ⢒
⸳⟎Ḱ஻ਛ
22.0 %

࿖┙ᄢቇᴺੱ,32.0 %

⑳┙ᄢቇ
43.4%

ᄢቇ㒮
ୃ჻⺖⒟ᢎ⢒
39.8 %ᄢቇ㒮ඳ჻⺖⒟(೨ᦼ䊶ᓟᦼ)ᢎ⢒ 38.1 %౏┙ᄢቇ䊶౏┙ᄢቇᴺੱ
24.6 %

࿑ 21. ᄢቇߩ⸳⟎ᒻᘒ           ࿑ 22. ᄢቇ㒮ߩᢎ⢒⺖⒟ ࿁╵⠪߇ᚲዻߔࠆᄢቇ㒮⎇ⓥ⑼߇᝼ਈߒߡ޿ࠆቇ૏ߪ 78 ᩞ㧔74.3㧑㧕߇ୃ჻㧔⋴⼔ቇ㧕‫ޔ‬27 ᩞ㧔25.7㧑㧕߇ୃ჻㧔⋴⼔ቇએᄖ㧕ߣ╵߃ߡ߅ࠅ㧔࿑ 23㧕‫ޔ‬ή࿁╵෸߮᝼ਈ੍ቯ߇ 17 ᩞߢ޽ߞߚ‫⼔⋴ޔߡߒߘޕ‬ቇએᄖߩቇ૏ߢߪ‫଻ޔ‬ஜቇ߇ᦨ߽ᄙߊ㧔8 ⎇ⓥ⑼㧕‫ޔ‬ක⑼ቇ‫ޔ‬ஜᐽ⑼ቇ‫ޔ‬ஜᐽ⑔␩ቇ‫଻ޔ‬ஜක≮ቇ‫଻ޔ‬ஜ⑼ቇ‫଻ޔ‬ஜ⋴⼔ቇ‫଻ޔ‬ஜ⑔␩ቇ߇ฦ㧝⎇ⓥ⑼ߕߟߣ
ߥߞߡ޿ߚ‫੹ޟߡߒߣઁߩߘޔߚ߹ޕ‬ᓟ‫ୃޔ‬჻㧔⋴⼔ቇ㧕ߣߥࠆ‫ޠ‬㧔2 ⎇ⓥ⑼㧕ߣ޿߁࿁╵߽޽ߞߚ㧔࿑ 24㧕‫ޕ‬ୃ჻䋨⋴⼔ቇએᄖ䋩25.7䋦

ୃ჻䋨⋴⼔ቇ䋩74.3䋦

࿑ 23. ᝼ਈߒߡ޿ࠆቇ૏ 㩷 㩷 㩷 㩷 㩷 㩷 㩷 㩷 㩷 㩷 㩷 㩷 㩷 ࿑ 24.㩷 ⋴⼔ቇએᄖߢ᝼ਈߐࠇߡ޿ࠆቇ૏ ߐࠄߦ‫ޔ‬ኾ㐷⋴⼔Ꮷᢎ⢒⺖⒟ߩ⹺ቯࠍฃߌߡ޿ࠆኾ㐷㗔ၞߦߟ޿ߡߪ‫ޔ‬‫⹺ޟ‬ቯࠍฃߌߚኾ
㐷㗔ၞ߇޽ࠆ‫ ߇ޠ‬57 ᩞ㧔51.4㧑㧕ߣᦨ߽ᄙߊ‫ޔ‬‫ޟ‬ኾ㐷⋴⼔Ꮷᢎ⢒⺖⒟ߪߥ޿‫ ߪޠ‬43 ᩞ㧔38.7㧑㧕‫ޔ‬‫᧪ޟ‬ᐕᐲ↳⺧੍ቯ‫ ߪޠ‬11 ᩞ㧔9.9㧑)⷗ࠄࠇߚ㧔࿑ 25㧕‫ޕ‬－ 63 －

᧪ᐕᐲ↳⺧੍ቯ9.9%ኾ㐷⋴⼔Ꮷᢎ⢒
⺖⒟䈭䈚
38.7%

ኾ㐷⋴⼔Ꮷ
ᢎ⢒⺖⒟䈅䉎
51.4%

࿑ 25. ኾ㐷⋴⼔Ꮷᢎ⢒⺖⒟ߩ᦭ήߦߟ޿ߡ

ߘߒߡ‫ޔ‬࿁╵⠪ߩ⡯૏ߪቇ㐳‫⎇ޔ‬ⓥ⑼㐳‫ޔ‬ᢎ᝼‫ઁߩߘޔ‬㧔ቇ⑼㐳‫ޔ‬ቇㇱ㐳‫ޔ‬ኾ᡹㐳ߥߤ㧕ߣߥߞߡ߅ࠅ‫ޔ‬ಎᢎ᝼ߪ฽߹ࠇߡ޿ߥ߆ߞߚ‫੹ޔ߽ࠄ߆ߣߎߩߎޕ‬࿁ߩ⾰໧⚕⺞ᩏߦߟ޿ߡߪ‫৻ޔ‬ቯߩℂ⸃ߩ߽ߣ‫⽿ޔ‬છ޽ࠆ࿁╵߇ߥߐࠇߚߣ⠨߃ࠄࠇࠆ‫ޕ‬㧞㧕ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈ 10 ߩ‫ޟ‬⢻ജ‫ߦޠ‬ኻߔࠆหᗧ
ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈ 10 ߩ‫ޟ‬⢻ജ‫ߦޠ‬ኻߔࠆหᗧߪ‫ ߽ࠇߕ޿ޔ‬84.0㧑㨪97.5㧑ߣ㜞޿᳓Ḱߢ޽ߞߚ㧔⴫ 13㧕‫ޕ‬หᗧߩഀว߇ᦨ߽㜞߆ߞߚ‫ޟ‬⢻ജ‫ޟޔߪޠ‬Ψ㧚ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫ޟߣޠ‬ά㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆࠕࠗ࠺ࡦ
࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ‫ ߩޠ‬97.5㧑ߢ޽ࠅ‫߽ᦨޔ‬ૐ߆ߞߚ‫ޟ‬⢻ജ‫ޔߪޠ‬‫ޟ‬Ω㧚⃻ⴕߩᴺᓞ࡮೙ᐲ࡮
᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ‫ ߩޠ‬84.0㧑ߢ޽ߞߚ‫ޕ‬
⴫ 13. ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈ 10 ߩ‫ޟ‬⢻ജ‫ߦޠ‬ኻߔࠆหᗧ
ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈ 10 ߩ⢻ജ‫ޟ‬หᗧ‫ޠ‬࿁╵⠪ੱᢙ㧔%㧕 ᢙ (n)Σ㧚⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦត᳞ߒ‫ࠍࠬࡦ࠺ࡆࠛޔ‬ᵴ↪ߔࠆ

117(96.7)n=121++㧚⋴⼔ߩኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ㧕ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆ

113(95.0)n=119Υ㧚⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡขࠅ⚵߻

114(95.8)n=119Φ㧚ࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ࠕࠤޔ‬ⅣႺࠍᡷༀߔࠆ

108(90.8)n=119Χ㧚ࠤࠕࠍផㅴߢ߈ࠆ႐߿ੱ⊛ⅣႺࠍᢛ߃ࠆߚ߼ߦ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆ

116(96.7)n=120Ψ㧚ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ

116(97.5)n=119Ω㧚⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ 100(84.0)n=119Ϊ㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆᢎ⢒ⅣႺߠߊࠅߦขࠅ⚵߻

112(95.7)n=117Ϋ㧚୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ

115(95.8)n=120ά㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ

117(97.5)

n=119－ 64 －

㧟㧕‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢ⠌ᓧߔߴ߈⢻ജ‫ ࠆߌ߅ߦޠ‬10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬42 㗄⋡ߦߟ޿ߡ ᰴߦ‫ޔ‬వߩ⺞ᩏ⚿ᨐࠃࠅୃᱜߒߚ‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈⢻ജ‫ࠆߌ߅ߦޠ‬10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬42 㗄⋡ߩᅷᒰᕈߦߟ޿ߡ‫੹ޔ‬࿁ߩ⺞ᩏ⚿ᨐࠍㅀߴࠆ‫ޕ‬㧔㧝㧕‫ޟ‬Σ.⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ࠍࠬࡦ࠺ࡆࠛޔ‬ᵴ↪ߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈ ߎߩ‫ޟ‬⢻ജ‫ޔߪߡ޿ߟߦޠ‬117 ฬ㧔96.7㧑㧕߇‫ޟ‬หᗧߔࠆ‫ߣޠ‬࿁╵ߒߡ߅ࠅ‫ޟޔ‬หᗧߒߥ޿‫߁޿ߣޠ‬ᗧ⷗ߪ 4 ฬ㧔3.3㧑㧕ߦߣߤ߹ߞߚ㧔࿑ 26㧕‫ޕ‬
หᗧ䈚䈭䈇
3.3%

หᗧ䈜䉎
96.7%

㩷 㩷 㩷 ࿑ 26.㩷 ‫ޟ‬Σ⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ࠍࠬࡦ࠺ࡆࠛޔ‬ᵴ↪ߔࠆ‫ޠ‬⢻ജߦኻߔࠆหᗧ
‫ޟ‬หᗧߒߥ޿‫ޠ‬ℂ↱ߦ޽ߍࠄࠇߚߩߪ‫ޔ‬‫ޟ‬㧔ୃ჻⺖⒟ߦ᳞߼ࠆ࡟ࡌ࡞ߪ㧕ࠛࡆ࠺ࡦࠬࠍ⷗
޿಴ߔ㆏ߔߓ߇ℂ⸃ߢ߈ࠆ࡟ࡌ࡞‫ޠ‬‫ޔ‬‫ޟ‬ᓥ᧪᳞߼ࠄࠇߡ޿ࠆ‫⎇⼔⋴ޔ‬ⓥ⢻ജࠍୃᓧߔࠆᗧ๧
޽޿߇߁ߔࠇߡ޿ࠆ‫߁޿ߣޠ‬ᗧ⷗ߩߺߢ޽ߞߚ‫ޕ‬ԙ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈ ߹ߚ‫ޟߩߎޔ‬⢻ജߩౝኈ‫ߡߒߣޠ‬ឭ␜ߒߚ 4 㗄⋡ߦߟ޿ߡ߽‫ޔ‬95.8%㨪99.2%߇‫ޟ‬หᗧߔࠆ‫ߣޠ‬࿁╵ߒߡ߅ࠅ‫ޔ‬એਅߩࠃ߁ߥ⚿ᨐߣߥߞߚ㧔࿑ 27㧕
‫ޕ‬－ 65 －

0%

20%

40%

60%

80%

100%

Σ-1⋴⼔ታ〣䈪䈱໧㗴䉕⸃᳿䈜䉎䈢䉄䈮䇮ᔅⷐ䈭䉣䊎䊂䊮䉴䉕ត᳞䈜䉎(n=121)97.5

2.5

Σ-2䉣䊎䊂䊮䉴䉕ᛕ್⊛䈮⺒⸃䈚䇮⹏ଔ䈜䉎 (n=119)

99.2

0.8

Σ-3 Evidence-based practice䉕ℂ⸃䈜䉎 (n=119)

97.5

2.5

Σ-4ᣂ䈢䈭⍮⼂䉇వㅴ⊛䈭ᛛⴚ䉕ត⚝䈚䇮ᵴ↪䈜䉎 (n=118)

95.8

4.2

หᗧ䈜䉎

หᗧ䈚䈭䈇

࿑ 27.㩷 ‫ޟ‬Σ⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ࠍࠬࡦ࠺ࡆࠛޔ‬ᵴ↪ߔࠆ‫ߩޠ‬ౝኈߦኻߔࠆหᗧ ‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬95.8%ߢ޽ߞߚ‫ޟ‬ᣂߚߥ⍮⼂߿వㅴ⊛ߥᛛⴚࠍត⚝ߒ‫ޔ‬ᵴ↪ߔࠆ‫ߦޠ‬ኻߒߡߪ‫ޔ‬‫ޟ‬Σ1 ߣߩ⼂೎߇ਇ᣿⏕‫ߩࠬࡦ࠺ࡆࠛޔ‬ᵴ↪ߦߟ޿ߡߩౝኈ߇ࠊ߆ࠅߦߊ޿‫ޔޠ‬‫ୃޟ‬჻⺖⒟ߢᔅ㗇ߣߪᕁࠊߥ޿‫ޔޠ‬‫ޟ‬ඳ჻ᓟᦼ⺖⒟ߩ࡟ࡌ࡞‫߁޿ߣޠ‬ᗧ⷗߇ነߖࠄࠇߚ‫ޔߒ߆ߒޕ‬ᧄ⺞ᩏߢߪ‫ߦࠬࡦ࠺ࡆࠛޔ‬ኻߔࠆ⺑᣿ᢥ┨ࠍട߃ߚߎߣ߆ࠄ‫ߔ␜߇ࠬࡦ࠺ࡆࠛޔ‬ౝኈߩਇ᣿⍎ߐࠍᜰ៰ߔࠆᗧ⷗ߪ⷗ࠄࠇߥ߆ߞߚ‫ޕ‬㧔㧞㧕‫ޟ‬Τ.⋴⼔ߩኻ⽎(୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ)ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈߎߩ‫ޟ‬⢻ജ‫ޔߪߡ޿ߟߦޠ‬113 ฬ㧔95.0㧑㧕߇‫ޟ‬หᗧߔࠆ‫ߣޠ‬࿁╵ߒߡ߅ࠅ‫ޟޔ‬หᗧߒߥ޿‫߁޿ߣޠ‬ᗧ⷗ߪ 6 ฬ㧔5.0㧑㧕ߢ޽ߞߚ㧔࿑ 28㧕‫ޕ‬‫ޟ‬หᗧߒߥ޿‫ޠ‬ℂ↱ߣߒߡ‫ޔ‬‫ޟ‬CNS ࠦ࡯ࠬߦߪㆡ↪ߐࠇࠆ߇‫ୃߩߡోޔ‬჻ߢߪߥ޿‫ޔޠ‬‫⎇ޟ‬ⓥࠦ࡯ࠬߩ႐ว‫ޔ‬ᔅ㗇ߣߪᕁࠊߥ޿‫“ޔࠅ޽߇ߤߥޠ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆ”ߣ޿߁⴫⃻ߦኻߔࠆᗧ⷗߇ነߖࠄࠇߚ‫ޕ‬
หᗧ䈚䈭䈇
5.0%

หᗧ䈜䉎
95.0%

࿑ 28.㩷 ‫ޟ‬Τ⋴⼔ߩኻ⽎ ୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆ‫ޠ‬⢻ജߦኻߔࠆหᗧ

－ 66 －

ԙ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈߎߩ‫ޟ‬⢻ജߩౝኈ‫ߡߒߣޠ‬ឭ␜ߒߚ 8 㗄⋡ߦߟ޿ߡߪ‫ޔ‬93.3㧑㨪96.7㧑߇‫ޟ‬หᗧߔࠆ‫ޠ‬ߣ࿁╵ߒߡ߅ࠅ‫ޔ‬એਅߩࠃ߁ߥ⚿ᨐߣߥߞߚ㧔࿑ 29㧕‫ޕ‬
0%

20%

40%

60%

80%

100%

Τ-1ᦨᣂ䈱䉬䉝ᛛⴚ䉇䉣䊎䊂䊮䉴䈮ၮ䈨䈇䈩䇮⋴⼔䉕ታ〣䈜䉎 (n=119)

96.6

3.4

Τ-2ឭଏ䈘䉏䈩䈇䉎ක≮䈱୶ℂᕈ䉕್ᢿ䈚ታ〣䈜䉎(n=120)95.8

4.2

Τ-3୶ℂ⊛䈮ㆡᱜ䈭ᖱႎᛛⴚ䈱೑↪䉕ଦㅴ䈜䉎 (n=118)

94.9

5.1

Τ-4ᄙ⡯⒳䈫䈫䉅䈮ක≮䈱቟ోᕈ䉕⏕⹺䈚䇮଻㓚䈜䉎(n=120)95.8

4.2

Τ-5ኻ⽎ਛᔃ䈮䇮⋴⼔⡯䈍䉋䈶ᄙ⡯⒳䈫䈱⺞ᢛ䉕ⴕ䈇䇮ද௛䈚䈩䉬䉝䈜䉎 (n=120)

96.7

3.3

Τ-6⋴⼔䈮䈧䈇䈩䈱⺑᣿ജ䉕䉅䈤䇮ද௛䉕ផㅴ䈜䉎(n=120)96.7

3.3

Τ-7੐଀ಽᨆ䈫⛔⸘ಽᨆ䈱⍮⼂䉕ㅢ䈛䇮ஜᐽ䉕଻ᜬჇㅴ䈜䉎 (n=119)

93.3

6.7

Τ-8⋴⼔䈱ኻ⽎䈮ኻ䈚䈩䇮∉ቇ⊛䈭⍮⼂䉕ᵴ↪䈚䈩੍㒐⊛ⷰὐ䉕〯䉁䈋䈩ஜᐽ䈱଻ᜬ䊶Ⴧㅴ䈮ข䉍⚵䉃 (n=119)

95.8

4.2

หᗧ䈜䉎

หᗧ䈚䈭䈇

࿑ 29. 䇸Τ⋴⼔ߩኻ⽎ ୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆ‫ߩޠ‬ౝኈߦኻߔࠆหᗧ ߎߩ⢻ജߩౝኈߣߒߡߪ‫ޔ‬Τ3‫୶ޟ‬ℂ⊛ߦㆡᱜߥᖱႎᛛⴚߩ೑↪ࠍଦㅴߔࠆ‫ޔߣޠ‬Τ-7‫ޟ‬੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍㅢߓ‫ޔ‬ஜᐽࠍ଻ᜬჇㅴߔࠆ‫ߩޠ‬หᗧ߇‫ޔ‬112 ੱ㧔94.9%㧕‫ޔ‬
111 ੱ㧔93.3%㧕ߣઁߦᲧߴߡૐ߆ߞߚ‫ޕ‬‫ޟ‬หᗧߒߥ޿‫ޠ‬ℂ↱ߣߒߡ‫ޔ‬Τ3‫୶ޟ‬ℂ⊛ߦㆡᱜߥᖱႎᛛⴚߩ೑↪ࠍଦㅴߔࠆ‫ߦޠ‬ኻߒߡߪ‫ޔ‬‫ޟ‬ᢥ┨ߩᗧ๧߇ࠃߊࠊ߆ࠄߥ޿‫ޔޠ‬‫“ޟ‬ᖱႎᛛⴚߩ೑↪ࠍଦㅴߔࠆ”ߣ޿߁ౝኈ߇ࠊ߆ࠅ
ߦߊ޿‫ߩ╬ޠ‬ᗧ⷗߇ነߖࠄࠇߚ‫ޔߚ߹ޕ‬Τ-7‫ޟ‬੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍㅢߓ‫ޔ‬ஜᐽࠍ଻ᜬჇㅴߔࠆ‫ޟޔ߽ߡ޿ߟߦޠ‬ᢥ┨߇વࠊࠅߦߊ޿‫ޔޠ‬‫“ޟ‬੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍ”ߩ⴫⃻߇ಽ߆ࠅߦߊ޿‫ޔޠ‬‫ޟ‬ౝኈߩᗧ࿑ߒߡ޿ࠆߎߣ߇ࠊ߆ࠅߦߊ޿‫ߩ⃻⴫ޔ╬ޠ‬ಽ߆ࠅߦߊߐ߇
ᜰ៰ߐࠇߚ‫ޔઁߩߘޕ‬Τ-8‫ߩ⼔⋴ޟ‬ኻ⽎ߦኻߒߡ‫∉ޔ‬ቇ⊛ߥ⍮⼂ࠍᵴ↪ߒߡ‫੍ޔ‬㒐⊛ⷰὐࠍ〯߹߃ߡஜᐽߩ଻ᜬ࡮Ⴧㅴߦขࠅ⚵߻‫ޔ߽ߡ޿ߟߦޠ‬‫∉“ޟ‬ቇ⊛ߥ⍮⼂ࠍᵴ↪ߒߡ”‫੍“ޔ‬㒐⊛ⷰὐࠍ〯߹߃ߡ”ߣ޿߁⴫⃻߇ಽ߆ࠅߦߊ޿‫߁޿ߣޠ‬ᗧ⷗߇␜ߐࠇߡ޿ߚ‫ޕ‬ એ਄ߩὐ߆ࠄ‫ ࠄࠇߎޔ‬3 㗄⋡ߦߟ޿ߡߪ‫ޔ‬㗄⋡ฬߩᬌ⸛߇ᔅⷐߢ޽ࠆߎߣ߇⠨߃ࠄࠇߚ‫ޕ‬㧔㧟㧕‫ޟ‬Υ㧚⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡขࠅ⚵߻‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈߎߩ‫ޟ‬⢻ജ‫ޔߪߡ޿ߟߦޠ‬115 ฬ㧔96.6㧑㧕߇‫ޟ‬หᗧߔࠆ‫ߣޠ‬࿁╵ߒߡ߅ࠅ‫ޟޔ‬หᗧߒߥ޿‫߁޿ߣޠ‬ᗧ⷗ߪ 4 ฬ㧔4.1㧑㧕ߢ޽ߞߚ㧔࿑ 30㧕‫ޕ‬ ‫ޟ‬หᗧߒߥ޿‫ޠ‬ℂ↱ߣߒߡߪ‫“ޟޔ‬ኻ⽎”߿“႐”߇ᗧ๧ߔࠆ߽ߩࠍᢛℂߔࠆᔅⷐ߇޽ࠆ‫ޠ‬－ 67 －߿‫ޔ‬‫ޟ‬ኻ⽎ߩ⾰ߩᡷༀߪࠊ߆ࠅߦߊ޿‫߁޿ߣޠ‬ᗧ⷗߇޽ߍࠄࠇߚ‫ޕ‬หᗧ䈚䈭䈇,
3.4䋦

หᗧ䈜䉎
96.6䋦

࿑ 30.‫ޟ‬Υ㧚⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡขࠅ⚵߻‫ޠ‬⢻ജߦኻߔࠆหᗧ

ԙ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈߎߩ‫ޟ‬⢻ജߩౝኈ‫ߡߒߣޠ‬ឭ␜ߒߚ 4 㗄⋡ߦߟ޿ߡߪ‫ޟޔ‬หᗧߔࠆ‫ ߇ޠ‬88.1㧑㨪93.3%
ߢ޽ࠅ‫ޔ‬Ύ1 ߦߟ޿ߡߪ 90㧑ࠍਅ࿁ߞߚ㧔࿑ 31㧕
‫ޕ‬
0%

20%

40%

60%

80%

100%

Υ-1⾌↪ኻലᨐ䇮⚵❱⊛᦭ലᕈ䈭䈬䈱ⷰὐ䉕฽䉄䇮ኻ⽎䈮䈫䈦䈩䈱ലᨐ䉕⹏ଔ䈜䉎 (n=118)

88.1

11.9

Υ-2䉬䉝䈱⾰䉕ᡷༀ䈜䉎䈢䉄䈮䉣䊎䊂䊮䉴䉕↪䈇䈩⚵❱䉇㓸࿅䈻௛䈐䈎䈔䉎 (n=119)

93.3

6.7

Υ-3ᖱႎ䉲䉴䊁䊛䇮⛔⸘䈫∉ቇ䈱⍮⼂䉕↪䈇䈩䇮䉝䉡䊃䉦䊛䈱ᡷༀ䉇䊥䉴䉪ૐᷫ䈱䈢䉄䈱ᚢ⇛䉕┙䈩䉎 (n=116)

90.5

9.5

Υ-4᡽╷⊛䈭ⷰὐ䈪䉬䉝䈱⾰଻⸽䉇䊥䉴䉪䊙䊈䉳䊜䊮䊃䉕ℂ⸃䈜䉎 (n=117)

93.2

6.8

หᗧ䈜䉎

หᗧ䈚䈭䈇

࿑ 31.㩷 䇸Υ㧚⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡขࠅ⚵߻‫ߩޠ‬ౝኈߦኻߔࠆหᗧ ‫ޟ‬หᗧߒߥ޿ℂ↱‫ޔߡߒߣޠ‬Υ1‫↪⾌ޟ‬ኻലᨐ‫᦭⊛❱⚵ޔ‬ലᕈߥߤߩⷰὐࠍ฽߼‫ޔ‬ኻ⽎ߦߣߞߡߩലᨐࠍ⹏ଔߔࠆ‫ߦޠ‬ኻߒߡߪ‫ޔ‬‫ޟ‬૗ߩലᨐ߆ਇ᣿‫ޔ߿ߩ߽߁޿ߣޠ‬‫↪⾌“ޟ‬ኻലᨐ‫ޔ‬“⚵❱⊛᦭ലᕈߥߤߩⷰὐࠍ฽߼”ߩᗧ๧ߦࠃࠆ߇‫್ߩࠄࠇߎޔ‬ᢿߪ㧔ୃ჻⺖⒟ߩ࡟ࡌ࡞ߢߪ㧕㔍ߒ޿‫߁޿ߣޠ‬ᗧ⷗߇޽ߞߚ‫ޔߚ߹ޕ‬Υ-3‫ޟ‬ᖱႎࠪࠬ࠹ࡓ‫∉ߣ⸘⛔ޔ‬ቇߩ⍮⼂ࠍ↪޿ߡ‫ࠕޔ‬࠙࠻ࠞࡓߩᡷༀ߿࡝ࠬࠢૐᷫߩߚ߼ߩᚢ⇛ࠍ┙ߡࠆ‫ޟޔߪߡ޿ߟߦޠ‬ᔅⷐߛߣᕁ߁߇‫⚻ޔ‬༡⊛‫ⷞ⊛ࡓ࠹ࠬࠪޔ‬ὐߩ⠌ᓧߪℂ⸃ߩ࡟ࡌ࡞߹ߢߢ޽ࠆߣᕁ߁‫ޔ߿ޠ‬‫“ޟ‬ᚢ⇛ࠍ┙ߡࠆ”߹ߢߪ‫ޔ‬⺖㗴߇ᄢ߈޿‫ޔߤߥޠ‬᳞߼ࠆ࡟ࡌ࡞߇㜞޿ߎߣ߇ᜰ៰ߐࠇߚ‫ޔߡߒߘޕ‬Υ-4‫ޟ‬᡽╷⊛ߥⷰὐ－ 68 －

ߢࠤࠕߩ⾰଻⸽߿࡝ࠬࠢࡑࡀࠫࡔࡦ࠻ࠍℂ⸃ߔࠆ‫ߦޠ‬ኻߒߡߪ‫ޔ‬‫ޟ‬᡽╷⊛ⷰὐߢ‫ࠅ߆ࠊߪޠ‬ߦߊ޿‫ޔ‬‫ޟ‬ඳ჻ᓟᦼ⺖⒟ୃੌᤨ㧔ߩ࡟ࡌ࡞㧕‫߁޿ߣޠ‬ᗧ⷗߇⷗ࠄࠇߚ‫ޕ‬ એ਄ࠃࠅ‫ߩߡߴߔޔ‬㗄⋡ߦߟ޿ߡ 80㧑એ਄ߩหᗧ߇ᓧࠄࠇߡ޿ࠆߚ߼‫ޔ‬ౝኈߦߟ޿ߡߩ
วᗧᒻᚑߪᓧࠄࠇߚ߇‫ޔ‬Υ-1‫ޔ‬Υ3‫ޔ‬Υ-4 ߦߟ޿ߡߪ‫ޔ‬㗄⋡ฬߩᬌ⸛߇ᔅⷐߢ޽ࠆߎߣ߇
⠨߃ࠄࠇߚ‫ޕ‬㧔㧠㧕‫ޟ‬Φ㧚ࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ࠕࠤޔ‬ⅣႺࠍᡷༀߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈߎߩ‫ޟ‬⢻ജ‫ޔߪߡ޿ߟߦޠ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬108 ฬ㧔90.8%㧕
‫ޔ‬‫ޟ‬หᗧߒߥ޿‫ ߪޠ‬11 ฬ㧔9.2%㧕
ߢ޽ࠅ㧔࿑ 32㧕‫ޔ‬10 ߩ⢻ജߦኻߔࠆ‫ޟ‬หᗧ‫ޠ‬ഀวߣߒߡߪ‫߿߿ޔ‬ૐ޿⚿ᨐߣߥߞߚ‫ޕ‬

หᗧ䈚䈭䈇
9.2䋦

หᗧ䈜䉎
90.8䋦

࿑ 32. 䇸Φ㧚ࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ࠕࠤޔ‬ⅣႺࠍᡷༀߔࠆ‫ޠ‬⢻ജߦኻߔࠆหᗧ㩷 ‫ޟ‬หᗧߒߥ޿‫ޠ‬ℂ↱ߣߒߡߪ‫ޔ‬‫ޟ‬ඳ჻⺖⒟ߩ࡟ࡌ࡞ߢ޽ࠆ‫ޔޠ‬‫ޟ‬2 ᐕ㑆ߩᢎ⢒ߢߎߎ߹ߢ᳞߼
ࠄࠇࠆ߆⇼໧ߢ޽ࠆ‫ޔߤߥޠ‬᳞߼ࠆ࡟ࡌ࡞߇㜞޿ߣ޿߁ᗧ⷗߇ᄙߊ‫ޔ‬ᗧ๧ߩਇ᣿⍎ߐ߿⢻ജࠍ⇼໧ⷞߔࠆౝኈߪ⷗ࠄࠇߥ߆ߞߚ‫ޕ‬ԙ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈߎߩ‫ޟ‬⢻ജߩౝኈ‫ߡߒߣޠ‬ឭ␜ߒߚ 4 㗄⋡ߦߟ޿ߡߪ‫ޔ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬88.8㧑㨪94.9%ߢ
޽ࠅ‫ޔ‬એਅߩࠃ߁ߥ⚿ᨐߢ޽ߞߚ㧔࿑ 33㧕‫ޟޔߚ߹ޕ‬หᗧߒߥ޿‫ޠ‬ℂ↱ߪ‫ޔ‬Φ1‫ޔ‬Φ3‫ޔ‬Φ
4 ߦߟ޿ߡ޽ߍࠄࠇߡ޿ߚ‫ޕ‬－ 69 －

0%

20%

40%

60%

80%

100%

Φ-1୘䈫⚵❱䈱ਔ஥㕙䈎䉌䇮⋴⼔䉕䉲䉴䊁䊛䈫䈚䈩ᝒ䈋䉎 (n=118)

94.9

5.1

Φ-2䉬䉝ⅣႺ䈫䈚䈩䈱⚵❱䉕ಽᨆ䈚䇮⺖㗴⸃᳿䈱䈢䉄䈱ᣇ⇛䉕ឭ᩺䈜䉎 (n=120)

91.7

8.3

Φ-3䉬䉝䉕ታ〣䈜䉎䈢䉄䈮ᔅⷐ䈫䈭䉎ᄙ⡯⒳䉇⾗
Ḯ䉕Ꮞ䈐ㄟ䉂䈭䈏䉌䇮䉬䉝ⅣႺ䈱ᡷༀ䈮ข䉍⚵䉃(n=118)91.5

8.5

Φ-4⚵❱䈱⺖㗴䈮䈧䈇䈩ᢎ⢒⊛䈮௛䈐䈎䈔䉎(n=116)

88.8

11.2

หᗧ䈜䉎

หᗧ䈚䈭䈇

࿑ 33.‫ޟ‬Φ㧚ࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ࠕࠤޔ‬ⅣႺࠍᡷༀߔࠆ‫ߩޠ‬ౝኈߦኻߔࠆหᗧ

‫ޟ‬หᗧߒߥ޿‫ޠ‬ℂ↱ߣߒߡ‫ޔ‬Φ1‫ޟ‬୘ߣ⚵❱ߩਔ஥㕙߆ࠄ‫߃ᝒߡߒߣࡓ࠹ࠬࠪࠍ⼔⋴ޔ‬ࠆ‫ߦޠ‬ኻߒߡ‫❱⚵ޟޔ‬㑆ߩ⋴⼔ߦ㑐ࠊࠆ୘‫ߩޘ‬໧㗴㧔⺖㗴㧕ࠍࠪࠬ࠹ࡓߢᝒ߃ࠆ‫߆ࠊࠄߥޔ‬ࠆ߇‫߁޿ߣޠ‬ᗧ⷗߿‫ޔ‬‫“ޟ‬୘”ߣ޿߁ᗧ๧ߪ᏷ᐢ޿ᗧ๧ࠍᜬߜߔ߉ࠆ‫ޔ‬㧔୘߇␜ߔ߽ߩࠍ㧕ዋߒ㒢ቯߢ߈ߥ޿߆‫ߩ⃻⴫ޔࠇࠄߍ޽߇ߤߥޠ‬ಽ߆ࠅߦߊߐࠍᜰ៰ߔࠆౝኈߢ޽ߞߚ‫ޕ‬߹ߚ‫ޔ‬Φ3‫ࠍࠕࠤޟ‬ታ〣ߔࠆߚ߼ߦᔅⷐߣߥࠆᄙ⡯⒳߿⾗ḮࠍᏎ߈ߎߺߥ߇ࠄ‫ࠕࠤޔ‬ⅣႺߩᡷༀߦขࠅ⚵߻‫ޟޔߪߡ޿ߟߦޠ‬ᔅⷐߣߥࠆᄙ⡯⒳ߣ޿߁ߩߪ߅߆ߒ޿‫ޔޠ‬‫ޟ‬᳞߼ߚ޿ߣ
ߪᕁ߁߇‫ޔ‬⡯૏ߩᓇ㗀߇߆ߥࠅᒝ޿ߩߢߪߥ޿߆‫ޔߤߥޠ‬ቇ↢ߣ޿߁┙႐ߢߢ߈ࠆߎߣߦ
㒢ࠅ߇޽ࠆ‫߁޿ߣޔ‬ౝኈߩᗧ⷗߇⷗ࠄࠇߚ‫ޔߡߒߘޕ‬Φ4‫⺖ߩ❱⚵ޟ‬㗴ߦߟ޿ߡᢎ⢒⊛ߦ௛߈߆ߌࠆ‫ߦޠ‬ኻߒߡߪ‫ޟޔ‬ᢎ⢒⊛ߥ௛߈߆ߌߩኻ⽎ࠍ᣿␜ߒߚᣇ߇ࠃ޿‫߆ߣࠕࠤޟޔ߿ޠ‬⋴⼔ߣ޿߁↪⺆߇ߥߊᗧ๧߇ߣࠅߠࠄ޿‫ߩ⃻⴫ޔߤߥޠ‬ਇ᣿⏕ߐࠍᜰ៰ߒߚౝኈ߇⷗ࠄࠇ
ߚ‫ޕ‬એ਄ࠃࠅ‫ޔ‬Φ-1‫ޔ‬Φ-3‫ޔ‬Φ-4 ߦߟ޿ߡߪ‫ޔ‬㗄⋡ฬߩౣᬌ⸛߇ᔅⷐߢ޽ࠆߣ⠨߃ࠄࠇߚ‫ޕ‬㧔㧡㧕‫ޟ‬Χ㧚ࠤࠕࠍផㅴߢ߈ࠆ႐߿ੱ⊛ⅣႺࠍᢛ߃ࠆߚ߼ߦ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈߎߩ‫ޟ‬⢻ജ‫ޔߪߡ޿ߟߦޠ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬116 ฬ㧔96.7%㧕
‫ޔ‬‫ޟ‬หᗧߒߥ޿‫ ߪޠ‬4 ฬ㧔3.3%㧕
ߢ޽ߞߚ㧔࿑ 34㧕‫ޕ‬ߎߩࠃ߁ߦ‫ޔ‬96.7㧑ߣ㜞޿ഀวߢ‫ޟ‬หᗧߔࠆ‫⹏߁޿ߣޠ‬ଔࠍᓧߚ߇‫ޟޔ‬หᗧߒߥ޿ℂ↱‫ޠ‬ߣߒߡ‫ޟ‬㊀ⷐߥ੐㗄ߛ߇‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝“ޔ‬ើߔࠆߚ߼ߩၮ⋚ࠍ૞ࠆ”߹ߢߢߪߥ޿߆‫ޔޠ‬‫⋥ੌୃޟ‬ᓟߢߥ޿ߣ޿߁࠾ࡘࠕࡦࠬߥࠄ‫ޔ‬หᗧߢ߈ࠆ‫ᤨੌୃޔߤߥޠ‬ὐߢ᳞߼ࠆ࡟ࡌ࡞ߦ
ኻߔࠆᗧ⷗߇ㅀߴࠄࠇߚ‫ޕ‬－ 70 －

 

หᗧ䈚䈭䈇
3.3䋦

หᗧ䈜䉎
96.7䋦


࿑ 34.‫ޟ‬Χ㧚ࠤࠕࠍផㅴߢ߈ࠆ႐߿ੱ⊛ⅣႺࠍᢛ߃ࠆߚ߼ߦ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆ‫ޠ‬⢻ജߦኻߔࠆหᗧ

㩷㩷ԙ䇸⢻ജ䈱ౝኈ䇹䈱ᅷᒰᕈߎߩ‫ޟ‬⢻ജߩౝኈ‫ߡߒߣޠ‬ឭ␜ߒߚ 3 㗄⋡ߦߟ޿ߡߪ‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬86.4㧑㨪96.7%ߣ
ߥߞߡ߅ࠅ‫ޔ‬Χ2 ߩหᗧ߇ᦨ߽ૐ߆ߞߚ㧔࿑ 35㧕
‫ޕ‬

0%

20%

Χ-1ᣂ䈚䈇⍮⼂䉇䊝䊂䊦䉕ታ〣䈮ዉ౉䈜䉎䈢䉄䈱
ᚻᴺ䉕ℂ⸃䈚䇮䈠䈱ታ⃻䈮ะ䈔䈩䊥䊷䉻䊷䉲䉾䊒䉕⊒ើ䈜䉎 (n=120)

40%

60%

80%

100%

3.3

96.7

Χ-2㓸࿅䉇⚵❱䈱႐䈱ജേ䉕ಽᨆ䈚䇮㓸࿅䉇⚵❱䉕േ䈎䈜 (n=118)

86.4

13.6

Χ-3ᦨༀ䈱ක≮䉰䊷䊎䉴䉕ឭଏ䈜䉎䈢䉄䈮䉬䉝䈱ᡷༀ䉕ਥዉ䈜䉎 (n=119)

92.4

7.6

หᗧ䈜䉎

หᗧ䈚䈭䈇

࿑ 35.‫ޟ‬Χ㧚ࠤࠕࠍផㅴߢ߈ࠆ႐߿ੱ⊛ⅣႺࠍᢛ߃ࠆߚ߼ߦ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆ‫ޠ‬ߩౝኈߦኻߔࠆหᗧ

‫ޟ‬หᗧߒߥ޿‫ޠ‬ℂ↱ߣߒߡ‫ޔ‬Χ1‫ޟ‬ᣂߒ޿⍮⼂߿ࡕ࠺࡞ࠍታ〣ߦዉ౉ߔࠆߚ߼ߩᚻᴺࠍ
ℂ⸃ߒ‫ߩߘޔ‬ታ⃻ߦะߌߡ࡝࡯࠳࡯ࠪ࠶ࡊࠍ⊒ើߔࠆ‫ޟޔߪߡ޿ߟߦޠ‬ዉ౉ߔࠆߚ߼ߩᚻᴺ
એ೨ߦ⍮⼂࡮ࡕ࠺࡞ߩℂ⸃߇ᔅⷐ‫ޟޔ߿ޠ‬㊀ⷐߥ੐㗄ߛ߇‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆߚ߼
ߩၮ⋚ࠍ૞ࠆ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔߤߥޠ߆޿ߥߪߢߢ߹ޔ‬ើߔࠆ߹ߢߩ 1 Ბ㓏ࠍട߃ࠆߎߣࠍ᳞߼ࠆᗧ⷗߇⷗ࠄࠇߚ‫ޟޔߚ߹ޕ‬หᗧߔࠆ‫ ߇ޠ‬86.4㧑ߣߎߩ㗄⋡ߢᦨ߽ૐ߆ߞߚ‫ޔ‬Χ2‫ޟ‬㓸࿅߿⚵❱ߩ႐ߩജേࠍಽᨆߒ‫ޔ‬㓸࿅߿⚵❱ࠍേ߆ߔ‫ߦޠ‬ኻߒߡߪ‫ޟޔ‬㊀ⷐߛ߇‫ޔ‬࡝࡯࠳࡯ࠪ࠶ࡊࠍ⊒ើߔࠆߚ߼ߩၮ⋚ࠍ૞ࠆ‫ޠ߆޿ߥߪߢߢ߹ޔ‬‫“ޟޔ‬㓸࿅߿⚵❱ࠍേ߆ߔ”－ 71 －

ߪ⋡ᮡߣߒߡ㜞ߔ߉ࠆߩߢߪߥ޿߆‫ޔޠ‬‫ޟ‬ಽᨆജߪᔅⷐߛ߇‫ࠍ❱⚵ޔ‬േ߆ߔ⢻ജ߇᳞߼ࠄࠇ
ࠆߣߪᕁࠊߥ޿‫ߦᤨੌୃޔߤߥޠ‬᳞߼ࠆ⢻ജߩ࡟ࡌ࡞߇㜞޿‫߁޿ߣޔ‬ᗧ⷗ߢ޽ߞߚ‫ޕ‬ߘߒߡ‫ޔ‬Χ3‫ᦨޟ‬ༀߩක≮ࠨ࡯ࡆࠬࠍឭଏߔࠆߚ߼ߦ‫ߩࠕࠤޔ‬ᡷༀࠍਥዉߔࠆ‫޿ߟߦޠ‬ߡߪ‫ޔ‬‫ޟ‬᛽⽎⊛ߔ߉ࠆ‫ޕ‬Ṽὼߣߒߡ޿ࠆ‫ޟ߿ޠ‬ක≮ࠨ࡯ࡆࠬߪ㒢ቯ⊛‫ߩ⃻⴫ޔߤߥޠ‬ਇ᣿⍎ߐࠍᜰ៰ߔࠆᗧ⷗߇⷗ࠄࠇߚ‫ޕ‬એ਄ߩߎߣ߆ࠄ‫ޔ‬Χߦߟ޿ߡߪ‫ୃޔ‬჻ୃੌ↢ߩ⢻ജߣߒߡ᳞߼ࠆ࡟ࡌ࡞߿⴫⃻ᣇᴺߦߟ
޿ߡᬌ⸛߇ᔅⷐߢ޽ࠆߣ޿߁⚿ᨐࠍᓧߚ‫ޕ‬㧔㧢㧕‫ޟ‬Ψ㧚ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈ ߎߩ⢻ജߦߟ޿ߡߪ‫ޔ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬116 ฬ㧔97.5%㧕
‫ޔ‬‫ޟ‬หᗧߒߥ޿‫ ߪޠ‬3 ฬ㧔2.5%㧕ߢ޽ߞߚ㧔࿑ 36㧕‫ޕ‬หᗧ䈚䈭䈇,
2.5䋦

㩷

หᗧ䈜䉎
97.5䋦

࿑ 36.‫ޟ‬Ψ㧚ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫ޠ‬⢻ജߦኻߔࠆหᗧ
ԙ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈ ߎߩ‫ޟ‬⢻ജߩౝኈ‫ߡߒߣޠ‬ឭ␜ߒߚ 4 㗄⋡ߦߟ޿ߡ߽‫ޔ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬97.5㧑㨪98.3㧑ߣ㜞޿⹏ଔࠍᓧߚ㧔࿑ 37㧕
‫ޕ‬
0%

20%

40%

60%

80%

100%

Ψ-1ኾ㐷⡯⒳㑆䈱ലᨐ⊛䈭ㅪ៤㑐ଥ䉕▽䈒䈢䉄䈮䇮੕䈇䉕ዅ㊀䈚䈢䉮䊚䊠䊆䉬䊷䉲䊢䊮䉕䈫䉎 (n=119)

97.5

2.5

Ψ-2⋴⼔Ꮷ䉇ઁ⡯⒳䈮ኻ䈚䈩⋴⼔䈱ᗧ࿑䉇ᔅⷐᕈ䉕⺑᣿䈚䇮ද௛䈜䉎 (n=119)

98.3

1.7

Ψ-3ኻ⽎䈱⺖㗴䉕นⷞൻ䈚䇮ઁ⡯⒳䈫ද௛䈚䈩⸃᳿䈮ዉ䈒 (n=118)

98.3

1.7

Ψ-4䉮䊷䊂䉞䊈䊷䉺䊷䈱ᓎഀ䉕ᜂ䈇䇮ද௛䈱౞Ṗൻ䉕ផㅴ䈜䉎(n=119)

97.5

2.5

หᗧ䈜䉎

หᗧ䈚䈭䈇

࿑ 37.‫ޟ‬Ψ㧚ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫ߩޠ‬ౝኈߦኻߔࠆหᗧ

－ 72 －

‫ޟ‬หᗧߒߥ޿‫ޠ‬ℂ↱ߣߒߡߪ‫ޔ‬Ψ́3‫ޟ‬ኻ⽎ߩ⺖㗴ࠍนⷞൻߒ‫ઁޔ‬⡯⒳ߣද௛ߒߡ⸃᳿ߦ
ዉߊ‫ߦޠ‬ኻߒߡ‫ޔ‬‫“ޟ‬นⷞൻ”ߪ߅߆ߒ޿‫ޕ‬᣿⏕ൻ࡮⸒⺆ൻߢߪߥ޿߆‫ޔ߿ޠ‬‫“ޟ‬ኻ⽎ߩ⺖㗴”ߣߪ૗߆㧫‫߁޿ߣޠ‬ᗧ⷗߇಴ߐࠇߚ‫ޔࠄ߆ߣߎߩߎޕ‬‫ޟ‬Ψ́3 ኻ⽎ߩ⺖㗴ࠍนⷞൻߒ‫ઁޔ‬⡯⒳ߣද௛ߒߡ⸃᳿ߦዉߊ‫ޔߪߡ޿ߟߦޠ‬㗄⋡ฬߩౣᬌ⸛߇ᔅⷐߢ޽ࠆߣ⠨߃ࠄࠇߚ‫ޕ‬㧔㧣㧕‫ޟ‬Ω㧚⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈ ߎߩ⢻ജߦߟ޿ߡߪ‫ޟޔ‬หᗧߔࠆ‫ ߇ޠ‬100 ฬ㧔84.0㧑㧕‫ޟ‬หᗧߒߥ޿‫ ߪޠ‬19 ฬ㧔16.0%㧕
ߢ޽ࠅ‫ޔ‬10 ߩ⢻ജߩਛߢ‫ޟ‬หᗧߔࠆ‫ߩޠ‬ഀว߇ᦨ߽ૐ߆ߞߚ㧔࿑ 38㧕
‫ޕ‬
㩷
หᗧ䈚䈭䈇
16.0䋦

หᗧ䈜䉎,
84.0䋦

࿑ 38.‫ޟ‬Ω㧚⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ‫ޠ‬⢻ജߦኻߔࠆหᗧ

ԙ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈߎߩ‫ޟ‬⢻ജߩౝኈ‫ߡߒߣޠ‬ឭ␜ߒߚ 4 㗄⋡ߦߟ޿ߡ߽‫ޔ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬79.5㧑㨪89.8㧑ߣઁߩ⢻ജߦ㑐ߔࠆౝኈߣᲧセߒߡ‫߽ᦨޔ‬ૐ޿⚿ᨐߣߥߞߚ㧔࿑ 39㧕‫ޕ‬
0%

20%

40%

60%

80%

100%

Ω-1ੱ䇱䈱ஜᐽჇㅴ䈫䈇䈉ⷞὐ䈎䉌䇮⋴⼔䈱᡽╷䉕ᬌ⸛䈜䉎(n=118)

89.8

10.2

Ω-2ක≮᡽╷䈏୘䇮㓸࿅䇮⚵❱䈮䉅䈢䉌䈜ᓇ㗀䉕ಽᨆ䈚䇮ᡷༀ╷䉕⠨᩺䈜䉎 (n=117)

86.3

13.7

Ω-3⋴⼔ኾ㐷⡯䈫䈚䈩䈱⠨䈋䉇ଔ୯䈏᡽╷䈮෻ᤋ䈘䉏䉎䉋䈉ᣇ╷䉕⠨䈋䉎 (n=118)

86.4

13.6

Ω-4⸻≮ႎ㈽䉇੺⼔଻ஜ䈭䈬䈱᡽╷䊶೙ᐲ䈏䉬䉝ឭଏᣇᴺ䉇䉝䉡䊃䉦䊛䈮෸䈿䈜ᓇ㗀䉕ಽᨆ䈚䇮ᡷༀ╷䉕ឭ᩺䈜䉎 (n=117)
หᗧ䈜䉎

79.5

20.5

หᗧ䈚䈭䈇

࿑ 39. ‫ޟ‬Ω㧚⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ‫ޠ‬ߩౝኈߦኻߔࠆหᗧ

－ 73 － ‫ޟ‬Ω㧚⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ‫ޠ‬ߦ‫ޟ‬หᗧߒߥ޿‫ޠ‬ℂ↱ߣߒߡߪ‫ޟޔ‬ඳ჻⺖⒟࡟ࡌ࡞ߢ޽ࠆ‫ޔ߿ޠ‬‫ߩⴕ⃻ޟ‬ᴺᓞ╬߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߔࠆ߹ߢߩ⢻ജߪᜂ଻ߐࠇࠆߴ߈ߛ߇‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ⢻ജߪୃ჻⺖⒟એ਄ߣ⠨߃ࠆ‫ޠ‬‫⸃ޟޔ‬᳿╷ߩឭ᩺߹ߢߩ೔㆐ߪ㔍ߒ޿‫ޔ߁޿ߣޠ‬᳞߼ࠆ࡟ࡌ࡞ߩ㜞ߐߦኻߔࠆᗧ⷗߇ㅀߴࠄࠇߚ‫ޕ‬ Ω1‫ߩޘੱޟ‬ஜᐽߣ޿߁ⷞὐ߆ࠄ‫ߩ⼔⋴ޔ‬᡽╷ࠍᬌ⸛ߔࠆ‫ߦޠ‬ኻߒߡߪ‫ޔ‬‫ޟ‬᡽╷߳ߩᓇ㗀ࠍᜬߟ߹ߢߪ㔍ߒ޿߇‫ޔ‬ᬌ⸛߹ߢߪน⢻‫ޔ߿ޠ‬‫ߩ⼔⋴ߥޘ⦡ޟ‬ኾ㐷ᕈࠍ߽ߟୃੌ↢߇޿ࠆߎߣࠍ⠨߃‫߁߽ޔ‬ዋߒ൮᜝⊛⴫⃻ߩᣇ߇ࠃ޿ߩߢߪߥ޿߆‫߁޿ߣޠ‬ᗧ⷗߇⷗ࠄࠇߚ‫ޔߚ߹ޕ‬Ω3‫⼔⋴ޟ‬ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯߇᡽╷ߦ෻ᤋߐࠇࠆࠃ߁ᣇ╷ࠍ⠨߃ࠆ‫ޔߪߡ޿ߟߦޠ‬‫ޟ‬ᬌ⸛ߔࠆ࡟ࡌ࡞ߥࠄน⢻‫ޔޠ‬‫ޟ‬ᣇ╷(⸃᳿╷)ࠍឭ᩺ߔࠆߦߪ⚻㛎⊛ߦ߽ਇචಽ‫ୃޔ‬჻⺖⒟એ
਄ߦ᳞߼ࠆ⢻ജߢߪߥ޿߆‫߁⸒ߣޠ‬ᗧ⷗߇಴ߐࠇߚ‫ޕ‬ߘߒߡ‫ޔ‬‫ޟ‬หᗧߔࠆ‫߽ᦨ߇ޠ‬ૐ߆ߞߚ‫ޔ‬Ω4‫≮⸻ޟ‬ႎ㈽߿੺⼔଻ஜߥߤߩ᡽╷࡮೙ᐲ߇ࠤࠕ
ឭଏᣇᴺ߿ࠕ࠙࠻ࠞࡓߦ෸߷ߔᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍឭ᩺ߔࠆ‫ޔߪߡ޿ߟߦޠ‬‫ޟ‬ඳ჻ᓟᦼ
⺖⒟ୃੌᤨߩ⢻ജߢߪߥ޿߆‫ޠ‬‫ޔ‬‫ޟ‬ᡷༀ╷ߩឭ᩺߹ߢߪ෩ߒ޿‫ޔޠ‬‫ޟ‬㧔᡽╷߿೙ᐲߩⷞὐߪቇ჻
⺖⒟ߢߪਇ⿷ߒߡ޿ࠆߩߢ‫ߩߎޔ‬ᢎ⢒ߪᄢಾߛ߇㧕ឭ᩺߹ߢߪήℂ‫ޟޔޠ‬ឭ᩺ߔࠆ႐ᚲ߇ਇ
᣿⏕‫ޔߤߥޠ‬᳞߼ࠆ࡟ࡌ࡞ߩ㜞ߐߦኻߔࠆᗧ⷗߇ᄙߊㅀߴࠄࠇߚ‫ޕ‬એ਄ࠃࠅ‫ޔ‬Ωߦߟ޿ߡߪ‫ୃޔ‬჻ୃੌ↢ߩ⢻ജߣߒߡ᳞߼ࠆ࡟ࡌ࡞߿⴫⃻ᣇᴺߦߟ޿ߡౣ
ᬌ⸛߇ᔅⷐߢ޽ࠆߣ޿߁⚿ᨐࠍᓧߚ‫ޕ‬㧔㧤㧕‫ޟ‬Ϊ㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆᢎ⢒ⅣႺߠߊࠅߦขࠅ⚵߻‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈߎߩ‫ޟ‬⢻ജ‫ޔߪߡ޿ߟߦޠ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬112 ฬ㧔95.7%㧕
‫ޟ‬หᗧߒߥ޿‫ ߪޠ‬5 ฬ㧔4.3%㧕
ߢ޽ߞߚ㧔࿑ 40㧕‫ޔߚ߹ޕ‬Ϊߩ⢻ജߩౝኈߣߒߡឭ␜ߒߚ 4 㗄⋡ߦߟ޿ߡߪ‫ޔ‬‫ޟ‬หᗧߔࠆ‫ޠ‬
߇ 95.8%㨪96.6%ߢ޽ߞߚ㧔࿑ 41㧕
‫ޕ‬
หᗧ䈚䈭䈇
4.3䋦

หᗧ䈜䉎
95.7䋦

࿑ 40.‫ޟ‬Ϊ㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆᢎ⢒ⅣႺߠߊࠅߦขࠅ⚵߻‫ޠ‬⢻ജߦኻߔࠆหᗧ

－ 74 －

ԙ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈߎߩ‫ޟ‬⢻ജߩౝኈ‫ޟޔߪߡ޿ߟߦޠ‬หᗧߔࠆ‫ ߇ޠ‬90㧑એ਄ߣ޿߁⚿ᨐߢ޽ࠅ‫ޟޔ‬หᗧߒߥ޿‫ޠ‬ℂ↱ߣߒߡ޽ߍࠄࠇߚᗧ⷗ߦ߽‫ޔ‬ౝኈߩਇ⏕߆ߐ߿ਇ᣿⍎ߐࠍᜰ៰ߔࠆ߽ߩߪߥ
߆ߞߚ‫ޔߒ߆ߒޕ‬Ϊ2 ߩ‫⼔⋴ޟ‬ቇߩ⸘↹⊛࡮ലᨐ⊛ߥᢎ⢒ᣇᴺࠍឭ᩺ߔࠆ‫ߦޠ‬ኻߒߡߪ‫ޔ‬‫ޟ‬㜞ᐲߥ⋴⼔ቇᢎ⢒ߩ⢻ജ߇ᔅⷐߢ޽ࠅ‫߇࡞ࡌ࡟߿߿ޔ‬㜞޿ߩߢߪߥ޿߆‫߁޿ߣޠ‬ᗧ⷗߇⷗ࠄࠇߚ‫ޕ‬એ਄ࠃࠅ‫ߩߎޔ‬Ϊ2 ߩౝኈߦߟ޿ߡߪ‫ࠍ⃻⴫ޔ‬฽߼ߡ᳞߼ࠆ࡟ࡌ࡞ߦߟ޿ߡౣᬌ⸛ߔ
ࠆᔅⷐ߇޽ࠆߣ⠨߃ࠄࠇߚ‫ޕ‬
0%

20%

40%

60%

80%

100%

Ϊ-1ቇ⠌⠪䈱䊆䊷䉵䉕ᛠី䈚䇮ቇ⠌⠪䈮䈅䉒䈞䈢ᢎ⢒ᴺ䉕ℂ⸃䈜䉎 (n=118)

95.8

4.2

Ϊ-2⋴⼔ቇ䈱⸘↹⊛䊶ലᨐ⊛䈭ᢎ⢒ᣇᴺ䉕ឭ᩺䈜䉎 (n=117)

96.6

3.4

Ϊ-3ቇ⠌⠪䈱䊆䊷䉵䈮䈅䈦䈢ᢎ⢒⊛㑐䉒䉍䉕ⴕ䈉(n=117)96.6

3.4

Ϊ-4ቇ⠌䈏ଦㅴ䈜䉎䉋䈉䈮䇮ᢎ⢒ⅣႺ䉕ᢛ䈋䉎(n=114)

97.4

2.6

หᗧ䈜䉎

หᗧ䈚䈭䈇

࿑ 41.‫ޟ‬Ϊ㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆᢎ⢒ⅣႺߠߊࠅߦขࠅ⚵߻‫ߩޠ‬ౝኈߦኻߔࠆหᗧ

㧔㧥㧕‫ޟ‬Ϋ㧚୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ߩޠ‬ᅷᒰᕈ ߎߩ‫ޟ‬⢻ജ‫ޔߪߡ޿ߟߦޠ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬115 ฬ㧔95.8%㧕‫ޔ‬‫ޟ‬หᗧߒߥ޿‫ ߪޠ‬5 ฬ㧔4.2%㧕
ߢ޽ߞߚ㧔࿑ 42㧕‫ޕ‬‫ޟ‬หᗧߒߥ޿‫ޠ‬ℂ↱ߣߒߡ‫ޔ‬‫ޟ‬Ϋ୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ‫ߦޠ‬ኻߒ‫୶ޟޔ‬ℂ⊛ᗵฃᕈߣᢥൻ⊛ᗵฃᕈߪ⇣ߥࠆߚ߼‫ޔ‬หᗧ⺆ߩ᭽ߦᝒ߃ࠆ(⴫⃻ߔࠆ)ߎߣߦߪ⇼໧ࠍᗵߓࠆ‫߁޿ߣޠ‬ᗧ⷗߇⷗ࠄࠇߚ‫ޕ‬－ 75 －

หᗧ䈚䈭䈇
4.2䋦

㩷

หᗧ䈜䉎
95.8䋦

࿑ 42. 䇸Ϋ㧚୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ‫ޠ‬⢻ജߦኻߔࠆ
หᗧԙ‫ޟ‬⢻ജߩౝኈ‫ߩޠ‬ᅷᒰᕈ ߎߩ‫ޟ‬⢻ജߩౝኈ‫ߡߒߣޠ‬ឭ␜ߒߚ 3 㗄⋡ߦߟ޿ߡ߽‫ޟޔ‬หᗧߔࠆ‫ ߇ޠ‬95.8%㨪98.3%ߣ
㜞޿⹏น߇⷗ࠄࠇߚ㧔࿑ 43㧕‫ޕ‬Ϋ́2‫ޟ‬ኻ⽎ߩᠩ⼔ߩ┙႐߆ࠄ‫ޔ‬቟ోߥࠤࠕⅣႺࠍଦㅴߒ‫ޔ‬
୶ℂ⊛ታ〣ࠍ᥉෸ߔࠆ‫ޔߪߡ޿ߟߦޠ‬‫߇⃻⴫ޟ‬ᐢߔ߉޽޿߹޿ߢ޽ࠆ‫ߩ⃻⴫ޔ߁޿ߣޠ‬ਇ᣿⍎ߐࠍᜰ៰ߔࠆᗧ⷗߇ㅀߴࠄࠇߚ‫ޕ‬એ਄ߩߎߣ߆ࠄ‫ޔ‬‫ޟ‬Ϋ㧚୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ‫ޔߣޠ‬Ϋ́2‫ޟ‬ኻ⽎ߩᠩ⼔ߩ┙႐߆ࠄ‫ޔ‬቟ోߥࠤࠕⅣႺࠍଦㅴߒ‫୶ޔ‬ℂ⊛ታ〣ࠍ᥉෸ߔࠆ‫޿ߟߦޠ‬ߡߪ‫ࠍ⃻⴫ޔ‬ౣᬌ⸛ߔࠆᔅⷐ߇޽ࠆߣ⠨߃ࠄࠇߚ‫ޕ‬
0%

20%

40%

60%

80%

100%

Ϋ-1୘ੱ䊶ኅᣖ䊶㓸࿅䈱ᜬ䈧ᢥൻ䉇⢛᥊䉕ᛠី䈚䇮⋴⼔䉕ታ〣䈜䉎 (n=118)

95.8

4.2

Ϋ-2ኻ⽎䈱ᠩ⼔䈱┙႐䈎䉌䇮቟ో䈭䉬䉝ⅣႺ䉕ଦㅴ䈚䇮୶ℂ⊛ታ〣䉕᥉෸䈜䉎 (n=118)

97.5

2.5

Ϋ-3୶ℂ䈮㑐䈜䉎ℂ⺰䉕ᵴ↪䈚䈩䇮୶ℂ⊛໧㗴䈮⋥㕙䈚䈩䈇䉎ኻ⽎䉇ኾ㐷⡯䉕ᡰេ䈜䉎 (n=118)

98.3

1.7

หᗧ䈜䉎

หᗧ䈚䈭䈇

࿑ 43.‫ޟ‬Ϋ㧚୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ‫ߩޠ‬ౝኈߦኻߔࠆหᗧ



－ 76 －㧔㧕‫ޟ‬ά㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ‫ޠ‬Ԙ‫ޟ‬⢻ജ‫ޠ‬ᅷᒰᕈ ߎߩ‫ޟ‬⢻ജ‫ޔߪߡ޿ߟߦޠ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬117 ฬ㧔97.5%㧕ߣ㜞ߊ‫ޔ‬‫ޟ‬หᗧߒߥ޿‫ ߪޠ‬3
ฬ㧔2.5%㧕ߦߣߤ߹ߞߚ㧔࿑ 44㧕‫ޕ‬
หᗧ䈚䈭䈇
2.5䋦

หᗧ䈜䉎,
97.5䋦

࿑ 44.㩷 ‫ޟ‬ά㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ‫ޠ‬⢻ജߦኻߔࠆหᗧ
ԙ䇸⢻ജ䈱ౝኈ䇹䈱ᅷᒰᕈߎߩ‫ޟ‬⢻ജߩౝኈ‫ߡߒߣޠ‬ឭ␜ߒߚ 3 㗄⋡ߦߟ޿ߡ߽‫ޟޔ‬หᗧߔࠆ‫ ߇ޠ‬93.3%㨪97.5%ߣ
㜞޿⹏น߇⷗ࠄࠇߚ㧔࿑ 45㧕
‫ޕ‬
0%

20%

40%

60%

80%

100%

ά-1⋴⼔䉇ක≮䈮㑐䈜䉎ኾ㐷⡯䈫䈚䈩䈱ືቇ䉕⊒ዷ䈘䈞䇮⋴⼔ታ〣䈮⛔ว䈜䉎 (n=119)

95.0

5.0

ά-2⋴⼔ቇ䉕ข䉍Ꮞ䈒⺖㗴䈮䈧䈇䈩䈱ᗵฃᕈ䉕㜞䉄䇮ਥ૕ᕈ䉕ᜬ䈦䈩ᡷༀ䈜䉎 (n=119)

95.8

4.2

ά-3䉋䉍⦟䈇䉬䉝䉕᳿ቯ䈜䉎䈢䉄䈮ᦨᣂ䈱⍮⷗䉕ᓧ䈭䈏䉌ታ〣䈜䉎䊝䊂䊦䈮䈭䉎 (n=120)

97.5

2.5

ά-4ኾ㐷⡯䈫䈚䈩⋴⼔ⷰ䉕᣿⏕䈮䈜䉎 (n=119)

93.3

6.7

หᗧ䈜䉎

หᗧ䈚䈭䈇

࿑ 45.㩷 䇸ά㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ‫ߩޠ‬ౝኈߦኻߔࠆหᗧ ‫ޟ‬หᗧߒߥ޿‫ޠ‬ℂ↱ߣߒߡߪ‫ޔ‬ά-2‫⼔⋴ޟ‬ቇࠍขࠅᏎߊ⺖㗴ߦߟ޿ߡߩᗵฃᕈࠍ㜞߼‫ޔ‬ਥ૕ᕈࠍᜬߞߡᡷༀߔࠆ‫ߦޠ‬ኻߒ‫ޟޔ‬೨ᢥߣᓟᢥߦ㘧べ߇޽ࠆ‫ޟ߿ޠ޿ࠄߠࠅ߆ࠊޕ‬ᡷༀߦะߌߡߣࠅߊ߻ߣ޿߁࡟ࡌ࡞ߛߣ⠨߃ࠆ‫߁޿ߣޠ‬ᗧ⷗߇⷗ࠄࠇߚ‫ޔߚ߹ޕ‬ά3‫ࠤ޿⦟ࠅࠃޟ‬ࠕࠍ᳿ቯߔࠆߚ߼ߦᦨᣂߩ⍮⷗ࠍᓧߥ߇ࠄታ〣ߔࠆࡕ࠺࡞ߦߥࠆ‫ޔ߽ߡ޿ߟߦޠ‬
‫ޟ‬
㧔ᢥ┨߇㧕
ࠊ߆ࠅߠࠄ޿‫߁޿ߣޠ‬ᗧ⷗߇಴ߐࠇߚ‫ߩߎޔߡߒߘޕ‬⢻ജߩਛߢᦨ߽‫ޟ‬หᗧߔࠆ‫߇ޠ‬ૐ߆－ 77 －

ߞߚ‫ޔ‬ά4‫ޟ‬ኾ㐷⡯ߣߒߡ⋴⼔ⷰࠍ᣿⏕ߦߔࠆ‫ޔߪߡ޿ߟߦޠ‬‫ߩⷰ⼔⋴ޟ‬ቯ⟵ߘߩ߽ߩ߇޽
޿߹޿ߢ޽ࠆߚ߼‫޿ߥߒ↪૶ޔ‬ᣇ߇ࠃ޿‫ߥ޿߹޿޽߁޿ߣⷰ⼔⋴ޟޔޠ‬᭎ᔨࠍ૶߁ߎߣߦߪ
෻ኻ‫߁޿ߣޠ‬ᗧ⷗߇⷗ࠄࠇߚ‫ޕ‬ એ਄ߩߎߣ߆ࠄ‫ޔ‬ά-2‫⼔⋴ޟ‬ቇࠍขࠅᏎߊ⺖㗴ߦߟ޿ߡߩᗵฃᕈࠍ㜞߼‫ޔ‬ਥ૕ᕈࠍᜬߞߡ
ᡷༀߔࠆ‫ޠ‬‫ޔ‬ά3‫ࠍࠕࠤ޿⦟ࠅࠃޟ‬᳿ቯߔࠆߚ߼ߦᦨᣂߩ⍮⷗ࠍᓧߥ߇ࠄታ〣ߔࠆࡕ࠺࡞ߦߥࠆ‫ޠ‬‫ޔ‬ά4‫ޟ‬ኾ㐷⡯ߣߒߡ⋴⼔ⷰࠍ᣿⏕ߦߔࠆ‫߿⃻⴫ޔߪߡ޿ߟߦޠ‬᳞߼ࠆ࡟ࡌ࡞ߩౣᬌ
⸛߇ᔅⷐߢ޽ࠆߣ⠨߃ࠄࠇߚ‫ޕ‬㧠㧕ᧄ⺞ᩏ⎇ⓥߦኻߔࠆᗧ⷗ ᧄ⺞ᩏ⎇ⓥߢߪ‫⎇ޔ‬ⓥߦኻߔࠆ⾰໧߿ᗧ⷗ߦߟ޿ߡ߽‫⸥↱⥄ޔ‬タ߆ࠄ෼㓸ߒߚ‫ޕ‬ነߖࠄࠇߚᗧ⷗ߪ‫ޔ‬એਅߩౝኈߣߒߡ㓸⚂ߐࠇߚ‫ޕ‬㧔㧝㧕ኾ㐷⋴⼔Ꮷࠦ࡯ࠬߣ⎇ⓥࠦ࡯ࠬߩ㆑޿ߦߟ޿ߡ ‫ޟ‬ኾ㐷⋴⼔Ꮷࠦ࡯ࠬߣ⎇ⓥࠦ࡯ࠬߢߪ‫ޔ‬ᔅⷐߣߐࠇࠆ⢻ജߩ࡟ࡌ࡞߇⇣ߥࠆߣᕁ߁‫ޔޠ‬‫ୃޟ‬჻ߩ⎇ⓥࠦ࡯ࠬ‫ޔ‬ኾ㐷⋴⼔Ꮷࠦ࡯ࠬߦ౒ㅢߩ߽ߩࠍᬌ⸛ߒߡ޿ࠆߩ߆ߤ߁߆‫ޔ‬ಽ߆ࠅߦߊ
޿ߣߎࠈ߇޽ࠆ‫ޔޠ‬‫ోޟ‬૕⊛ߦߪ‫ޔ‬㜞ᐲታ〣⋴⼔Ꮷࠍᗧ⼂ߒߚ⢻ജߦὶὐ߇޽ߚߞߡ޿ࠆශ
⽎ߢ޽ࠆ‫ޟޔߤߥޠ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈⢻ജ‫ޔ߽ߦޠ‬ቇ↢߇ቇ߱ࠦ࡯ࠬߩ․ᕈߦࠃߞߡ‫ޔ‬᳞߼ࠄࠇࠆ⢻ജߪ⇣ߥࠆߩߢߪߥ޿߆‫߁޿ߣޔ‬ᗧ⷗ߢ޽ߞߚ‫ߕ޿ޔߒ߆ߒޕ‬ࠇߩᗧ⷗߽‫ޔ‬ᢥᧃߦߪ‫⚿ޟ‬ᨐࠍᭉߒߺߦߒߡ޿ࠆ‫ߣޠ‬ട߃ࠄࠇߡ߅ࠅ‫ߢࠬ࡯ࠦߩࠇߕ޿ޔ‬޽ߞߡ߽‫ޔ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߩቇ↢ࠍᢎ⢒ߔࠆߦ޽ߚࠅ‫ߩߢ߹ߎߤޔ‬㆐ᚑࠍ᳞߼ࠆߴ
߈߆‫߁޿ߣޔ‬ၮḰߦᦼᓙ߇ነߖࠄࠇߡ޿ࠆߎߣ߇ಽ߆ߞߚ‫ޕ‬㧔㧞㧕⚿ᨐߩᵴ↪ߦߟ޿ߡ ‫ޟ‬ฦᄢቇߩᢎ⢒ℂᔨ‫⋡ޔ‬ᮡ‫ޔ‬ቇ↢ߩ⋡ᜰߔ߽ߩߦࠃࠅ‫ޔ‬⢻ജߩ⒟ᐲߪ㆑ߞߡߊࠆߣᕁ߁‫ޔޠ‬‫ޟ‬ᮡḰ⊛࡟ࡌ࡞ࠍ᣿⏕ൻߔࠆߎߣߩ㊀ⷐᕈࠍ߰߹߃ߟߟ‫ޔ‬ฦᄢቇߩᢎ⢒⋡⊛╬ߩ⁛⥄ᕈࠍ⹺߼ࠆౝኈߣߒߡᬌ⸛ߒߡ᰼ߒ޿‫߁޿ߣޔޠ‬ᗧ⷗߇⷗ࠄࠇߚ‫੹ޕ‬࿁ߩ⺞ᩏ⎇ⓥߢ᣿ࠄ߆ߦߒ
ࠃ߁ߣߒߡ޿ࠆ‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢ⠌ᓧߔߴ߈⢻ജ‫ࠅ⁛߇ޠ‬ᱠ߈ߖߕߦ‫߁ࠃߩߤޔ‬ߥឭ␜ߩߐࠇᣇ‫ޔ‬ᵴ↪ߩߐࠇᣇߣߥߞߡ޿ߊߩ߆‫ޔ‬ෂᗋߔࠆᗧ⷗߇᣿␜ߐࠇߚ‫ޕ‬ ߒ߆ߒ‫੹ޔ‬࿁ߩ⚿ᨐࠍฃߌ‫ޟ‬ቇ჻࡮ୃ჻࡮ߘߒߡඳ჻⺖⒟ߦ᳞߼ࠆ⢻ജࠍߤߩࠃ߁ߦ㑐ㅪߠߌ‫⊒ޔ‬ዷߐߖߡ޿ߊߩ߆ࠍౕ૕ൻߒߡ᰼ߒ޿‫߁޿ߣޠ‬ᗧ⷗߽ᄙߊ⷗ࠄࠇ‫੹ޔ‬ᓟߩ⋴⼔♽ᄢቇ㒮ߩᢎ⢒࡮⊒ዷߦኻߔࠆᦼᓙߩ㜞߹ࠅ߽⃻ࠇߡ޿ߚ‫ޕ‬㧔㧟㧕‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢ⠌ᓧߔߴ߈⢻ജ‫ߡ޿ߟߦᦼᤨߩޠ‬‫ୃޟ‬჻ߪߚ߆ߛ߆ 2 ᐕߢ޽ࠅ‫ࠍߣߎߩߡߴߔࠄࠇߎߦߋߔޔ‬りߦ⌕ߌߐߖࠆߩߪਇน⢻‫ޔޠ‬‫ޟ‬⢻ജߩਛߦߪ‫⃻ޔ‬႐ߦ಴ߡߔߋߢ߈ߥ޿ߎߣ߽฽߹ࠇߡ޿ࠆࠃ߁ߦᗵߓࠆ‫ޔߤߥޠ‬ឭ␜ߒߚ⢻ജࠍりߦ⌕ߌߐߖࠆߚ߼ߦߪ‫“ޔ‬ቇ↢”ߣ޿߁┙႐ߦ㒢⇇߇޽ࠆߩߢߪߥ޿߆‫߁޿ߣޔ‬ᗧ⷗߽⷗ࠄࠇߚ‫⎇ᧄޕ‬ⓥߢឭ␜ߒߚ⢻ജߣߘߩౝኈ߇‫ᤨੌୃޔ‬ὐߢ“ⴕേߢ߈ࠆ⢻ജ”ߣߒߡᜬߚߖࠆ㔍ߒߐ߇‫ޔ‬ᗧ⷗ߣߒߡ಴ߐࠇߡ޿ߚ‫ޕ‬－ 78 －

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 ㇷㅍᴺߦࠃࠆ৻⥸⊛ߥ࿁෼₸㧔20㧑㨪30㧑㧕ࠍ߰߹߃ࠆߣ‫੹ޔ‬࿁ߩ⺞ᩏ⎇ⓥߩ࿁෼₸㧔58.4㧑㧕ߪ㜞߆ߞߚߣ⸒߃ࠆ‫⼔⋴ޕ‬ቇ♽ᄢቇ㒮ߩჇടߦ઻޿‫ޔ‬ᢎ⢒ౝኈߛߌߢߥߊ‫ੌୃޔ‬ᤨߦ᳞߼ࠆ⢻ജ࡟ࡌ࡞߿ၮḰߦߟ޿ߡ‫ޔ‬㑐ᔃ߇㜞߹ߞߡ޿ࠆߎߣ߇߁߆߇߃ߚ‫ޕ‬ ੹࿁ߪ‫ޔ‬వߩࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯ෳട⠪ߦኻߔࠆ⾰໧⚕⺞ᩏߩ⚿ᨐ߆ࠄ‫ޔ‬‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢ⠌ᓧߔߴ߈⢻ജ‫ ࠆߌ߅ߦޠ‬10 ߩ⢻ജߣߘߩౝኈࠍ␜ߔ 42 㗄⋡ࠍౣᐲୃᱜߒ‫ޔ‬ࠃࠅ♖㍰ߒߚౝኈߢ⾰໧⚕⺞ᩏࠍታᣉߒߚߎߣ߽޽ࠅ‫ޔ‬10 ߩ⢻ജߣߘߩౝኈࠍ␜ߔ 42 㗄⋡ߔߴߡߦ 70㧑એ਄ߩหᗧࠍᓧࠆߎߣ߇ߢ߈ߚ‫⚿ߩߎޕ‬ᨐࠃࠅ‫ޔ‬10 ߩ⢻ജߣ 42 㗄⋡߇␜ߔౝኈߦߟ޿ߡ‫৻ޔ‬ቯߩวᗧᒻᚑ߇ᓧࠄࠇߚߣ⠨߃ࠄࠇࠆ߇‫ߩ⃻⴫ޔ‬ਇ᣿⍎ߐ߿᳞߼ࠆ࡟ࡌ
࡞ߩ㜞ߐߦߟ޿ߡߪ‫ޔ‬ౣᬌ⸛ࠍᔅⷐߣߔࠆᗧ⷗߇␜ߐࠇߚ‫ޕ‬ ߘߎߢ‫ޔ‬ฦ‫ޟ‬⢻ജ‫ޟߩߘߣޠ‬⢻ജߩౝኈ‫ߦޠ‬ኻߒߡ␜ߐࠇߚᗧ⷗ࠍ߽ߣߦୃᱜࠍട߃ߚ‫ޔ‬ᦨ⚳ߩ‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢ⠌ᓧߔߴ߈⢻ജ‫ ࠆߌ߅ߦޠ‬10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ ߔ␜ࠍޠ‬42 㗄⋡ߦߟ޿ߡ‫ޔ‬એਅߦㅀߴࠆ‫ޕ‬㧝㧕‫ޟ‬Σ.⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ࠍࠬࡦ࠺ࡆࠛޔ‬ᵴ↪ߔࠆ‫ޠ‬ ߎߩ⢻ജߦߟ޿ߡߪ‫ޔ‬96.7㧑߇‫ޟ‬หᗧߔࠆ‫ߣޠ‬࿁╵ߒߡ߅ࠅ‫ߩߎޔ‬⢻ജߩౝኈߣߒߡឭ␜
ߒߚ 4 㗄⋡ߦߟ޿ߡ߽‫ޔ‬95.8%㨪99.2%߇‫ޟ‬หᗧߔࠆ‫߁޿ߣޠ‬㜞޿⹏ଔࠍᓧߚ‫ޕ‬ᗧ⷗ߩਛߦߪ‫ߩࠬࡦ࠺ࡆࠛޟ‬ᵴ↪ߦߟ޿ߡߩౝኈ߇ࠊ߆ࠅߦߊ޿‫ޔޠ‬ඳ჻ᓟᦼ⺖⒟ߩ࡟ࡌ
࡞‫߁޿ߣޠ‬ᗧ⷗߽⷗ࠄࠇߚ߇‫ޔ‬ᣂߚߦࠛࡆ࠺ࡦࠬߦኻߔࠆ⺑᣿ᢥ┨ࠍട߃ߡ޿ࠆߎߣ㧔⾗ᢱ 4 ෳᾖ㧕‫ߔ␜߇ࠬࡦ࠺ࡆࠛߦઁޔ‬ౝኈߩਇ᣿⍎ߐࠍᜰ៰ߔࠆᗧ⷗߇⷗ࠄࠇߥ߆ߞߚߎߣ߆
ࠄ‫ୃޔ‬ᱜ╬ࠍട߃ߕ‫ޔ‬ឭ␜ߒߚౝኈߢᦨ⚳ߦߢ߈ࠆߣ್ᢿߒߚ‫ޕ‬㧞㧕‫ޟ‬Τ.⋴⼔ߩኻ⽎(୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ)ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆ‫ޠ‬ ߎߩ⢻ജߦߟ޿ߡ߽‫ޔ‬95.0㧑߇‫ޟ‬หᗧߔࠆ‫ߣޠ‬㜞޿⹏ଔࠍᓧߚ‫ߩߎޔߒ߆ߒޕ‬⢻ജߩౝኈߣߒߡឭ␜ߒߚ 8 㗄⋡ਛ‫ޔ‬Τ3‫୶ޟ‬ℂ⊛ߦㆡᱜߥᖱႎᛛⴚߩ೑↪ࠍଦㅴߔࠆ‫ޔߣޠ‬Τ-7‫ޟ‬੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍㅢߓ‫ޔ‬ஜᐽࠍ଻ᜬჇㅴߔࠆ‫ޔޠ‬Τ-8‫ߩ⼔⋴ޟ‬ኻ⽎ߦኻߒߡ‫ޔ‬∉ቇ⊛ߥ⍮⼂ࠍᵴ↪ߒߡ‫੍ޔ‬㒐⊛ⷰὐࠍ〯߹߃ߡஜᐽߩ଻ᜬ࡮Ⴧㅴߦขࠅ⚵߻‫ ߩޠ‬3 㗄⋡ߦߟ޿ߡߪ‫ߩ⃻⴫ޔ‬ਇ᣿⍎ߐ߇ᜰ៰ߐࠇߚߚ߼‫ޔ‬ౣᐲୃᱜ߇ᔅⷐߣ⠨߃ߚ‫ޕ‬㧔㧝㧕Τ3‫୶ޟ‬ℂ⊛ߦㆡᱜߥᖱႎᛛⴚߩ೑↪ࠍଦㅴߔࠆ‫ߡ޿ߟߦޠ‬ ߎߩ㗄⋡ߦߟ޿ߡߪ‫ޟޔ‬ᢥ┨ߩᗧ๧߇ࠃߊࠊ߆ࠄߥ޿‫ޔޠ‬‫“ޟ‬ᖱႎᛛⴚߩ೑↪ࠍଦㅴߔࠆ”ߣ޿߁ౝኈ߇ࠊ߆ࠅߦߊ޿‫ߩ╬ޠ‬ᗧ⷗߇ነߖࠄࠇߚ‫ޕ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߩቇ↢ߪ‫⎇ޔ‬ⓥ߿⋴⼔ታ〣ߦ⌕ᚻߔࠆߦ޽ߚࠅ‫ޔ‬ᄙ᭽ߥᖱႎࠍ᭽‫ߥޘ‬ᣇᴺߢᓧߡ޿ߊᔅⷐ߇޽ࠆ‫߆ߒޕ‬ߒ‫ߩࠄࠇߘޔ‬ᖱႎḮ߇ߤߎߦ޽ࠅ‫⎇ޔ‬ⓥ߿⋴⼔ታ〣ߦ↪޿ࠆߎߣߢߤߩࠃ߁ߥᓇ㗀߇ߤߩࠃ߁ߦᵄ෸ߒߡ޿ߊߩ߆‫ࠍޔ‬⠨߃ࠆߎߣ߇ᔅⷐߣߥࠆ‫ޕ‬એ਄ࠃࠅ‫ޔ‬Τ3 ߪ‫ޟ‬ᖱႎᛛⴚࠍ୶ℂ⊛ߦㆡᱜߦ೑↪ߔࠆ‫ߣޠ‬ᄌᦝߒߚ‫ޕ‬㧔㧞㧕Τ-7‫ޟ‬੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍㅢߓ‫ޔ‬ஜᐽࠍ଻ᜬჇㅴߔࠆ‫ޠ‬ ߎߩ㗄⋡ߦߟ޿ߡ߽‫ޟޔ‬ᢥ┨߇વࠊࠅߦߊ޿‫ޠ‬‫ޔ‬‫“ޟ‬੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍ”ߩ⴫⃻－ 79 －

߇ಽ߆ࠅߦߊ޿‫ޔޠ‬‫ޟ‬ౝኈߩᗧ࿑ߒߡ޿ࠆߎߣ߇ࠊ߆ࠅߦߊ޿‫ߩ⃻⴫ޔ╬ޠ‬ಽ߆ࠅߦߊߐ߇
ᜰ៰ߐࠇߚ‫ޕ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߩቇ↢ߦߣߞߡ‫⥄ޔ‬ಽ߇ኻ⽎ߣߔࠆੱߩஜᐽ໧㗴ࠍ⠨߃ࠆ㓙‫ޔ‬੐଀߿⛔⸘⊛⷗࿾߆ࠄᓧߚ⍮⼂ߛߌߢߥߊ‫ޔ‬ㄭធߔࠆቇ໧㗔ၞ߿⥄りߩ⚻㛎⍮߽฽߼ߚᄙ᭽ߥ⍮⼂ࠍวߖ‫߇ߣߎࠆ޿↪ޔ‬᳞߼ࠄࠇࠆߣ⠨߃ࠄࠇࠆ‫ޕ‬ ߘߎߢ‫ޔ‬Τ7 ߪ‫ޟ‬੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍ↪޿ߡ‫ޔ‬ஜᐽߩ଻ᜬჇㅴࠍߔࠆ‫ߣޠ‬ᄌᦝߒߚ‫ޕ‬
㧔㧟㧕ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߩቇ↢‫ߩ⼔⋴ޟ‬ኻ⽎ߦኻߒߡ‫∉ޔ‬ቇ⊛ߥ⍮⼂ࠍᵴ↪ߒߡ‫੍ޔ‬㒐⊛ⷰὐࠍ〯߹߃ߡஜᐽߩ଻ᜬ࡮Ⴧㅴߦขࠅ⚵߻‫ޠ‬ ߎߩ㗄⋡ฬߪ‫ޟ‬㨪ߒߡ‫ޔ‬㨪ߒߡ‫߁޿ߣޠ‬ᢥ┨᭴ᚑߢ޽ࠅ‫ޔ‬૗ࠍ⋡ᜰߔߩ߆߇ਇ᣿⍎ߥ⴫⃻ߦߥߞߡ޿ߚ‫⺞ޕ‬ᩏ⎇ⓥߢ߽‫∉“ޟޔ‬ቇ⊛ߥ⍮⼂ࠍᵴ↪ߒߡ”‫੍“ޔ‬㒐⊛ⷰὐࠍ〯߹߃ߡ”ߣ޿߁⴫⃻߇ಽ߆ࠅߦߊ޿‫߁޿ߣޠ‬ᗧ⷗߇␜ߐࠇߡ߅ࠅ‫ޔ‬㗄⋡ฬߩᄌᦝ߇ᔅⷐߢ޽ࠆߎߣ
߇⠨߃ࠄࠇߚ‫ޕ‬ ߘߎߢ‫ޔ‬Τ8 ߪ‫∉ޟ‬ቇ⊛ߥ⍮⼂ࠍᵴ↪ߒߡ‫ޔ‬ஜᐽߩ଻ᜬჇㅴߦขࠅ⚵߻‫ߦޠ‬ᄌᦝߔࠆߎ
ߣߣߒߚ‫ޕ‬㧟㧕‫ޟ‬Υ㧚⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡขࠅ⚵߻‫ޠ‬ߎߩ⢻ജߦߟ޿ߡߪ‫ޔ‬96.64㧑߇‫ޟ‬หᗧߔࠆ‫ߣޠ‬࿁╵ߒߡ޿ߚ߇‫“ޟޔ‬ኻ⽎”߿“႐”߇ᗧ๧ߔࠆ߽ߩࠍᢛℂߔࠆᔅⷐ߇޽ࠆ‫ޟޔ߿ޠ‬ኻ⽎ߩ⾰ߩᡷༀߪࠊ߆ࠅߦߊ޿‫߁޿ߣޠ‬ᗧ⷗߇޽ߍࠄࠇߡ޿ߚ‫ߩߎޔߢߎߘޕ‬⢻ജฬࠍ‫ޔ‬‫⼔⋴ޟ‬ታ〣߿ࠤࠕⅣႺߩ⾰ߩᡷༀߦะߌߡขࠅ⚵߻‫ޠ‬ߣ‫ୃޔ‬ᱜߒߚ‫ޕ‬ ߹ߚ‫ߩߎޔ‬⢻ജߩౝኈߣߒߡឭ␜ߒߚ 4 㗄⋡ਛ‫ޔ‬Υ1‫↪⾌ޟ‬ኻലᨐ‫᦭⊛❱⚵ޔ‬ലᕈߥߤߩⷰὐࠍ฽߼‫ޔ‬ኻ⽎ߦߣߞߡߩലᨐࠍ⹏ଔߔࠆ‫ޔޠ‬Υ-3‫ޟ‬ᖱႎࠪࠬ࠹ࡓ‫∉ߣ⸘⛔ޔ‬ቇߩ⍮⼂ࠍ↪޿ߡ‫ߩࡓࠞ࠻࠙ࠕޔ‬ᡷༀ߿࡝ࠬࠢૐᷫߩߚ߼ߩᚢ⇛ࠍ┙ߡࠆ‫ޔޠ‬Υ-4‫ޟ‬᡽╷⊛ߥⷰὐߢࠤࠕߩ⾰଻⸽߿࡝ࠬࠢࡑࡀࠫࡔࡦ࠻ࠍℂ⸃ߔࠆ‫ ߩޠ‬3 㗄⋡ߦߟ޿ߡߪ‫ޔ‬㗄⋡ฬ߿᳞߼ࠆ࡟ࡌ࡞ߦߟ޿ߡਇ᣿⍎ߐ߇ᜰ៰ߐࠇߚߚ߼‫ୃޔ‬ᱜ߇ᔅⷐߣ⠨߃ࠄࠇߚ‫ޕ‬㧔㧝㧕Υ1‫↪⾌ޟ‬ኻലᨐ‫᦭⊛❱⚵ޔ‬ലᕈߥߤߩⷰὐࠍ฽߼‫ޔ‬ኻ⽎ߦߣߞߡߩലᨐࠍ⹏ଔߔࠆ‫ޠ‬ ߎߩ㗄⋡ฬߦߟ޿ߡߪ‫ޟޔ‬૗ߩലᨐ߆ਇ᣿‫ޔޠ‬‫↪⾌“ޟ‬ኻലᨐ‫᦭⊛❱⚵“ޔ‬ലᕈߥߤߩⷰὐࠍ
฽߼”ߩᗧ๧ߦࠃࠆ߇‫್ߩࠄࠇߎޔ‬ᢿߪ㧔ୃ჻⺖⒟ߩ࡟ࡌ࡞ߢߪ㧕㔍ߒ޿‫߁޿ߣޠ‬ᗧ⷗߇޽ߞߚ‫⥃ޔߒ߆ߒޕ‬ᐥߢ⋴⼔ታ〣ࠍߔࠆߦ޽ߚࠅ‫ߩߎޔ‬㗄⋡߇␜ߔౝኈߪᔅⷐߢ޽ࠅ‫ޔ‬ඳ჻೨ᦼ(ୃ჻)⺖⒟ߩቇ↢ߦ߽᳞߼ߚ޿ߣ⠨߃ߚ‫ޕ‬ ߘߎߢ‫ޔ‬ౝኈ߇᣿⏕ߦવࠊࠆࠃ߁ߦ‫ޔ‬‫↪⾌ޟ‬ኻലᨐ‫᦭⊛❱⚵ޔ‬ലᕈߥߤߩⷰὐ߆ࠄ‫⾰ޔ‬ᡷༀߩലᨐࠍ⹏ଔߔࠆ‫ୃߦޠ‬ᱜߒߚ‫ޕ‬㧔㧞㧕Υ-3‫ޟ‬ᖱႎࠪࠬ࠹ࡓ‫∉ߣ⸘⛔ޔ‬ቇߩ⍮⼂ࠍ↪޿ߡ‫ߩࡓࠞ࠻࠙ࠕޔ‬ᡷༀ߿࡝ࠬࠢૐᷫߩ
ߚ߼ߩᚢ⇛ࠍ┙ߡࠆ‫ޠ‬ ߎߩ㗄⋡ߦߟ޿ߡߪ‫ޟޔ‬ᔅⷐߛߣᕁ߁߇‫⚻ޔ‬༡⊛‫ⷞ⊛ࡓ࠹ࠬࠪޔ‬ὐߩ⠌ᓧߪℂ⸃ߩ࡟ࡌ࡞

－ 80 －

߹ߢߢ޽ࠆߣᕁ߁‫“ޟޔ߿ޠ‬ᚢ⇛ࠍ┙ߡࠆ”߹ߢߪ‫⺖ޔ‬㗴߇ᄢ߈޿‫ޔߤߥޠ‬ᔅⷐߥౝኈߢߪ޽
ࠆ߇‫ޔ‬᳞߼ࠆ࡟ࡌ࡞߇㜞޿ߎߣ߇ᜰ៰ߐࠇߚ‫ޕ‬ ߘߎߢ‫ޔ‬‫ޟ‬ᖱႎࠪࠬ࠹ࡓ‫∉ߣ⸘⛔ޔ‬ቇߩ⍮⼂ࠍ↪޿ߡ‫ߩࡓࠞ࠻࠙ࠕޔ‬ᡷༀ߿࡝ࠬࠢૐᷫߩ
ߚ߼ߩᣇ⇛ࠍ┙ߡࠆ‫ୃߦޠ‬ᱜߔࠆߎߣߣߒߚ‫ޕ‬㧔㧟㧕Υ-4‫ޟ‬᡽╷⊛ߥⷰὐߢࠤࠕߩ⾰଻⸽߿࡝ࠬࠢࡑࡀࠫࡔࡦ࠻ࠍℂ⸃ߔࠆ‫ޠ‬ ߎߩ㗄⋡ߦߟ޿ߡߪ‫ޟޔ‬᡽╷⊛ⷰὐߢ‫ޟޔ޿ߊߦࠅ߆ࠊߪޠ‬ඳ჻ᓟᦼ⺖⒟ୃੌᤨ㧔ߩ࡟ࡌ࡞㧕‫߁޿ߣޠ‬ᗧ⷗߇⷗ࠄࠇߚ‫ޕ‬ឭଏߐࠇߡ޿ࠆࠤࠕߩ⾰߿࡝ࠬࠢࡑࡀࠫࡔࡦ࠻ߪ‫․ޔ‬ቯߩ⥃ᐥ⃻႐ߦ߅ߌࠆ⃻⽎ߛߌߢߥߊ‫ߩ⁁⃻ޔ‬᡽╷ߣ⷗วߖߥ߇ࠄℂ⸃ߔࠆߎߣ߇ᔅⷐߢ޽ࠅ‫ޔ‬᳞߼ࠄࠇࠆኻ⽎ߪ‫ޔ‬ඳ჻ᓟᦼ⺖⒟ߦ㒢ߞߚߎߣߢߪߥ޿ߣ⠨߃ࠄࠇࠆ‫ޕ‬ ࠃߞߡ‫ߩߎޔ‬㗄⋡ฬߪ‫ޟ‬᡽╷⊛ߥⷰὐ߆ࠄ‫ࠍ࠻ࡦࡔࠫࡀࡑࠢࠬ࡝߿⸽଻⾰ߩࠕࠤޔ‬ℂ⸃
ߔࠆ‫ୃߦޠ‬ᱜߔࠆߎߣߣߒߚ‫ޕ‬㧠㧕‫ޟ‬Φ㧚ࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ࠕࠤޔ‬ⅣႺࠍᡷༀߔࠆ‫ޠ‬ߎߩ⢻ജߦߟ޿ߡߪ‫ޔ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬90.8%ߣ‫ޔ‬10 ߩ⢻ജߦኻߔࠆ‫ޟ‬หᗧ‫ޠ‬ഀวߣߒߡߪ‫ޔ‬Ωߦᰴߋૐ޿⚿ᨐߣߥߞߚ‫ޕ‬‫ޟ‬หᗧߒߥ޿‫ߩޠ‬ᗧ⷗߆ࠄ‫ߩߘޔ‬ේ࿃ߦ‫ޔ‬‫ޟ‬ඳ჻೨ᦼ(ୃ჻)⺖⒟ߦ᳞߼ࠆ⢻ജߣߒߡߪ‫ޔ‬㜞ߔ߉ࠆ‫߁޿ߣޠ‬⠨߃ߦࠃࠆ߽ߩߣ޿߁ߎߣ߇ಽ߆ߞߚ‫ޕ‬ߎߩ⢻ജߪ‫ࠕࠤޔ‬ⅣႺࠍᡷༀߔࠆߚ߼ߦ‫ߦ❱⚵ޔ‬௛߈߆ߌߡ޿ߊߣ޿߁ᗧ๧ࠍᜬߞߡ߅
ࠅ‫ޔ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߩᢎ⢒ߦ߅޿ߡ‫ޔ‬㊀ⷐߥౝኈߣ⠨߃ࠆ‫ޕ‬ࠃߞߡ‫ޔ‬ᗧ⷗߇಴ߐࠇߚ‫ޔ‬Φ1‫ޟ‬୘ߣ⚵❱ߩਔ஥㕙߆ࠄ‫ޔޠࠆ߃ᝒߡߒߣࡓ࠹ࠬࠪࠍ⼔⋴ޔ‬Φ3‫ࠍࠕࠤޟ‬ታ〣ߔࠆߚ߼ߦᔅⷐߣߥࠆᄙ⡯⒳߿⾗ḮࠍᏎ߈ߎߺߥ߇ࠄ‫ࠕࠤޔ‬ⅣႺߩᡷༀߦขࠅ⚵߻‫ޠ‬‫ޔ‬Φ4‫⺖ߩ❱⚵ޟ‬㗴ߦߟ޿ߡᢎ⢒⊛ߦ௛߈߆ߌࠆ‫ୃޔߡ޿ߟߦޠ‬ᱜࠍട߃ࠆߎ
ߣߣߒߚ‫ޕ‬㧔㧝㧕Φ1‫ޟ‬୘ߣ⚵❱ߩਔ஥㕙߆ࠄ‫ޠࠆ߃ᝒߡߒߣࡓ࠹ࠬࠪࠍ⼔⋴ޔ‬ ߎߩ㗄⋡ߦߟ޿ߡߪ‫ޔ‬ᗧ⷗ߣߒߡ‫“ޟ‬୘”ߣ޿߁ᗧ๧ߪ᏷ᐢ޿ᗧ๧ࠍᜬߜߔ߉ࠆ‫ޔ‬㧔୘߇␜ߔ߽ߩࠍ㧕ዋߒ㒢ቯߢ߈ߥ޿߆‫ߩ⃻⴫ޔࠇࠄߍ޽߇ߤߥޠ‬ಽ߆ࠅߦߊߐࠍᜰ៰ߔࠆౝኈ߇
಴ߐࠇߡ޿ߚ‫ޕ‬ ߘߎߢ‫ޔ‬㗄⋡ฬࠍ‫ࠍ⼔⋴ޟ‬୘ߣ⚵❱ߩਔ㕙߆ࠄ‫ୃߦޠࠆ߃ᝒߡߒߣࡓ࠹ࠬࠪޔ‬ᱜߒߚ‫ޕ‬㧔㧞㧕Φ3‫ࠍࠕࠤޟ‬ታ〣ߔࠆߚ߼ߦᔅⷐߣߥࠆᄙ⡯⒳߿⾗ḮࠍᏎ߈ߎߺߥ߇ࠄ‫ࠕࠤޔ‬ⅣႺ
ߩᡷༀߦขࠅ⚵߻‫ޠ‬ ߎߩ㗄⋡ߦߟ޿ߡߪ‫ޟޔ‬ᔅⷐߣߥࠆᄙ⡯⒳ߣ޿߁ߩߪ߅߆ߒ޿‫ޟޔޠ‬᳞߼ߚ޿ߣߪᕁ߁߇‫ޔ‬⡯૏ߩᓇ㗀߇߆ߥࠅᒝ޿ߩߢߪߥ޿߆‫ޔߤߥޠ‬ቇ↢ߣ޿߁┙႐ߢߢ߈ࠆߎߣߦ㒢ࠅ߇޽ࠆ‫ޔ‬ߣ޿߁ౝኈߩᗧ⷗߇⷗ࠄࠇߚ‫ޕ‬ ߘߎߢ‫ޔ‬‫ޟ‬ᄙ⡯⒳߿ᔅⷐߣߥࠆ⾗Ḯࠍᵴ↪ߒߥ߇ࠄ‫ࠕࠤޔ‬ⅣႺߩᡷༀߦขࠅ⚵߻‫ୃߦޠ‬ᱜߔࠆߎߣߣߒߚ‫ޕ‬－ 81 －

㧔㧟㧕Φ4‫⺖ߩ❱⚵ޟ‬㗴ߦߟ޿ߡᢎ⢒⊛ߦ௛߈߆ߌࠆ‫ޠ‬ߎߩ㗄⋡ߦߟ޿ߡߪ‫ޔ‬‫ޟ‬ᢎ⢒⊛ߥ௛߈߆ߌߩኻ⽎ࠍ᣿␜ߒߚᣇ߇ࠃ޿‫⋴߆ߣࠕࠤޟޔ߿ޠ‬⼔ߣ޿߁↪⺆߇ߥߊᗧ๧߇ߣࠅߠࠄ޿‫ߩ⃻⴫ޔߤߥޠ‬ਇ᣿⏕ߐߦኻߔࠆᗧ⷗߇⷗ࠄࠇߚ‫ޕ‬ߘߎߢ‫ޔ‬‫⺖ߩ❱⚵ޟ‬㗴ߦߟ޿ߡ‫ࠕࠤޔ‬ឭଏ⠪ߦኻߒߡᢎ⢒⊛ߦ௛߈߆ߌࠆ‫ୃߦޠ‬ᱜߔࠆߎߣߣߒߚ‫ޕ‬㧡㧕‫ޟ‬Χ㧚ࠤࠕࠍផㅴߢ߈ࠆ႐߿ੱ⊛ⅣႺࠍᢛ߃ࠆߚ߼ߦ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆ‫ޠ‬ߎߩ⢻ജߦߟ޿ߡߪ‫ޔ‬96.7㧑ߣ㜞޿ഀวߢ‫ޟ‬หᗧߔࠆ‫⹏߁޿ߣޠ‬ଔࠍᓧߚ߇‫ޟޔ‬หᗧߒߥ
޿ℂ↱‫ޟߡߒߣޠ‬㊀ⷐߥ੐㗄ߛ߇‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝“ޔ‬ើߔࠆߚ߼ߩၮ⋚ࠍ૞ࠆ”߹ߢߢߪߥ޿߆‫ޠ‬‫ޔ‬‫⋥ੌୃޟ‬ᓟߢߪߥ޿‫ޔࠄߥࠬࡦࠕࡘ࠾߁޿ߣޔ‬หᗧߢ߈ࠆ‫ᤨੌୃޔߤߥޠ‬ὐߦ᳞߼ࠆ࡟ࡌ࡞ߦኻߔࠆᗧ⷗߇ㅀߴࠄࠇߡ޿ߚ‫ޕ‬ߘߎߢ‫ߩߎޔ‬⢻ജࠍ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޟ‬ើߒ‫ࠕࠤޔ‬ឭଏߩ႐߿ੱ⊛ⅣႺࠍᢛ߃ࠆ‫ߦޠ‬ୃᱜߔࠆߎߣߣߒߚ‫ߩߎޔߚ߹ޕ‬⢻ജߩౝኈߣߒߡឭ␜ߒߚ‫ޔ‬Χ1‫ޟ‬ᣂߒ޿⍮⼂߿ࡕ࠺࡞ࠍታ〣ߦዉ౉ߔࠆߚ߼ߩᚻᴺࠍℂ⸃ߒ‫ߩߘޔ‬ታ⃻ߦะߌߡ࡝࡯࠳࡯ࠪ࠶ࡊࠍ⊒ើߔࠆ‫ޔޠ‬Χ
2‫ޟ‬㓸࿅߿⚵❱ߩ႐ߩജേࠍಽᨆߒ‫ޔ‬㓸࿅߿⚵❱ࠍേ߆ߔ‫ޔޠ‬Χ3‫ᦨޟ‬ༀߩක≮ࠨ࡯ࡆࠬࠍ
ឭଏߔࠆߚ߼ߦ‫ߩࠕࠤޔ‬ᡷༀࠍਥዉߔࠆ‫ޔ߽ߡ޿ߟߦޠ‬ᗧ⷗߇಴ߐࠇߡ޿ߚߚ߼‫ޔ‬ᬌ⸛ߔࠆߎߣߣߒߚ‫ޕ‬㧔㧝㧕Χ1‫ޟ‬ᣂߒ޿⍮⼂߿ࡕ࠺࡞ࠍታ〣ߦዉ౉ߔࠆߚ߼ߩᚻᴺࠍℂ⸃ߒ‫ߩߘޔ‬ታ⃻ߦะߌߡ࡝࡯࠳࡯ࠪ࠶ࡊࠍ⊒ើߔࠆ‫ޠ‬ ߎߩ㗄⋡ߦߟ޿ߡߪ‫ޟޔ‬ዉ౉ߔࠆߚ߼ߩᚻᴺએ೨ߦ⍮⼂࡮ࡕ࠺࡞ߩℂ⸃߇ᔅⷐ‫ޟޔ߿ޠ‬㊀ⷐߥ੐㗄ߛ߇‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆߚ߼ߩၮ⋚ࠍ૞ࠆ‫࡝ޔߤߥޠ߆޿ߥߪߢߢ߹ޔ‬࡯࠳࡯ࠪ࠶ࡊࠍ⊒ើߔࠆ߹ߢߩ‫ޔ‬1 Ბ㓏ࠍ᳞߼ࠆᗧ⷗߇⷗ࠄࠇߚ‫ޕ‬ ߘߎߢ‫ޔ‬‫ޟ‬ᣂߒ޿⍮⼂߿ࡕ࠺࡞ࠍታ〣ߦዉ౉ߔࠆߚ߼ߩᚻᴺࠍℂ⸃ߒ‫ޔ‬ዉ౉ߦะߌߡ࡝
࠳࡯ࠪ࠶ࡊࠍ⊒ើߔࠆ‫ୃߦޠ‬ᱜߒߚ‫ޕ‬㧔㧞㧕Χ2‫ޟ‬㓸࿅߿⚵❱ߩ႐ߩജേࠍಽᨆߒ‫ޔ‬㓸࿅߿⚵❱ࠍേ߆ߔ‫ޠ‬ ߎߩ㗄⋡ߦኻߒߡߪ‫ޟޔ‬㊀ⷐߛ߇‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆߚ߼ߩၮ⋚ࠍ૞ࠆ‫ߢߢ߹ޔ‬ߪߥ޿߆‫ޠ‬‫ޔ‬‫“ޟ‬㓸࿅߿⚵❱ࠍേ߆ߔ”ߪ⋡ᮡߣߒߡ㜞ߔ߉ࠆߩߢߪߥ޿߆‫ޠ‬‫ޔ‬‫ޟ‬ಽᨆജߪᔅⷐ
ߛ߇‫ࠍ❱⚵ޔ‬േ߆ߔ⢻ജ߇᳞߼ࠄࠇࠆߣߪᕁࠊߥ޿‫ߦᤨੌୃޔߤߥޠ‬᳞߼ࠆ⢻ജߩ࡟ࡌ࡞
ߩ㜞ߐߦኻߔࠆᗧ⷗߇⷗ࠄࠇߡ޿ߚ‫ޕ‬ ߘߎߢ‫ޔ‬‫ޟ‬㓸࿅߿⚵❱ߩ႐ߩജേࠍಽᨆߒ‫ޔ‬㓸࿅߿⚵❱ࠍേ߆ߔߚ߼ߩᣇ⇛ࠍ┙ߡࠆ‫ߦޠ‬ୃᱜߔࠆߎߣߣߒߚ‫ޕ‬㧔㧟㧕Χ3‫ᦨޟ‬ༀߩක≮ࠨ࡯ࡆࠬࠍឭଏߔࠆߚ߼ߦ‫ߩࠕࠤޔ‬ᡷༀࠍਥዉߔࠆ‫ޠ‬ ߎߩ㗄⋡ߦߟ޿ߡߪ‫ޟޔ‬᛽⽎⊛ߔ߉ࠆ‫ޕ‬Ṽὼߣߒߡ޿ࠆ‫ޟ߿ޠ‬ක≮ࠨ࡯ࡆࠬߪ㒢ቯ⊛‫ߥޠ‬ߤ‫ߩ⃻⴫ޔ‬ਇ᣿⍎ߐࠍᜰ៰ߔࠆᗧ⷗߇⷗ࠄࠇߚ‫ޕ‬ ߘߎߢ‫ޔ‬‫ᦨޟ‬ༀߩ⋴⼔ࠨ࡯ࡆࠬࠍឭଏߔࠆߚ߼ߦ‫ߩࠕࠤޔ‬ᡷༀࠍਥዉߔࠆ‫ୃߦޠ‬ᱜߒߚ‫ޕ‬－ 82 －

㧢㧕‫ޟ‬Ψ㧚ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫ޠ‬ ߎߩ⢻ജߦߟ޿ߡߪ‫ޔ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬97.5%ߢ޽ࠅ‫ޔ‬⢻ജߩౝኈߣߒߡឭ␜ߒߚ 4 㗄⋡ߦߟ޿ߡ߽‫ޔ‬ห᭽ߦ‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬97.5㧑㨪98.3㧑ߣ㜞޿⹏ଔࠍᓧߚ‫ޔߒ߆ߒޕ‬4 㗄⋡ਛߩΨ3‫ޟ‬ኻ⽎ߩ⺖㗴ࠍนⷞൻߒ‫ઁޔ‬⡯⒳ߣද௛ߒߡ⸃᳿ߦዉߊ‫ޔߪߡ޿ߟߦޠ‬ᗧ⷗߇⷗ࠄࠇߚ
ߚ߼‫ޔ‬Ψ3 ߩୃᱜߩߺࠍᬌ⸛ߔࠆߎߣߣߒߚ‫ޕ‬㧔㧝㧕Ψ3‫ޟ‬ኻ⽎ߩ⺖㗴ࠍนⷞൻߒ‫ઁޔ‬⡯⒳ߣද௛ߒߡ⸃᳿ߦዉߊ‫ޠ‬ ߎߩ㗄⋡ߦኻߒߡߪ‫“ޟޔ‬นⷞൻ”ߪ߅߆ߒ޿‫ޕ‬᣿⏕ൻ࡮⸒⺆ൻߢߪߥ޿߆‫“ޟޔ߿ޠ‬ኻ⽎ߩ⺖㗴”ߣߪ૗߆㧫‫߁޿ߣޠ‬ᗧ⷗߇಴ߐࠇߚ‫ޕ‬ߘߎߢ‫ޔ‬‫ޟ‬ኻ⽎ߩ⋴⼔਄ߩ⺖㗴ࠍ᣿⏕ߦߒ‫ઁޔ‬⡯⒳ߣද௛ߒߡ⸃᳿ߦዉߊ‫ୃߦޠ‬ᱜߔࠆߎߣߣߒߚ‫ޕ‬㧣㧕‫ޟ‬Ω㧚⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ‫ޠ‬ ߎߩ⢻ജߦߟ޿ߡߪ‫ޟޔ‬หᗧߔࠆ‫ ߇ޠ‬84.0%‫ޔ‬‫ޟ‬หᗧߒߥ޿‫ ߪޠ‬16.0%ߢ޽ࠅ‫ޔ‬10 ߩ⢻ജߩਛߢ‫ޟ‬หᗧߔࠆ‫ߩޠ‬ഀว߇ᦨ߽ૐ߆ߞߚ‫ޔߚ߹ޕ‬⢻ജߩౝኈߣߒߡឭ␜ߒߚ 4 㗄⋡ߦߟ޿ߡ߽‫ޔ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬79.5㧑㨪89.8㧑ߣઁߩ⢻ജߦ㑐ߔࠆౝኈߣᲧセߒߡ‫߽ᦨޔ‬ૐ޿⚿ᨐߢ޽ߞߚ‫ߩߎޕ‬⢻ജߪ‫ޔ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ࠍୃੌߒߚ⠪ߦᔅⷐߥ⢻ജߢ޽ࠅ‫ޔ‬㊀ⷐߥ
ᢎ⢒ౝኈߢ޽ࠆߣ⠨߃ࠆ߇‫ޔ‬೙ᐲ߿᡽╷ߩ㊀ⷐᕈߦኻߔࠆℂ⸃߇‫ޔ‬ᢎ⢒஥ߦචಽߦ⹺⼂ߐࠇߡ޿ߥ޿น⢻ᕈ߇޽ࠆߣᕁࠊࠇߚ‫ޕ‬ หᗧߒߥ޿ℂ↱ߣߒߡߪ‫ޔ‬‫ޟ‬ඳ჻⺖⒟࡟ࡌ࡞ߢ޽ࠆ‫⸃ޟޔ߿ޠ‬᳿╷ࠍឭ᩺ߔࠆ⢻ജߪୃ჻
⺖⒟એ਄ߣ⠨߃ࠆ‫ޠ‬‫ޔ‬‫⸃ޟ‬᳿╷ߩឭ᩺߹ߢߩ೔㆐ߪ㔍ߒ޿‫ޔ߁޿ߣޠ‬᳞߼ࠆ࡟ࡌ࡞ߩ㜞ߐߦኻߔࠆᗧ⷗߇ㅀߴࠄࠇߚ‫ޕ‬ ߘߎߢ‫ߩߎޔ‬⢻ജߦߟ޿ߡߪ‫ߩⴕ⃻ޟޔ‬ᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍ⠨᩺ߔࠆ‫ୃߦޠ‬ᱜߔࠆߎߣߣߒߚ‫ߩߎޔߚ߹ޕ‬⢻ജߩౝኈߣߒߡឭ␜ߒߚ 4㗄⋡ߩ߁ߜ‫ޔ‬ᗧ⷗߇಴ߐࠇߚΏ1‫ߩޘੱޟ‬ஜᐽߣ޿߁ⷞὐ߆ࠄ‫ߩ⼔⋴ޔ‬᡽╷ࠍᬌ⸛ߔࠆ‫ޠ‬‫ޔ‬Ω3‫⼔⋴ޟ‬ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯߇᡽╷ߦ෻ᤋߐࠇࠆࠃ߁ᣇ╷ࠍ⠨߃ࠆ‫ޔޠ‬Ω4‫≮⸻ޟ‬
ႎ㈽߿੺⼔଻ஜߥߤߩ᡽╷࡮♖ᐲ߇ࠤࠕឭଏᣇᴺ߿ࠕ࠙࠻ࠞࡓߦ෸߷ߔᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍឭ᩺ߔࠆ‫ޔߡ޿ߟߦޠ‬ౣᬌ⸛ߔࠆߎߣߣߒߚ‫ޕ‬㧔㧝㧕Ω1‫ߩޘੱޟ‬ஜᐽߣ޿߁ⷞὐ߆ࠄ‫ߩ⼔⋴ޔ‬᡽╷ࠍᬌ⸛ߔࠆ‫ޠ‬ ߎߩ㗄⋡ߦߟ޿ߡߪ‫ޔ‬‫ޟ‬᡽╷߳ߩᓇ㗀ࠍᜬߟ߹ߢߪ㔍ߒ޿߇‫ޔ‬ᬌ⸛߹ߢߪน⢻‫ޔ߿ޠ‬‫ޘ⦡ޟ‬ߥ⋴⼔ߩኾ㐷ᕈࠍ߽ߟୃੌ↢߇޿ࠆߎߣࠍ⠨߃‫߁߽ޔ‬ዋߒ൮᜝⊛⴫⃻ߩᣇ߇ࠃ޿ߩߢߪߥ
޿߆‫߁޿ߣޠ‬ᗧ⷗߇⷗ࠄࠇߚ‫ޕ‬ ߘߎߢ‫ޔ‬‫ߩޘੱޟ‬ஜᐽჇㅴߩⷰὐ߆ࠄ‫ߩ⼔⋴ޔ‬᡽╷ࠍᬌ⸛ߔࠆ‫ୃߦޠ‬ᱜߒߚ‫ޕ‬㧔㧞㧕Ω3‫⼔⋴ޟ‬ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯߇᡽╷ߦ෻ᤋߐࠇࠆࠃ߁ᣇ╷ࠍ⠨߃ࠆ‫ޠ‬ ߎߩ㗄⋡ߦߟ޿ߡߪ‫ޟޔ‬ᬌ⸛ߔࠆ࡟ࡌ࡞ߥࠄน⢻‫ޠ‬‫ޟޔ‬ᣇ╷(⸃᳿╷)ࠍឭ᩺ߔࠆߦߪ⚻㛎⊛ߦ߽ਇචಽ‫ୃޔ‬჻⺖⒟એ਄ߦ᳞߼ࠆ⢻ജߢߪߥ޿߆‫߁⸒ߣޠ‬ᗧ⷗߇಴ߐࠇ‫ޔ‬᳞߼ࠆ⢻ജߩ࡟ࡌ࡞ߦኻߔࠆᗧ⷗߇಴ߐࠇߡ޿ߚ‫ޕ‬ ߘߎߢ‫ޔ‬‫⼔⋴ޟ‬ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯߇᡽╷ߦ෻ᤋߐࠇࠆࠃ߁ߦ‫ޔ‬ᣇ╷ࠍ⠨᩺ߔࠆ‫ޠ‬－ 83 －

ߦୃᱜߔࠆߎߣߣߒߚ‫ޕ‬㧔㧟㧕Ω4‫≮⸻ޟ‬ႎ㈽߿੺⼔଻ஜߥߤߩ᡽╷࡮೙ᐲ߇ࠤࠕឭଏᣇᴺ߿ࠕ࠙࠻ࠞࡓߦ෸߷ߔ
ᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍឭ᩺ߔࠆ‫ޠ‬ ߎߩ㗄⋡ߪ‫ޟ‬หᗧߔࠆ‫߽ᦨ߇ޠ‬ૐߊ‫ޟޔ‬ඳ჻ᓟᦼ⺖⒟ୃੌᤨߩ⢻ജߢߪߥ޿߆‫ޠ‬‫ޟޔ‬ᡷༀ╷ߩឭ᩺߹ߢߪ෩ߒ޿‫ޠ‬‫ޔ‬‫ޟ‬㧔᡽╷߿೙ᐲߩⷞὐߪቇ჻⺖⒟ߢߪਇ⿷ߒߡ޿ࠆߩߢ‫ߩߎޔ‬ᢎ⢒ߪᄢಾߛ߇㧕ឭ᩺߹ߢߪήℂ‫ޔޠ‬‫ޟ‬ឭ᩺ߔࠆ႐ᚲ߇ਇ᣿⏕‫ޔߤߥޠ‬᳞߼ࠆ࡟ࡌ࡞ߩ㜞ߐߦኻߔࠆᗧ⷗߇ᄙߊㅀߴࠄࠇߚ‫ޕ‬ ߘߎߢ‫ޔ‬‫≮⸻ޟ‬ႎ㈽߿੺⼔଻ஜߥߤߩ᡽╷࡮೙ᐲ߇ࠤࠕឭଏᣇᴺ߿ࠕ࠙࠻ࠞࡓߦ෸߷ߔᓇ
㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍ⠨᩺ߔࠆ‫ୃߦޠ‬ᱜߒߚ‫ޕ‬㧤㧕‫ޟ‬Ϊ㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆᢎ⢒ⅣႺߠߊࠅߦขࠅ⚵߻‫ޠ‬ߎߩ⢻ജߦߟ޿ߡߪ‫ޔ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬95.7%‫ޔ‬Ϊߩ⢻ജߩౝኈߣߒߡឭ␜ߒߚ 4 㗄⋡ߦߟ޿ߡ߽‫ޔ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬95.8%㨪97.4%ߣ㜞޿⹏ଔߢ޽ࠅ‫ߚࠇࠄߍ޽ޔ‬ᗧ⷗ߦ߽‫ޔ‬ౝኈߩਇ⏕߆ߐ߿ਇ᣿⍎ߐࠍᜰ៰ߔࠆ߽ߩߪߥ߆ߞߚ‫ޕ‬ߒ߆ߒ‫ޔ‬Ϊ2 ߩ‫⼔⋴ޟ‬ቇߩ⸘↹⊛࡮ലᨐ⊛ߥᢎ⢒ᣇᴺࠍឭ᩺ߔࠆ‫ߦޠ‬ኻߒߡᗧ⷗߇಴ߐ
ࠇߡ޿ߚߩߢ‫ߩߎޔ‬ౝኈߦߟ޿ߡౣᬌ⸛ߔࠆߎߣߣߒߚ‫ޕ‬㧔㧝㧕Ϊ2 ߩ‫⼔⋴ޟ‬ቇߩ⸘↹⊛࡮ലᨐ⊛ߥᢎ⢒ᣇᴺࠍឭ᩺ߔࠆ‫ޠ‬ߎߩ㗄⋡ߦߟ޿ߡߪ‫ޔ‬‫ޟ‬㜞ᐲߥ⋴⼔ቇᢎ⢒ߩ⢻ജ߇ᔅⷐߢ޽ࠅ‫߇࡞ࡌ࡟߿߿ޔ‬㜞޿ߩߢߪߥ޿߆‫߁޿ߣޠ‬ᗧ⷗߇޽ߍࠄࠇߡ޿ߚ‫ߩߎޔߢߎߘޕ‬㗄⋡߇᳞߼ࠆౝኈߣߒߡ‫ޔ‬‫⼔⋴ޟ‬ቇߩ
⸘↹⊛࡮ലᨐ⊛ߥᢎ⢒ᣇᴺࠍ⠨᩺ߔࠆ‫ୃߦޠ‬ᱜߒߚ‫ޕ‬㧥㧕‫ޟ‬Ϋ㧚୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ‫ޠ‬ߎߩ⢻ജߦߟ޿ߡߪ‫ޔ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬95.8%ߢ޽ࠅ‫ޔ‬⢻ജߩౝኈߣߒߡឭ␜ߒߚ 3 㗄⋡ߦߟ޿ߡ߽‫ޔ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬95.8㨪98.3%ߣ㜞޿⹏ଔ߇⷗ࠄࠇߚ‫ޕ‬ ߒ߆ߒ‫ޔ‬‫ޟ‬Ϋ㧚୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ‫߁޿ߣޠ‬⢻ജߦኻߒ‫ޔ‬‫୶ޟ‬ℂ⊛ᗵฃᕈߣᢥൻ⊛ᗵฃᕈߪ⇣ߥࠆߚ߼‫ޔ‬หᗧ⺆ߩ᭽ߦᝒ߃ࠆ(⴫⃻ߔࠆ)ߎߣ
ߦߪ⇼໧ࠍᗵߓࠆ‫߁޿ߣޠ‬ᗧ⷗߇⷗ࠄࠇߚ‫ߩߎޔߢߎߘޕ‬⢻ജߩ⴫⃻ࠍ‫୶ޟ‬ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߜ‫ޔ‬ኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ‫ୃߦޠ‬ᱜߒߚ‫ޕ‬߹ߚ‫ޔ‬Ϋߩ⢻ജߩౝኈߣߒߡឭ␜ߒߚ 3 㗄⋡ߩ߁ߜ‫ޔ‬Ϋ2‫ޟ‬ኻ⽎ߩᠩ⼔ߩ┙႐߆ࠄ‫ޔ‬቟ోߥࠤࠕⅣႺࠍଦㅴߒ‫୶ޔ‬ℂ⊛ታ〣ࠍ᥉෸ߔࠆ‫ߡ޿ߟߦޠ‬ᗧ⷗߇ㅀߴࠄࠇߡ߅ࠅ‫ޔ‬ౣᬌ⸛ߔࠆߎߣߣߒߚ‫ޕ‬㧔㧝㧕Ϋ2‫ޟ‬ኻ⽎ߩᠩ⼔ߩ┙႐߆ࠄ‫ޔ‬቟ోߥࠤࠕⅣႺࠍଦㅴߒ‫୶ޔ‬ℂ⊛ታ〣ࠍ᥉෸ߔࠆ‫ޠ‬ ߎߩ㗄⋡ߦߟ޿ߡߪ‫߇⃻⴫ޟޔ‬ᐢߔ߉‫ߩ⃻⴫ޔ߁޿ߣޠࠆ޽ߢ޿߹޿޽ޔ‬ਇ᣿⍎ߐࠍᜰ៰ߔࠆᗧ⷗߇ㅀߴࠄࠇߡ޿ߚ‫ޕ‬ ߘߎߢ‫ޔ‬‫ޟ‬ኻ⽎ߩᠩ⼔ߩ┙႐߆ࠄ‫୶ޔ‬ℂ⊛ታ〣ࠍ᥉෸ߔࠆ‫ୃߦޠ‬ᱜߒߚ‫ޕ‬㧕‫ޟ‬ά㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ‫ޠ‬－ 84 －

ߎߩ⢻ജߦߟ޿ߡߪ‫ޔ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬97.5%ߣ㜞ߊ‫ޔ‬⢻ജߩౝኈߣߒߡឭ␜ߒߚ 4 㗄⋡ߦߟ޿ߡ߽‫ޔ‬‫ޟ‬หᗧߔࠆ‫ ߇ޠ‬93.3%㨪97.5%ߣห᭽ߦ㜞޿⹏ଔ߇⷗ࠄࠇߚ‫ޕ‬ ߒ߆ߒ‫ޔ‬⢻ജߩౝኈߣߒߡឭ␜ߒߚ 4 㗄⋡ߩਛߢ‫ޔ‬ά-2‫⼔⋴ޟ‬ቇࠍขࠅᏎߊ⺖㗴ߦߟ޿ߡߩᗵฃᕈࠍ㜞߼‫ޔ‬ਥ૕ᕈࠍᜬߞߡᡷༀߔࠆ‫ޔޠ‬ά3‫ࠍࠕࠤ޿⦟ࠅࠃޟ‬᳿ቯߔࠆߚ߼ߦᦨᣂߩ
⍮⷗ࠍᓧߥ߇ࠄታ〣ߔࠆࡕ࠺࡞ߦߥࠆ‫ޔޠ‬ά4‫ޟ‬ኾ㐷⡯ߣߒߡ⋴⼔ⷰࠍ᣿⏕ߦߔࠆ‫ ߩޠ‬3 㗄⋡ߦߟ޿ߡᗧ⷗߇಴ߐࠇߡ޿ߚߩߢ‫ߡ޿ߟߦࠄࠇߎޔ‬ౣᬌ⸛ߔࠆߎߣߣߒߚ‫ޕ‬㧔㧝㧕ά-2‫⼔⋴ޟ‬ቇࠍขࠅᏎߊ⺖㗴ߦߟ޿ߡߩᗵฃᕈࠍ㜞߼‫ޔ‬ਥ૕ᕈࠍᜬߞߡᡷༀߔࠆ‫ޠ‬ ߎߩ㗄⋡ߦߟ޿ߡߪ‫ޟޔ‬೨ᢥߣᓟᢥߦ㘧べ߇޽ࠆ‫ޔ߿ޠ޿ࠄߠࠅ߆ࠊޕ‬‫ޟ‬ᡷༀߦะߌߡߣ
ࠅߊ߻ߣ޿߁࡟ࡌ࡞ߛߣ⠨߃ࠆ‫߁޿ߣޠ‬ᗧ⷗߇⷗ࠄࠇߚ‫ޕ‬ ߘߎߢ‫ߩ⃻⴫ޔ‬ಽ߆ࠅ߿ߔߐ߿‫ޔ‬᳞߼ࠆ࡟ࡌ࡞ߦߟ޿ߡᬌ⸛ࠍട߃ߚ⚿ᨐ‫ޔ‬‫⼔⋴ޟ‬ቇࠍข
ࠅᏎߊ⺖㗴ߦߟ޿ߡ‫ޔ‬ᗵฃᕈࠍ㜞߼‫ޔ‬ਥ૕⊛ߦขࠅ⚵߻‫ୃߦޠ‬ᱜߒߚ‫ޕ‬㧔㧞㧕ά3‫ࠍࠕࠤ޿⦟ࠅࠃޟ‬᳿ቯߔࠆߚ߼ߦᦨᣂߩ⍮⷗ࠍᓧߥ߇ࠄታ〣ߔࠆࡕ࠺࡞ߦߥࠆ‫ޠ‬㧔㧟㧕ά4‫ޟ‬ኾ㐷⡯ߣߒߡ⋴⼔ⷰࠍ᣿⏕ߦߔࠆ‫ޠ‬ ߎࠇࠄߩ㗄⋡ߦߟ޿ߡ߽‫ޔ‬‫ޟ‬㧔ᢥ┨߇㧕ࠊ߆ࠅߠࠄ޿‫߁޿ߣޠ‬ᗧ⷗㧔ά3㧕߿‫ޔ‬‫ߩⷰ⼔⋴ޟ‬ቯ⟵ߘߩ߽ߩ߇޽޿߹޿ߢ޽ࠆߚ߼‫޿ߥߒ↪૶ޔ‬ᣇ߇ࠃ޿‫ߥ޿߹޿޽߁޿ߣⷰ⼔⋴ޟޔޠ‬᭎ᔨࠍ૶߁ߎߣߦߪ෻ኻ‫ޠ‬㧔ά4㧕‫߁޿ߣޔ‬ᗧ⷗߇⷗ࠄࠇߚ‫ޕ‬ ߘߎߢ‫ޔ‬ά3 ࠍ‫ࠍࠕࠤ޿⦟ࠅࠃޟ‬᳿ቯߔࠆߚ߼ߦ‫ᦨޔ‬ᣂߩ⍮⷗ࠍᓧߥ߇ࠄታ〣ߔࠆࡕ࠺࡞ߦߥࠆ‫ޠ‬‫ޔ‬ά4 ࠍ‫ޟ‬ኾ㐷⡯ߣߒߡ‫ޔ‬ℂᔨ߿ଔ୯ⷰࠍ᣿⏕ߦߔࠆ‫ୃߦޠ‬ᱜߒߚ‫ޕ‬ એ਄ߩୃᱜὐࠍ‫ୃޔ‬ᱜ೨ߣᲧセߒߡ৻ⷩ⴫ߣߒߡ߹ߣ߼ߚ߽ߩ߇‫ ⴫ޔ‬14 ߢ޽ࠆ‫ޕ‬－ 85 －

⴫ 14‫ޟ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢ⠌ᓧߔߴ߈⢻ജ‫ ࠆߌ߅ߦޠ‬10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬
ࠍ␜ߔ 42 㗄⋡ߩୃᱜኻᲧ⴫
ୃᱜ೨ߩ 10 ߩ‫ޟ‬⢻ജ‫ߣޠ‬‫ޟ‬⢻ജߩౝኈ‫ޠ‬42 㗄⋡஻⠨ᦨ⚳ ࡮10 ߩ‫ޟ‬⢻ജ‫ߣޠ‬‫ޟ‬⢻ജߩౝኈ‫ޠ‬42 㗄⋡Σ㧚⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ ޔ‬Σ㧚⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ
ࠛࡆ࠺ࡦࠬࠍᵴ↪ߔࠆࠛࡆ࠺ࡦࠬࠍᵴ↪ߔࠆ㧝㧚⋴⼔ታ〣ߢߩ໧㗴ࠍ⸃᳿ߔࠆ 㧝㧚⋴⼔ታ〣ߢߩ໧㗴ࠍ⸃᳿ߔࠆ
ߚ߼ߦ‫ޔ‬ᔅⷐߥࠛࡆ࠺ࡦࠬࠍ
ߚ߼ߦ‫ޔ‬ᔅⷐߥࠛࡆ࠺ࡦࠬࠍ
ត᳞ߔࠆ
ត᳞ߔࠆ
㧞㧚ࠛࡆ࠺ࡦࠬ࡟ࡌ࡞ࠍᛕ್⊛ߦ 㧞㧚ࠛࡆ࠺ࡦࠬ࡟ࡌ࡞ࠍᛕ್⊛ߦ⺒⸃ߒ‫⹏ޔ‬ଔߔࠆ⺒⸃ߒ‫⹏ޔ‬ଔߔࠆ
㧟㧚'XKFGPEGDCUGFRTCEVKEG ࠍ 㧟㧚'XKFGPEGDCUGFRTCEVKEG ࠍ
ℂ⸃ߔࠆ
ℂ⸃ߔࠆ
㧠㧚ᣂߚߥ⍮⼂߿వㅴ⊛ߥᛛⴚࠍ 㧠㧚ᣂߚߥ⍮⼂߿వㅴ⊛ߥᛛⴚࠍត⚝ߒ‫ޔ‬ᵴ↪ߔࠆត⚝ߒ‫ޔ‬ᵴ↪ߔࠆ Τ㧚⋴⼔ߩኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸 Τ㧚⋴⼔ߩኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ㧕ߦኻߒߡ‫ޔ‬㜞ᐲߥ࿅࡮࿾ၞ㧕ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆ
⋴⼔ࠍታ〣ߔࠆ
㧝㧚ᦨᣂߩࠤࠕᛛⴚ߿ࠛࡆ࠺ࡦࠬ 㧝㧚ᦨᣂߩࠤࠕᛛⴚ߿ࠛࡆ࠺ࡦࠬ
ߦၮߠ޿ߡ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆߦၮߠ޿ߡ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆ㧞㧚ឭଏߐࠇߡ޿ࠆක≮ߩ୶ℂᕈ 㧞㧚ឭଏߐࠇߡ޿ࠆක≮ߩ୶ℂᕈ
ࠍ್ᢿߒታ〣ߔࠆࠍ್ᢿߒታ〣ߔࠆ






ٟୃᱜ▎ᚲߥߒ೑↪ࠍߪ߆ࠅψ
㧟㧚୶ℂ⊛ߦㆡᱜߥᖱႎᛛⴚߩ೑ 㧟㧚ᖱႎᛛⴚࠍ୶ℂ⊛ߦㆡᱜߦ೑
୶ℂ⊛ߦㆡᱜߦ
↪ࠍߪ߆ࠅ‫ޔ‬ଦㅴߔࠆ
↪ߔࠆ
೑↪ߔࠆ
㧠㧚ᄙ⡯⒳ߣߣ߽ߦක≮ߩ቟ోᕈ 㧠㧚ᄙ⡯⒳ߣߣ߽ߦක≮ߩ቟ోᕈ ࠍ⏕⹺ߒ‫଻ޔ‬㓚ߔࠆࠍ⏕⹺ߒ‫଻ޔ‬㓚ߔࠆ㧡㧚ኻ⽎ਛᔃߦ‫⼔⋴ޔ‬⡯߅ࠃ߮ᄙ 㧡㧚ኻ⽎ਛᔃߦ‫⼔⋴ޔ‬⡯߅ࠃ߮ᄙ ⡯⒳ߣߩ⺞ᢛࠍⴕ޿‫ޔ‬ද௛ߒ⡯⒳ߣߩ⺞ᢛࠍⴕ޿‫ޔ‬ද௛ߒߡࠤࠕߔࠆ
ߡࠤࠕߔࠆ
㧢㧚⋴⼔ߦߟ޿ߡߩ⺑᣿ജࠍ߽ߜ‫ ޔ‬㧢㧚⋴⼔ߦߟ޿ߡߩ⺑᣿ജࠍ߽ߜ‫ ޔ‬ද௛ࠍផㅴߔࠆ
ද௛ࠍផㅴߔࠆ
㧣㧚੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍ ⍮⼂ࠍㅢߓψ㧣㧚੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍ↪޿ߡ‫ޔ‬ஜᐽߩ଻ᜬჇㅴࠍߔ ⍮⼂ࠍ↪޿ߡㅢߓ‫ޔ‬ஜᐽࠍ଻ᜬჇㅴߔࠆ
ࠆ㧤㧚⋴⼔ߩኻ⽎ߦኻߒߡ‫∉ޔ‬ቇ⊛ 㧤㧚∉ቇ⊛ߥ⍮⼂ࠍᵴ↪ߒߡ‫ޔ‬ஜ ‫ߩ⼔⋴ޟ‬ኻ⽎ߦኻߥ⍮⼂ࠍᵴ↪ߒ‫੍ޔ‬㒐⊛ߥⷰᐽߩ଻ᜬჇㅴߦขࠅ⚵߻ߒߡ‫੍ޟޔޠ‬㒐ὐࠍ〯߹߃ߡஜᐽߩ଻ᜬ࡮Ⴧ
⊛ߥⷰὐࠍ〯߹ㅴߦขࠅ⚵߻
߃ߡ‫ࠍޠ‬೥㒰Υ㧚⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦ Υ㧚⋴⼔ታ〣߿ࠤࠕⅣႺߩ⾰ߩᡷ ‫߇⼔⋴ޟ‬ឭଏߐࠇኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡขࠅ
ༀߦ߻ߌߡขࠅ⚵߻ ࠆኻ⽎߿႐ߦኻ
⚵߻ߒ‫ޠ‬ψ
‫⼔⋴ޟ‬ታ〣߿ࠤࠕⅣႺ‫ߦޠ‬ᄌᦝ㧝㧚⾌↪ኻലᨐ‫᦭⊛❱⚵ޔ‬ലᕈߥ 㧝㧚⾌↪ኻലᨐ‫᦭⊛❱⚵ޔ‬ലᕈߥ ‫ޟ‬ኻ⽎ߦߣߞߡߩ
ߤߩⷰὐࠍ฽߼‫ޔ‬ኻ⽎ߦߣߞߤߩⷰὐ߆ࠄ‫⾰ޔ‬ᡷༀߩലᨐ ലᨐ‫ޠ‬ψߡߩലᨐࠍ⹏ଔߔࠆ‫ޕ‬ࠍ⹏ଔߔࠆ
‫⾰ޟ‬ᡷༀߩലᨐ‫ޠ‬ߦᄌᦝ㧞㧚ࠤࠕߩ⾰ࠍᡷༀߔࠆߚ߼ߦࠛ 㧞㧚ࠤࠕߩ⾰ࠍᡷༀߔࠆߚ߼ߦࠛ
ࡆ࠺ࡦࠬࠍ↪޿ߡ⚵❱߿㓸࿅ࡆ࠺ࡦࠬࠍ↪޿ߡ⚵❱߿㓸࿅ ߳௛߈߆ߌࠆ
߳௛߈߆ߌࠆ
－ 86 －

㧟㧚ᖱႎࠪࠬ࠹ࡓ‫∉ߣ⸘⛔ޔ‬ቇߩ⍮⼂ࠍ↪޿ߡ‫ߩࡓࠞ࠻࠙ࠕޔ‬ᡷༀ߿࡝ࠬࠢૐᷫߩߚ߼ߩᚢ
⇛ࠍ┙ߡࠆ

㧟㧚ᖱႎࠪࠬ࠹ࡓ‫∉ߣ⸘⛔ޔ‬ቇߩ⍮⼂ࠍ↪޿ߡ‫ߩࡓࠞ࠻࠙ࠕޔ‬ᡷༀ߿࡝ࠬࠢૐᷫߩߚ߼ߩᣇ
⇛ࠍ┙ߡࠆ

㧠㧚᡽╷⊛ߥⷰὐߢߩࠤࠕߩ⾰଻⸽߿࡝ࠬࠢࡑࡀࠫࡔࡦ࠻ࠍℂ⸃ߔࠆΦ㧚ࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ࠕࠤޔ‬ⅣႺ
ࠍ⺞ᢛߔࠆ
㧝㧚୘ߣ⚵❱ߩਔ஥㕙߆ࠄ‫⼔⋴ޔ‬ࠍࠪࠬ࠹ࡓߣߒߡᝒ߃ࠆ

㧠㧚᡽╷⊛ߥⷰὐ߆ࠄ‫⾰ߩࠕࠤޔ‬଻⸽߿࡝ࠬࠢࡑࡀࠫࡔࡦ࠻ࠍ
ℂ⸃ߔࠆΦ㧚ࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ࠕࠤޔ‬ⅣႺ
ࠍ⺞ᢛߔࠆ
㧝㧚⋴⼔ࠍ୘ߣ⚵❱ߩਔ㕙߆ࠄ‫ޔ‬ࠪࠬ࠹ࡓߣߒߡᝒ߃ࠆ

‫ޟ‬ᚢ⇛‫ޠ‬ψ‫ޟ‬ᣇ⇛‫ޠ‬ߦᄌᦝ‫ޟ‬᡽╷⊛ߥⷰὐߢ‫ޠ‬ψ‫ޟ‬᡽╷⊛ߥⷰὐ߆ࠄ‫ߦޠ‬ᄌᦝ‫ޟ‬୘ߣ⚵❱ߩਔ஥㕙߆ࠄ‫ޠ‬ψ‫ࠍ⼔⋴ޟ‬୘ߣ⚵❱ߩਔ㕙߆ࠄ‫ߦޠ‬ᄌᦝ㧞㧚ࠤࠕⅣႺߣߒߡߩ⚵❱ࠍಽᨆ 㧞㧚ࠤࠕⅣႺߣߒߡߩ⚵❱ࠍಽᨆߒ‫⺖ޔ‬㗴✭๺㧔⸃᳿㧕ߩߚ߼ߒ‫⺖ޔ‬㗴✭๺㧔⸃᳿㧕ߩߚ߼ߩᣇ⇛ࠍឭ᩺ߔࠆ
ߩᣇ⇛ࠍឭ᩺ߔࠆ
㧟㧚ࠤࠕࠍታ〣ߔࠆߚ߼ߦᔅⷐߣ 㧟㧚ᄙ⡯⒳߿ᔅⷐߣߥࠆ⾗Ḯࠍᵴ ‫ࠍࠕࠤޟ‬ታ〣ߔࠆߥࠆᄙ⡯⒳߿⾗ḮࠍᏎ߈ㄟߺ
↪ߒߥ߇ࠄ‫ࠕࠤޔ‬ⅣႺߩᡷༀ ߚ߼ߦᔅⷐߣߥࠆ
ߥ߇ࠄ‫ࠕࠤޔ‬ⅣႺࠍᡷༀߔࠆ
ߦขࠅ⚵߻ᄙ⡯⒳߿⾗ḮࠍᏎ߈ㄟߺߥ߇ࠄ‫ޠ‬ψ‫ޟ‬ᄙ⡯⒳߿ᔅⷐߣ
ߥࠆ⾗Ḯࠍᵴ↪ߒߥ߇ࠄ‫ߦޠ‬ᄌᦝ㧠㧚⚵❱ߩ⺖㗴ߦߟ޿ߡᢎ⢒⊛ߦ 㧠㧚⚵❱ߩ⺖㗴ߦߟ޿ߡ‫ࠕࠤޔ‬ឭ ‫ࠕࠤޟ‬ឭଏ⠪ߦኻ௛߈߆ߌࠆ
ଏ⠪ߦኻߒߡᢎ⢒⊛ߦ௛߈߆ߒߡ‫ࠍޠ‬ㅊടߌࠆΧ㧚ࠤࠕࠍផㅴߢ߈ࠆ႐߿ੱ⊛Ⅳ Χ㧚࡝࡯࠳࡯ࠪ࠶ࡊࠍ⊒ើߒ‫ߩ⪲⸒ ࠤޔ‬㗅ᐨࠍ౉ࠇႺࠍᢛ߃‫ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ࠕឭଏ⠪ߩ႐߿ੱ⊛ⅣႺࠍᢛ ᦧ߃ߚ
⊒ើߔࠆ
߃ࠆ
㧝㧚ᣂߒ޿⍮⼂߿ࡕ࠺࡞ࠍታ〣ߦ 㧝㧚ᣂߒ޿⍮⼂߿ࡕ࠺࡞ࠍታ〣ߦ ‫ߩߘޟ‬ታ⃻ߦ߻ߌዉ౉ߔࠆߚ߼ߩᚻᴺࠍℂ⸃ߒ‫ޔ‬ዉ౉ߔࠆߚ߼ߩᚻᴺࠍℂ⸃ߒ‫ޔ‬ߡ‫ޠ‬ߘߩታ⃻ߦะߌߡ࡝࡯࠳࡯ࠪ࠶
ዉ౉ߦะߌߡ࡝࡯࠳࡯ࠪ࠶ࡊࠍ ψ‫ޟ‬ዉ౉ߦะߌߡ‫ޠ‬ࡊࠍ⊒ើߔࠆ
⊒ើߔࠆߦᄌᦝ㧞㧚㓸࿅߿⚵❱ߩ႐ߩജേࠍಽᨆ 㧞㧚㓸࿅߿⚵❱ߩ႐ߩജേࠍಽᨆ ‫ޟ‬േ߆ߔ‫ޠ‬ψߒ‫ޔ‬㓸࿅߿⚵❱ࠍേ߆ߔ
ߒ‫ޔ‬㓸࿅߿⚵❱ࠍേ߆ߔߚ߼ ‫ޟ‬േ߆ߔߚ߼ߩ
ߩᣇ⇛ࠍ┙ߡࠆᣇ⇛ࠍ┙ߡࠆ‫ޠ‬ߦᄌᦝ㧟㧚ᦨༀߩක≮ࠨ࡯ࡆࠬࠍឭଏߔ 㧟㧚ᦨༀߩ⋴⼔ࠨ࡯ࡆࠬࠍឭଏߔ ‫ޟ‬ක≮ࠨ࡯ࡆࠬ‫ޠ‬ࠆߚ߼ߦࠤࠕߩᡷༀࠍਥዉߔ
ࠆߚ߼ߦࠤࠕߩᡷༀࠍਥዉߔψࠆࠆ‫ޠࠬࡆ࡯ࠨ⼔⋴ޟ‬Ψ㧚ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢ Ψ㧚ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢ ᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ
㧝㧚ኾ㐷⡯㑆ߩലᨐ⊛ߥㅪ៤㑐ଥ 㧝㧚ኾ㐷⡯㑆ߩലᨐ⊛ߥㅪ៤㑐ଥ ࠍ▽ߊߚ߼ߦ‫ޔ‬੕޿ࠍዅ㊀ߒࠍ▽ߊߚ߼ߦ‫ޔ‬੕޿ࠍዅ㊀ߒߚࠦࡒࡘ࠾ࠤ࡯࡚ࠪࡦࠍߣࠆ
ߚࠦࡒࡘ࠾ࠤ࡯࡚ࠪࡦࠍߣࠆ
㧞㧚⋴⼔Ꮷ߿ઁ⡯⒳ߦኻߒߡ⋴⼔ 㧞㧚⋴⼔Ꮷ߿ઁ⡯⒳ߦኻߒߡ⋴⼔ ߩᗧ࿑߿ᔅⷐᕈࠍ⺑᣿ߒ‫ޔ‬දߩᗧ࿑߿ᔅⷐᕈࠍ⺑᣿ߒ‫ޔ‬ද
௛ߔࠆ
௛ߔࠆ
㧟㧚ኻ⽎ߩ⺖㗴ࠍนⷞൻߒ‫ઁޔ‬⡯ 㧟㧚ኻ⽎ߩ⋴⼔਄ߩ⺖㗴ࠍ᣿⏕ߦ ‫⺖ޟ‬㗴ࠍนⷞൻ
⒳ߣද௛ߒߡ⸃᳿ߦዉߊ
ߒ‫ઁޔ‬⡯⒳ߣද௛ߒߡ⸃᳿ߦ ߒ‫ޠ‬ψ‫⼔⋴ޟ‬਄ߩዉߊ⺖㗴ࠍ᣿⏕ߦߒ‫ޠ‬ߦᄌᦝ

－ 87 －

㧠㧚ࠦ࡯࠺ࠖࡀ࡯࠲࡯ߩᓎഀࠍᜂ
޿‫ޔ‬ᄙ⡯⒳㑆ද௛ߩ౞ṖൻࠍផㅴߔࠆΩ㧚⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ
㧝㧚ੱ‫ߩޘ‬ஜᐽჇㅴߣ޿߁ⷞὐ߆
ࠄ‫ߩ⼔⋴ޔ‬᡽╷ࠍᬌ⸛ߔࠆ

㧠㧚ࠦ࡯࠺ࠖࡀ࡯࠲࡯ߩᓎഀࠍᜂ ‫ઁޟ‬⡯⒳㑆‫ࠍޠ‬޿‫ޔ‬ද௛ߩ౞Ṗൻࠍផㅴߔࠆ೥㒰㧞㧚ක≮᡽╷߇୘‫ޔ‬㓸࿅‫ߦ❱⚵ޔ‬߽ߚࠄߔᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍ⠨᩺ߔࠆ
㧟㧚⋴⼔ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯߇᡽╷ߦ෻ᤋߐࠇࠆࠃ߁ᣇ
╷ࠍ⠨߃ࠆ
㧠㧚⚻ᷣ߿᡽╷࡮೙ᐲ߇ࠤࠕឭଏ
ᣇᴺ߿ࠕ࠙࠻ࠞࡓߦ෸߷ߔᓇ
㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍឭ  ᩺ߔࠆ Ϊ㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆᢎ
⢒ⅣႺߠߊࠅߦขࠅ⚵߻㧝㧚ቇ⠌⠪ߩ࠾࡯࠭ࠍᛠីߒ‫ޔ‬ቇ⠌⠪ߦวࠊߖߚᢎ⢒ᴺࠍℂ⸃ߔࠆ‫ޕ‬

㧞㧚ක≮᡽╷߇୘‫ޔ‬㓸࿅‫ߦ❱⚵ޔ‬߽ߚࠄߔᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍ⠨᩺ߔࠆ
㧟㧚⋴⼔ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯߇᡽╷ߦ෻ᤋߐࠇࠆࠃ߁
ߦ‫ޔ‬ᣇ╷ࠍ⠨᩺ߔࠆ㧠㧚⚻ᷣ߿᡽╷࡮೙ᐲ߇ࠤࠕឭଏ
ᣇᴺ߿ࠕ࠙࠻ࠞࡓߦ෸߷ߔᓇ
㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷  ࠍ⠨᩺ߔࠆΪ㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆᢎ
⢒ⅣႺߠߊࠅߦขࠅ⚵߻㧝㧚ቇ⠌⠪ߩ࠾࡯࠭ࠍᛠីߒ‫ޔ‬ቇ⠌⠪ߦวࠊߖߚᢎ⢒ᴺࠍℂ⸃ߔࠆ‫ޕ‬

Ω㧚⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍ⠨᩺ߔࠆ㧝㧚ੱ‫ߩޘ‬ஜᐽჇㅴߩⷰὐ߆ࠄ‫ޔ‬⋴⼔ߩ᡽╷ࠍᬌ⸛ߔࠆ

㧞㧚⋴⼔ቇߩ⸘↹⊛࡮ലᨐ⊛ߥᢎ 㧞㧚⋴⼔ቇߩ⸘↹⊛࡮ലᨐ⊛ߥᢎ
⢒ᣇᴺࠍឭ᩺ߔࠆ
⢒ᣇᴺࠍ⠨᩺ߔࠆ

‫ޟ‬ឭ᩺‫ޠ‬ψ‫ޟ‬⠨᩺‫ޠ‬ߦᄌᦝ‫ⷞޟ‬ὐ߆ࠄ‫ޠ‬ψ‫ⷰޟ‬ὐ߆ࠄ‫ߦޠ‬ᄌᦝ‫ޟ‬⠨߃ࠆ‫ޠ‬ψ‫ޟ‬⠨᩺ߔࠆ‫ߦޠ‬ᄌᦝ‫ޟ‬ឭ᩺ߔࠆ‫ޠ‬ψ‫ޟ‬⠨᩺ߔࠆ‫ޠ‬‫ޟ‬ឭ᩺‫ޠ‬ψ‫ޟ‬⠨᩺ߔࠆ‫ߦޠ‬ᄌᦝ㧟㧚ቇ⠌⠪ߩ࠾࡯࠭ߦวߞߚᢎ⢒ 㧟㧚ቇ⠌⠪ߩ࠾࡯࠭ߦวߞߚᢎ⢒⊛㑐ࠊࠅࠍⴕ߁
⊛㑐ࠊࠅࠍⴕ߁
㧠㧚ቇ⠌߇ଦㅴߔࠆࠃ߁ߦᢎ⢒Ⅳ 㧠㧚ቇ⠌߇ଦㅴߔࠆࠃ߁ߦᢎ⢒Ⅳ Ⴚࠍᢛ߃ࠆ
Ⴚࠍᢛ߃ࠆ
Ϋ㧚୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞ Ϋ㧚୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߜ‫ޟ ޔ‬ᜬߞߡ‫ޠ‬ψߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ ‫ޟ‬ᜬߜ‫ߦޠ‬ᄌᦝߔ㧝㧚୘ੱ࡮ኅᣖ࡮㓸࿅ߩᜬߟᢥൻ 㧝㧚୘ੱ࡮ኅᣖ࡮㓸࿅ߩᜬߟᢥൻ ߿⢛᥊ࠍᛠីߒ‫ࠍ⼔⋴ޔ‬ታ〣߿⢛᥊ࠍᛠីߒ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆߔࠆ㧞㧚ኻ⽎ࠍᠩ⼔ߔࠆ┙႐߆ࠄ‫ޔ‬቟ 㧞㧚ኻ⽎ᠩ⼔ߩ┙႐߆ࠄ‫୶ޔ‬ℂ⊛ ‫ޟ‬቟ోߥࠤࠕⅣႺ
ోߥࠤࠕⅣႺࠍଦㅴߒ‫୶ޔ‬ℂታ〣ࠍ᥉෸ߔࠆ
ࠍଦㅴߒ‫ࠍޠ‬೥㒰⊛ታ〣ࠍ᥉෸ߔࠆ
㧟㧚୶ℂߦ㑐ߔࠆℂ⺰ࠍᵴ↪ߒߡ‫ ޔ‬㧟㧚୶ℂߦ㑐ߔࠆℂ⺰ࠍᵴ↪ߒߡ‫ ޔ‬୶ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆኻ
୶ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆኻ
⽎߿ኾ㐷⡯ࠍᡰេߔࠆ
⽎߿ኾ㐷⡯ࠍᡰេߔࠆά㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆ ά㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆ
ࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ
ࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ
㧝㧚⋴⼔߿ක≮ߦ㑐ߔࠆኾ㐷⡯ߣ 㧝㧚⋴⼔߿ක≮ߦ㑐ߔࠆኾ㐷⡯ߣ ߒߡߩືቇࠍ⊒ዷߐߖ‫⼔⋴ޔ‬ߒߡߩືቇࠍ⊒ዷߐߖ‫⼔⋴ޔ‬ታ〣ߦ⛔วߔࠆ
ታ〣ߦ⛔วߔࠆ
㧞㧚⋴⼔ቇࠍขࠅᏎߊ⺖㗴ߦߟ޿ 㧞㧚⋴⼔ቇࠍขࠅᏎߊ⺖㗴ߦߟ޿ ‫ޟ‬ਥ૕ᕈࠍᜬߞߡ
ߡߩᗵฃᕈࠍ㜞߼‫ޔ‬ਥ૕ᕈࠍߡ‫ޔ‬ᗵฃᕈࠍ㜞߼‫ޔ‬ਥ૕⊛ߦ ᡷༀߔࠆ‫ޠ‬ψᜬߞߡᡷༀߔࠆ
ขࠅ⚵߻‫ޟ‬ਥ૕⊛ߦขࠅ⚵߻‫ߦޠ‬ᄌᦝ

－ 88 －㧟㧚ࠃࠅ⦟޿ࠤࠕࠍ᳿ቯߔࠆߚ߼ 㧟㧚ࠃࠅ⦟޿ࠤࠕࠍ᳿ቯߔࠆߚ߼ ‫ ޟ‬᳿ ቯ ߔ ࠆ ߚ ߼ߦᦨᣂߩ⍮⷗ࠍᓧߥ߇ࠄታ〣ߦ‫ᦨޔ‬ᣂߩ⍮⷗ࠍᓧߥ߇ࠄታ
ߦ‫ޠ‬ψ
ߔࠆࡕ࠺࡞ߦߥࠆ
〣ߔࠆࡕ࠺࡞ߦߥࠆ
‫ޟ‬᳿ቯߔࠆߚ߼
ߦ‫ߦޠޔ‬ᄌᦝ㧠㧚ኾ㐷⡯ߣߒߡ⋴⼔ⷰࠍ᣿⏕ߦ 㧠㧚ኾ㐷⡯ߣߒߡ‫ޔ‬ℂᔨ߿ଔ୯ⷰ ‫ޠⷰ⼔⋴ޟ‬ψߔࠆࠍ᣿⏕ߦߔࠆ
‫ޟ‬ℂᔨ߿ଔ୯ⷰ‫ޠ‬ߦᄌᦝ

－ 89 －╙  ┨ ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢୃᓧߔߴ߈⢻ജ㧝㧚⋴⼔ቇߩඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ୃੌ↢߇ୃᓧߔߴ߈⢻ജ ᐔᚑ  ᐕᐲࠃࠅⴕߞߡ߈ߚ৻ㅪߩ⺞ᩏߢ᣿ࠄ߆ߣߥߞߚ⋴⼔ቇߩඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ୃੌ↢߇ୃᓧߔߴ߈⢻ജߪ‫ޟߩ ޔ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬42 㗄⋡ߢ޽ࠆ‫ߩࠄࠇߎޕ‬⢻ജߪ‫ୃޔ‬჻㧔⋴⼔ቇ㧕ࠍ᝼ਈߐࠇߚߔߴߡߩୃੌ↢߇‫ޔ‬ታ〣࡮ᢎ⢒࡮⎇ⓥߥߤ᭽‫ߥޘ‬ᓎഀࠍᜂߞߡ޿ߊਛߢ‫౒ޔ‬ㅢߒߡ⊒ើߔࠆߎߣ߇ᦼᓙߐࠇߡ޿ࠆ‫ޕ‬Σ ⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ࠍࠬࡦ࠺ࡆࠛޔ‬ᵴ↪ߔࠆୃ჻⺖⒟ୃੌ↢ߪ‫⼔⋴ޔ‬ታ〣߿ࠤࠕ  ឭଏߩ႐ߦ߅޿ߡ‫⇼ޔ‬໧ࠍ߽ߜត᳞ߔࠆᘒᐲߢ‫⸃ޔ‬᳿ߔߴ߈⋴⼔ߩ⺖㗴ࠍ⷗಴ߔߎߣ‫ߦࠄߐޔ‬ᣢሽߩ᭽‫ࠍࠬࡦ࠺ࡆࠛߩ࡞ࡌ࡟ߥޘ‬෼㓸‫⛔ޔ‬วߒ‫ࠇߘޔ‬ࠄࠍ⎇ⓥ߿ታ〣ߦᵴ↪ߒ‫⺖ޔ‬㗴⸃᳿ߦ❬޿ߢ޿ߊߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬Σ́ ⋴⼔ታ〣ߢߩ໧㗴ࠍ⸃᳿ߔࠆߚ߼ߦ‫ޔ‬ᔅⷐߥࠛࡆ࠺ࡦࠬࠍត᳞ߔࠆ
Σ́ ࠛࡆ࠺ࡦࠬࠍᛕ್⊛ߦ⺒⸃ߒ‫⹏ޔ‬ଔߔࠆΣ́ 'XKFGPEGDCUGFRTCEVKEG ࠍℂ⸃ߔࠆΣ́ ᣂߚߥ⍮⼂߿వㅴ⊛ߥᛛⴚࠍត⚝ߒ‫ޔ‬ᵴ↪ߔࠆΤ ⋴⼔ߩኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ㧕ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆୃ჻⺖⒟ୃੌ↢ߦ᳞߼ࠆ㜞ᐲߥ⋴⼔ߣߪ‫ޟޔ‬ㆡ⏕ߦᖱႎ್ᢿߒ‫߇ߣߎ߈ߴߔߥޔ‬ታ〣ߢ߈ࠆ‫ޠ‬ߣ޿߁ߎߣߢ޽ࠆ‫ߩࠄࠇߎޕ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆߦ޽ߚࠅ‫ୃޔ‬჻⺖⒟ୃੌ↢ߪ‫ߦࠬࡦ࠺ࡆࠛޔ‬ၮߠ޿ߡᦨᣂߥࠄ߮ߦᦨༀߩࠤࠕࠍᄙ⡯⒳ߣද௛ߒߥ߇ࠄឭଏߒ‫⥄ޔ‬り߇ⴕ߁⋴⼔ߦኻߒߡ⺑᣿ߢ߈ߥߌࠇ߫ߥࠄߥ޿‫∛ޔߦࠄߐޕ‬᳇߿∔ᖚߩ⍮⼂ߦട߃‫∉ޔ‬ቇ⊛࠺࡯࠲߿␠ળ㨯ⅣႺ࠺࡯࠲߽
↪޿ߥ߇ࠄ‫ޔ‬୘ੱ࡮ኅᣖߛߌߢߥߊ‫ޔ‬㓸࿅࡮࿾ၞߦ߽⋡ࠍ߻ߌߚ⋴⼔ࠍᬌ⸛ߔࠆ‫ୃޕ‬჻⺖⒟ୃੌ
↢ߪ‫ޔ‬ஜᐽߣ޿߁᭎ᔨࠍ߭ࠈߊᷓߊᝒ߃‫∔ޔ‬ᖚ߿㓚⎹ࠍᛴ߃ߚኻ⽎߳ߩ௛߈߆ߌ߆ࠄ‫ߩޘੱޔ‬ஜᐽߩ଻ᜬ࡮Ⴧㅴߦะߌߚขࠅ⚵ߺ߹ߢ‫߇ࠅߣ߭ੱ৻ޔ‬ᜬߟജࠍᒁ߈಴ߒ‫ޔ‬ኻ⽎ߩ⁁ᘒߦᔕߓߚ⋴⼔ࠍᗧ࿑⊛ߦⴕ߁‫ୃߚ߹ޕ‬჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኻ⽎ߦᢎ⢒⊛ᡰេ߇ᔅⷐߥᤨߦߪ‫ޔ‬ℂ⺰߿ࠛࡆ࠺ࡦ
ࠬߦၮߠ޿ߚ௛߈߆ߌࠍߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬Τ́ ᦨᣂߩࠤࠕᛛⴚ߿ࠛࡆ࠺ࡦࠬߦၮߠ޿ߡ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆΤ́ ឭଏߐࠇߡ޿ࠆක≮ߩ୶ℂᕈࠍ್ᢿߒታ〣ߔࠆΤ́ ᖱႎᛛⴚࠍ୶ℂ⊛ߦㆡᱜߦ೑↪ߔࠆΤ́ ᄙ⡯⒳ߣߣ߽ߦක≮ߩ቟ోᕈࠍ⏕⹺ߒ‫଻ޔ‬㓚ߔࠆ
1‫⼔⋴ߪޠ⼔⋴ޟ‬⡯߇ⴕ߁ታ〣‫⼔⋴ߪޠࠕࠤޟޔ‬⡯߇ᄙ⡯⒳ߣද௛ߒߡⴕ߁ታ〣ߣߒߡ‫ޔ‬ឭ␜ߒߚ‫ޕ‬

2 ࠛࡆ࠺ࡦࠬ‫⑼ࠅ߹ߟޔ‬ቇ⊛ߦታ⸽ߐࠇߚᩮ᜚㧔⑼ቇ⊛ᩮ᜚㧕㧙ታ㛎߿⺞ᩏߥߤ⾰⊛⎇ⓥ߽฽߼ߚ⎇ⓥ⚿ᨐ߆ࠄዉ߆ࠇ

ߚ‫ⵣޟ‬ઃߌ‫ޠ‬㧙ߦၮߠ޿ߡ⋴⼔ታ〣߿ࠤࠕឭଏࠍⴕ߁ߎߣ߇᳞߼ࠄࠇߡ޿ࠆ‫ࠍࠬࡦ࠺ࡆࠛޕ‬ᵴ↪ߔࠆߦߪ‫ޔ‬ᓧߚࠛࡆ࠺
ࡦࠬ߇ᅷᒰߢା㗬ߢ߈ࠆ߽ߩ߆ߤ߁߆ࠍ⷗ᭂ߼ࠆߎߣ߇ᔅⷐߢ޽ࠅ‫⎇ߥ߁ࠃߩߤޔ‬ⓥᣇᴺࠍ↪޿ߡ޿ࠆ߆‫ࠆ޿ߡ޿↪ޔ‬
ᣇᴺ߆ࠄ↢ߓࠆࡃࠗࠕࠬ㧔ㆬᛯࡃࠗࠕࠬ‫ޔ‬ᖱႎࡃࠗࠕࠬ‫ޔ‬੤⛊ࡃࠗࠕࠬߥߤ㧕ࠍߤߩࠃ߁ߦ೙ᓮߒߡ޿ࠆ߆ߥߤ‫ߩߘޔ‬ࠛࡆ࠺ࡦࠬ߇ߤߩࠃ߁ߦዉ߈಴ߐࠇߡ޿ࠆ߆ࠍ⏕⹺ߒ‫ߩࠬࡦ࠺ࡆࠛޔ‬ᅷᒰᕈ߿ା㗬ᕈߩ⒟ᐲࠍ⹏ଔߔࠆߣߣ߽ߦ‫ߩߘޔ‬࡟ࡌ࡞ߦၮߠ߈ߤߩࠃ߁ߦ⎇ⓥ⚿ᨐࠍណ↪ߔࠆ߆್ᢿߔࠆᔅⷐ߇޽ࠆ‫৻ࠄࠇߎޕ‬ㅪߩࠛࡆ࠺ࡦࠬߩ⠨߃ᣇࠍℂ⸃ߒߡ‫ޔ‬⋴⼔ߦᵴ↪ߔࠆࠛࡆ࠺ࡦࠬࠍត⚝࡮តⓥߒ⹏ଔߢ߈ࠆߎߣ߇ୃ჻⺖⒟ୃੌ↢ߦߪ᳞߼ࠄࠇࠆ‫ޕ‬－ 90 －

Τ́ ኻ⽎ਛᔃߦ‫⼔⋴ޔ‬⡯߅ࠃ߮ᄙ⡯⒳ߣߩ⺞ᢛࠍⴕ޿‫ޔ‬ද௛ߒߡࠤࠕߔࠆ
Τ́ ⋴⼔ߦߟ޿ߡߩ⺑᣿ജࠍ߽ߜ‫ޔ‬ද௛ࠍផㅴߔࠆ
Τ́ ੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍ↪޿ߡ‫ޔ‬ஜᐽࠍ଻ᜬჇㅴߔࠆ
Τ́ ∉ቇ⊛ߥ⍮⼂ࠍᵴ↪ߒߡ‫ޔ‬ஜᐽߩ଻ᜬჇㅴߦขࠅ⚵߻㩷Υ ⋴⼔ታ〣߿ࠤࠕⅣႺߩ⾰ߩᡷༀߦะߌߡขࠅ⚵߻ୃ჻⺖⒟ୃੌ↢ߪ‫ᦨޔ‬ᣂߩᖱႎࠍᵴ↪ߒߡ‫⼔⋴ޔ‬ታ〣߿ࠤࠕⅣႺࠍᡷༀߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬Ύ ⾌↪ኻലᨐ‫᦭⊛❱⚵ޔ‬ലᕈߥߤߩⷰὐ߆ࠄ‫⾰ޔ‬ᡷༀߩലᨐࠍ⹏ଔߔࠆ
Ύ ࠤࠕߩ⾰ࠍᡷༀߔࠆߚ߼ߦࠛࡆ࠺ࡦࠬࠍ↪޿ߡ⚵❱߿㓸࿅߳௛߈߆ߌࠆ
Ύ ᖱႎࠪࠬ࠹ࡓ‫∉ߣ⸘⛔ޔ‬ቇߩ⍮⼂ࠍ↪޿ߡ‫ߩࡓࠞ࠻࠙ࠕޔ‬ᡷༀ߿࡝ࠬࠢૐᷫߩߚ
߼ߩᣇ⇛ࠍ┙ߡࠆΎ ᡽╷⊛ߥⷰὐ߆ࠄ‫ࠍ࠻ࡦࡔࠫࡀࡑࠢࠬ࡝߿⸽଻⾰ߩࠕࠤޔ‬ℂ⸃ߔࠆΦ ࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ࠕࠤޔ‬ⅣႺࠍᡷༀߔࠆ ୃ჻⺖⒟ୃੌ↢ߪ‫⺖ࠆ޿ߡߓ↢ߦ❱⚵ޔ‬㗴ࠍಽᨆߒ‫߇ࠕࠤ޿⦟ࠅࠃޔ‬ឭଏߐࠇࠆࠃ߁ߦࠤࠕ
ⅣႺࠍ⺞ᢛߔࠆߎߣ߿ᢎ⢒⊛ߦ௛߈߆ߌࠆߎߣ߇᳞߼ࠄࠇࠆ‫ࠕࠤޕ‬ⅣႺࠍᡷༀߔࠆߦߪ቟ోߢ᦭
ലߥࠤࠕᛛⴚ߿ᖱႎᛛⴚߩ೑↪ߦߟ޿ߡ‫ޔ‬ኾ㐷⡯ߦኻߒᢎ⢒⊛ߦ௛߈߆ߌࠆߎߣ߽฽߹ࠇࠆ‫ޕ‬Φ́ ⋴⼔ࠍ୘ߣ⚵❱ߩਔ㕙߆ࠄ‫ࠆ߃ᝒߡߒߣࡓ࠹ࠬࠪޔ‬Φ́ ࠤࠕⅣႺߣߒߡߩ⚵❱ࠍಽᨆߒ‫⺖ޔ‬㗴⸃᳿ߩߚ߼ߩᣇ⇛ࠍឭ᩺ߔࠆ
Φ́ ᄙ⡯⒳߿ᔅⷐߣߥࠆ⾗Ḯࠍᵴ↪ߒߥ߇ࠄ‫ࠕࠤޔ‬ⅣႺߩᡷༀߦขࠅ⚵߻Φ́ ⚵❱ߩ⺖㗴ߦߟ޿ߡ‫ࠕࠤޔ‬ឭଏ⠪ߦኻߒߡᢎ⢒⊛ߦ௛߈߆ߌࠆΧ ࡝࡯࠳࡯ࠪ࠶ࡊࠍ⊒ើߒ‫ࠕࠤޔ‬ឭଏߩ႐߿ੱ⊛ⅣႺࠍᢛ߃ࠆ
ୃ჻⺖⒟ୃੌ↢ߪ‫ߩࠕࠤޔ‬ᡷༀߦะߌߡ‫ޔ‬㓸࿅߿⚵❱ߦ௛߈߆ߌ‫ޔ‬ᄌൻࠍ⿠ߎߔᓎഀࠍᜂ߁ߎ
ߣ߇᳞߼ࠄࠇࠆ‫ޔߦ߼ߚߩߘޕ‬ᔅⷐߥ⍮⼂࡮ᛛⴚࠍᵴ↪ߒ‫ࠢ࡟ࡈ࡝߿ࠣࡦࠠࡦࠪ࡞ࠞࠖ࠹࡝ࠢޔ‬࡚ࠪࡦࠍขࠅ౉ࠇߡ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬Χ́ ᣂߒ޿⍮⼂߿ࡕ࠺࡞ࠍታ〣ߦዉ౉ߔࠆߚ߼ߩᚻᴺࠍℂ⸃ߒ‫ޔ‬ዉ౉ߦะߌߡ࡝࡯࠳
࡯ࠪ࠶ࡊࠍ⊒ើߔࠆΧ́ 㓸࿅߿⚵❱ߩ႐ߩജേࠍಽᨆߒ‫ޔ‬㓸࿅߿⚵❱ࠍേ߆ߔߚ߼ߩᣇ⇛ࠍ┙ߡࠆΧ́ ᦨༀߩ⋴⼔ࠨ࡯ࡆࠬࠍឭଏߔࠆߚ߼ߦ‫ߩࠕࠤޔ‬ᡷༀࠍਥዉߔࠆΨ ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ
ୃ჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኾ㐷⡯㑆ߩലᨐ⊛ߥㅪ៤㑐ଥࠍଦߔߚ߼ߦ‫⋧ޔ‬੕ߦቇ⠌ߔࠆⅣႺࠍ⺞ᢛߒߚࠅ‫⼔⋴ޔ‬⡯߿ᄙ⡯⒳߆ࠄߩ⋧⺣ߦᔕߓߚࠅߒߡ‫ޔ‬ᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫ߩߘޕ‬㓙ߦߪ‫ޔ‬⋴⼔ࠍઁ⡯⒳ߦ⺑᣿ߔࠆ⢻ജ߇᳞߼ࠄࠇࠆ‫ޕ‬Ψ́ ኾ㐷⡯㑆ߩലᨐ⊛ߥㅪ៤㑐ଥࠍ▽ߊߚ߼ߦ‫ޔ‬੕޿ࠍዅ㊀ߒߚࠦࡒࡘ࠾ࠤ࡯࡚ࠪࡦ
ࠍߣࠆΨ́ ⋴⼔Ꮷ߿ઁ⡯⒳ߦኻߒߡ⋴⼔ߩᗧ࿑߿ᔅⷐᕈࠍ⺑᣿ߒ‫ޔ‬ද௛ߔࠆ
Ψ́ ኻ⽎ߩ⋴⼔਄ߩ⺖㗴ࠍ᣿⏕ߦߒ‫ઁޔ‬⡯⒳ߣද௛ߒߡ⸃᳿ߦዉߊ
Ψ́ ࠦ࡯࠺ࠖࡀ࡯࠲࡯ߩᓎഀࠍᜂ޿‫ޔ‬ද௛ߩ౞Ṗൻࠍផㅴߔࠆ

－ 91 －Ω ⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍ⠨᩺ߔࠆୃ჻⺖⒟ୃੌ↢ߪ‫ߩⴕ⃻ޔ‬ᴺᓞ㨯೙ᐲ࡮᡽╷߇ੱ‫ߩޘ‬ஜᐽ߿⋴⼔ߦߤߩࠃ߁ߥᓇ㗀ࠍ߽ߚࠄߒ
ߡ޿ࠆ߆ࠍಽᨆߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫ߩߘޕ‬ಽᨆ⚿ᨐߦၮߠ߈‫⸃ޔ‬᳿╷ࠍ⠨߃ࠆ߇‫ߩߘޔ‬㓙ߦ⋴⼔ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯ⷰࠍ෻ᤋߒߚᣇ╷ࠍ⠨߃ࠆߎߣ߽᳞߼ࠄࠇࠆ‫ޕ‬Ώ ੱ‫ߩޘ‬ஜᐽჇㅴߩⷰὐ߆ࠄ‫ߩ⼔⋴ޔ‬᡽╷ࠍᬌ⸛ߔࠆ
Ώ ක≮᡽╷߇୘‫ޔ‬㓸࿅‫ߔࠄߚ߽ߦ❱⚵ޔ‬ᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍ⠨᩺ߔࠆΏ ⋴⼔ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯߇᡽╷ߦ෻ᤋߐࠇࠆࠃ߁ߦ‫ޔ‬ᣇ╷ࠍ⠨᩺ߔࠆΏ ⸻≮ႎ㈽߿੺⼔଻ஜߥߤߩ᡽╷࡮೙ᐲ߇ࠤࠕឭଏᣇᴺ߿ࠕ࠙࠻ࠞࡓߦ෸߷ߔᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍ⠨᩺ߔࠆΪ ⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆᢎ⢒ⅣႺߠߊࠅߦขࠅ⚵߻ୃ჻⺖⒟ୃੌ↢ߪ‫⼔⋴ޔ‬ኾ㐷⡯ࠍ⢒ߡࠆߚ߼ߩᢎ⢒⊛ᕁ⠨ࠍ߽ߟߎߣ߇ᔅⷐߢ޽ࠆ‫ޕ‬Ϊ́ ቇ⠌⠪ߩ࠾࡯࠭ࠍᛠីߒ‫ޔ‬ቇ⠌⠪ߦ޽ࠊߖߚᢎ⢒ᴺࠍℂ⸃ߔࠆΪ́ ⋴⼔ቇߩ⸘↹⊛࡮ലᨐ⊛ߥᢎ⢒ᣇᴺࠍ⠨᩺ߔࠆΪ́ ቇ⠌⠪ߩ࠾࡯࠭ߦ޽ߞߚᢎ⢒⊛㑐ࠊࠅࠍⴕ߁
Ώ ቇ⠌߇ଦㅴߔࠆࠃ߁ߦ‫ޔ‬ᢎ⢒ⅣႺࠍᢛ߃ࠆΫ ୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߜ‫ޔ‬ኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ
ୃ჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኻ⽎ࠍᠩ⼔ߔࠆߚ߼ߦ୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍ㜞߼ࠆߣߣ߽ߦ‫ࠕࠤޔ‬ᛛⴚ߿ᖱႎᛛⴚߩ૶↪ߦ㑐ߔࠆ୶ℂේೣ߿ၮḰࠍℂ⸃ߒߚ߁߃ߢታ〣ࠍⴕ޿‫ޔ‬ኾ㐷⡯ߣߒߡߩ୶ℂ⊛
⽿ോࠍᨐߚߔߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬Ϋ́ ୘ੱ࡮ኅᣖ࡮㓸࿅ߩᜬߟᢥൻ߿⢛᥊ࠍᛠីߒ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆΫ́ ኻ⽎ᠩ⼔ߩ┙႐߆ࠄ‫୶ޔ‬ℂ⊛ታ〣ࠍ᥉෸ߔࠆ
Ϋ́ ୶ℂߦ㑐ߔࠆℂ⺰ࠍᵴ↪ߒߡ‫୶ޔ‬ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆኻ⽎߿ኾ㐷⡯ࠍᡰេߔࠆά ⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ
ୃ჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኾ㐷⡯ߣߒߡߩືቇࠍ⊒ዷߐߖ‫ࠍⷰ⼔⋴ޔ‬᣿⏕ߦ⴫⃻ߒ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫↢ޔߦࠄߐޕ‬ᶦࠍㅢߓߡቇ⠌ߒߡ޿ߊᆫ൓ࠍ߽ߜ‫ᦨޔ‬ᣂߩ⍮⷗ࠍᓧߡ⋴⼔ߦᵴ↪ߔࠆദജࠍ⛯ߌ‫⼔⋴ߩઁޔ‬⡯ߩᓎഀࡕ࠺࡞ߣߥࠆߎߣ߽᳞߼ࠄࠇࠆ‫ޕ‬ά́ ⋴⼔߿ක≮ߦ㑐ߔࠆኾ㐷⡯ߣߒߡߩືቇࠍ⊒ዷߐߖ‫⼔⋴ޔ‬ታ〣ߦ⛔วߔࠆά́ ⋴⼔ቇࠍขࠅᏎߊ⺖㗴ߦߟ޿ߡ‫ޔ‬ᗵฃᕈࠍ㜞߼‫ޔ‬ਥ૕⊛ߦขࠅ⚵߻ά́ ࠃࠅ⦟޿ࠤࠕࠍ᳿ቯߔࠆߚ߼ߦ‫ᦨޔ‬ᣂߩ⍮⷗ࠍᓧߥ߇ࠄታ〣ߔࠆࡕ࠺࡞ߦߥࠆ
ά́ ኾ㐷⡯ߣߒߡ‫ޔ‬ℂᔨ߿ଔ୯ⷰࠍ᣿⏕ߦߔࠆ㧞㧚੹ᓟߩ⺖㗴 ᄢቇߦ߅ߌࠆ⋴⼔♽ੱ᧚㙃ᚑߩ࿷ࠅᣇߦ㑐ߔࠆᬌ⸛ળᦨ⚳ႎ๔㧔2011㧕ߢߪ‫ޔ‬‫♽⼔⋴ޟ‬ᄢቇ㒮߅ߌࠆੱ᧚㙃ᚑߪ‫⼔⋴ޔ‬ቇߩቇⴚ⎇ⓥࠍㅢߓߡ␠ળߦ⽸₂ߢ߈ࠆ⎇ⓥ⠪߿ᢎ⢒⠪ߩ㙃ᚑ‫ޔ‬ቇ჻⺖⒟ߢߪ㙃ᚑ࿎㔍ߥ․ቯ㗔ၞߩ㜞ᐲኾ㐷⡯ᬺੱ߿଻ஜ‫ޔ‬ක≮‫ߦ╬␩⑔ޔ‬៤ࠊࠆኾ－ 92 －

㐷⡯ߩද௛ߦ߅޿ߡࡑࡀࠫࡔࡦ࠻⢻ജࠍ⊒ើߢ߈ࠆੱ᧚㙃ᚑࠍ⋡ᜰߔ‫ߣޠ‬ㅀߴࠄࠇߡ޿ࠆ‫ޕ‬ߎߩࠃ߁ߦୃੌ↢߇ᜂ߁ᓎഀߪ᭽‫ޔߦ߃ࠁࠇߘޔࠅ޽ߢޘ‬ฦᄢቇ㒮ߦ߅޿ߡ‫ޔ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟߇⋡ᜰߔੱ᧚⢒ᚑࠍ᣿⏕ߦߔࠆߎߣ߇᳞߼ࠄࠇߡ޿ࠆ‫৻ߩߘޕ‬ᣇߢ‫ޔ‬ᄢቇ㒮ᢎ⢒ߩ⾰ߩ଻⸽ߣߒߡ‫ޔ‬ᚒ߇࿖ߩඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ୃੌߣ޿߁ቇ૏߇ᜂ଻ߔߴ߈ߎߣࠍ᣿
⏕ߦߔࠆߎߣ߽᳞߼ࠄࠇߡ޿ࠆ‫ޔߢߎߘޕ‬ᤓᐕᐲࠃࠅ৻ㅪߩ⺞ᩏࠍታᣉߒ‫ୃޔ‬჻㧔⋴⼔ቇ㧕ߩቇ૏ࠍ᝼ਈߐࠇࠆ⠪߇౒ㅢߒߡᜬߟߴ߈ 10 ߩ‫ޟ‬⢻ജ‫ޟߣޠ‬⢻ജߩౝኈ‫ޠ‬42 㗄⋡ࠍ᣿ࠄ߆ߦߒߚ‫⺞ᧄޔߚ߹ޕ‬ᩏߪ⋴⼔♽ᄢቇߩᢎຬࠍኻ⽎ߦⴕ޿‫৻ޔ‬ቯߩࠦࡦ࠮ࡦࠨࠬࠍᓧࠆߎ
ߣ߇ߢ߈ߚ‫ޔࠄ߇ߥߒ߆ߒޕ‬ฦᄢቇ㒮߇ߘࠇߙࠇ⁛⥄ߩᢎ⢒⋡ᮡࠍ〯߹߃ߡ‫ ߩߎޔ‬10 ߩ‫ޟ‬⢻ജ‫ୃࠍޠ‬჻ߩቇ૏᝼ਈߩࡐ࡝ࠪ࡯߿ࠞ࡝ࠠࡘ࡜ࡓࡐ࡝ࠪ࡯ߦ૏⟎ߠߌࠄࠇࠆࠃ߁ࠦࡦ࠮ࡦ
ࠨࠬࠍᓧࠆᔅⷐ߇޽ࠅ‫߇ࡊ࠶ࠪ࡯࠳࡯࡝ߩ߼ߚߩߘޔ‬᳞߼ࠄࠇࠃ߁‫ޕ‬੹ᓟߩ⺖㗴ߣߒߡߪ‫⼔⋴ޔ‬ታ〣߿ઁߩක≮⡯‫⼔⋴ޔ‬⡯⢻࿅૕ઍ⴫⠪╬ߣߩᗧ⷗੤឵ࠍⴕ
޿‫ୃޔ‬჻㧔⋴⼔ቇ㧕ࠍ᝼ਈߐࠇࠆඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ୃੌ↢߇߽ߟ⢻ജ߳ߩ౒ㅢℂ⸃ࠍᓧࠆദജࠍⴕ߁ߎߣߢ޽ࠆ‫ޔߦࠄߐޕ‬ᐢߊ␠ળߦ⽸₂ߢ߈ࠆੱ᧚ߣߒߡᵴべߢ߈ࠆⅣႺߠߊࠅࠍ‫␠ޔ‬ળߣߣ߽ߦഃㅧߒߡ޿ߊߎߣ߇ᔅⷐߣߥࠆ‫ޕ‬ ೨ㅀߒߚࠃ߁ߦ‫ޔ‬ᄙ᭽ߥੱ᧚㙃ᚑ߇⋴⼔ቇඳ჻೨ᦼ⺖⒟ߦ᳞߼ࠄࠇߡ߅ࠅ‫ߩࠇߙࠇߘޔ‬ᄢቇ㒮߇ੱ᧚㙃ᚑ⋡⊛ߦ޽ߞߚ⁛⥄ߩᢎ⢒⋡ᮡࠍᛂߜ಴ߒ‫ࠄࠇߎޔ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߢቇ߱⋴⼔ቇୃੌ↢ߦ౒ㅢߒߚ‫ޟ‬⢻ജ‫ࠍޠ‬ၮᧄߣߒߚᢎ⢒⺖⒟ߩ᭴▽‫⼔⋴ޔ‬ᢎ⢒ᣇᴺߩల
ታ߇᳞߼ࠄࠇࠆ‫ޕ‬หᤨߦ‫ ߩ߼ߚߩߘޔ‬FD ࡊࡠࠣ࡜ࡓߩలታ߽᳞߼ࠄࠇࠆߎߣ߆ࠄ‫ޔ‬AACNߩ‫ୃޟ‬჻ᢎ⢒ߩࠛ࠶࠮ࡦࠪࡖ࡞‫ߩޠ‬ᵴ↪ߩ઀ᣇߩ㧝଀ࠍ⾗ᢱ㧡ߦ␜ߒߚ‫ޕ‬ᦨᓟߦ‫⎇ᧄޔ‬ⓥߩᚑᨐߪ‫ޔ‬ᄢቇ㒮ߩኾ㐷ಽ㊁೎╙ਃ⠪⹏ଔࠍⴕ߁ߚ߼ߩࠪࠬ࠹ࡓߩ᭴▽ߩ৻ഥߣߥࠆߢ޽ࠈ߁‫ޕ‬ᄙ᭽ൻ߇ㅴ߻⋴⼔ቇߩᄢቇ㒮ᢎ⢒ߦ߅޿ߡ‫ޔ‬ᢎ⢒ߩ⾰଻⸽૕೙ߩ
᭴▽߽༛✕ߩ⺖㗴ߢ޽ࠆߎߣ߆ࠄ‫੹ޔ‬࿁ឭ␜ߒߚ 10 ߩ‫ޟ‬⢻ജ‫ޟ߿ޠ‬⢻ജߩౝኈ‫ޠ‬42 㗄⋡߆ࠄᢎ⢒⺖⒟ߩ⹏ଔ‫ޔ‬ᡷༀߩߚ߼ߩᢎ⢒⹏ଔၮḰࠍ╷ቯߢ߈ࠆߣ⠨߃ࠆ‫ޔࠅࠃߦࠇߘޕ‬ᄢቇ㒮ߩኾ㐷ಽ㊁೎╙ਃ⠪⹏ଔߩෳᾖၮḰߣ߽ߥࠅ‫ޔ‬ᚒ߇࿖ߩᄢቇ㒮ᢎ⢒ߩ⾰ࠍᜂ଻ߔࠆߎ
ߣ߇น⢻ߣߥࠆ‫ޕ‬－ 93 －

ᒁ↪ᢥ₂
American Association of Colleges of Nursing (AACN) (2011), The Essentials ofMaster’s Education in Nursingਛᄩክ⼏ળ㧔2007㧕ᣂᤨઍߩᄢቇ㒮ᢎ⢒㧙࿖㓙⊛ߦ㝯ജ޽ࠆᄢቇ㒮ᢎ⢒ߩ᭴▽ߦะߌߡ㧙╵↳, http://www.mext.go.jp/b_menu/shingi/chukyo/chukyo0/toushin/05090501.htm
ਛᄩክ⼏ળ㧔2011㧕ࠣࡠ࡯ࡃ࡞ൻ␠ળߩᄢቇ㒮ᢎ⢒㨪਎⇇ߩᄙ᭽ߥಽ㊁ߢᄢቇ㒮ୃੌ⠪߇ᵴべߔࠆߚ߼ߦ㨪╵↳,
http://www.mext.go.jp/b_menu/shingi/chukyo/chukyo0/toushin/1301929.htm
ᄢቇߦ߅ߌࠆ⋴⼔♽ੱ᧚㙃ᚑߩ޽ࠅᣇߦ㑐ߔࠆᬌ⸛ળ㧔2011㧕ᄢቇߦ߅ߌࠆ⋴⼔♽ੱ᧚㙃ᚑߩ޽ࠅᣇߦ㑐ߔࠆᬌ⸛ળᦨ⚳ႎ๔,
http://www.mext.go.jp/b_menu/shingi/chousa/koutou/40/toushin/1302921.htm
⽷࿅ᴺੱᄢቇၮḰදળ㧔2002㧕, 21 ਎♿ߩ⋴⼔ቇᢎ⢒－ 94 －⾗ ᢱ































⾗ᢱ㧝
ࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯ෳടᄢቇ৻ⷩ

資料１


ࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯ෳടᄢቇ
39 ᄢቇ㧦࿖┙ 11 ᄢቇ‫ ┙౏ޔ‬15 ᄢቇ‫ ┙⑳ޔ‬13 ᄢቇ㧔ࡉࡠ࠶ࠢ඙ಽߪ‫♽⼔⋴ޔ‬ᄢቇද⼏ળࡎ࡯ࡓࡍ࡯ࠫળຬᩞߩឝタߦᓥߞߚ㧕‫ޣ‬ർᶏ㆏࡮᧲ർࡉࡠ࠶ࠢ‫ޤ‬6 ᄢቇ㕍᫪⋵┙଻ஜᄢቇᄢቇ㒮ஜᐽ⑼ቇ⎇ⓥ⑼㧔౏┙㧕ർᶏ㆏ක≮ᄢቇᄢቇ㒮⋴⼔⑔␩ቇ⎇ⓥ⑼㧔⑳┙㧕ᒄ೨ᄢቇᄢቇ㒮଻ஜቇ⎇ⓥ⑼㧔࿖┙㧕ጤᚻ⋵┙ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔౏┙㧕ᧅᏻᏒ┙ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔౏┙㧕ጊᒻᄢቇᄢቇ㒮ක♽⎇ⓥ⑼㧔࿖┙㧕‫ޣ‬㑐᧲ࡉࡠ࠶ࠢ‫ޤ‬10 ᄢቇජ⪲ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔࿖┙㧕⨙ၔࠠ࡝ࠬ࠻ᢎᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔⑳┙㧕ᘮᙥ⟵Ⴖᄢቇᄢቇ㒮ஜᐽࡑࡀࠫࡔࡦ࠻⎇ⓥ⑼㧔⑳┙㧕⋡⊕ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔⑳┙㧕ᣣᧄ⿒චሼ⋴⼔ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔⑳┙㧕ၯ₹⋵┙ᄢቇᄢቇ㒮଻ஜක≮⑔␩ቇ⎇ⓥ⑼㧔౏┙㧕᧲ᶏᄢቇᄢቇ㒮ஜᐽ⑼ቇ⎇ⓥ⑼㧔⑳┙㧕᧲੩ᘏᕺળක⑼ᄢቇᄢቇ㒮කቇ⎇ⓥ⑼㧔⑳┙㧕᧲੩ᅚሶක⑼ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔⑳┙㧕╳ᵄᄢቇᄢቇ㒮ੱ㑆✚ว⑼ቇ⎇ⓥ⑼㧔࿖┙㧕‫ޣ‬ਛㇱࡉࡠ࠶ࠢ‫ޤ‬11 ᄢቇᗲ⍮⋵┙ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔౏┙㧕ጘ㒂⋵┙⋴⼔ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔౏┙㧕ጘ㒂ᄢቇᄢቇ㒮කቇ♽⎇ⓥ⑼㧔࿖┙㧕⍹Ꮉ⋵┙⋴⼔ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔౏┙㧕
㊄ᴛᄢቇᄢቇ㒮ක⮎଻ஜቇ✚ว⎇ⓥ⑼㧔࿖┙㧕
㐳㊁⋵⋴⼔ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔౏┙㧕ฬฎደᄢቇᄢቇ㒮කቇ♽⎇ⓥ⑼㧔࿖┙㧕ንጊᄢቇᄢቇ㒮කቇ⮎ቇᢎ⢒ㇱ㧔࿖┙㧕⡛㓮ࠢ࡝ࠬ࠻ࡈࠔ࡯ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔⑳┙㧕資料１㕒ጟ⋵┙ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔౏┙㧕ጊ᪸⋵┙ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔౏┙㧕‫ޣ‬㑐⷏࡮ㄭ⇰ࡉࡠ࠶ࠢ‫ޤ‬4 ᄢቇ౓ᐶක≮ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔⑳┙㧕੩ㇺᯌᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔⑳┙㧕ㄭᄢᆢ〝ᄢቇ㧔⑳┙㧕
ਃ㊀⋵┙⋴⼔ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔౏┙㧕‫ޣ‬ਛ࿖࡮྾࿖ࡉࡠ࠶ࠢ‫ޤ‬7 ᄢቇᐢፉᢥൻቇ࿦ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔⑳┙㧕ᐢፉᄢቇᄢቇ㒮කᱤ଻ஜቇ⎇ⓥ⑼㧔࿖┙㧕    㚅Ꮉ⋵┙଻ஜක≮ᄢቇᄢቇ㒮଻ஜක≮ቇ⎇ⓥ⑼㧔౏┙㧕㜞⍮⋵┙ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔౏┙㧕ᣂ⷗౏┙ᄢቇ㧔౏┙㧕ጟጊᄢቇᄢቇ㒮଻ஜቇ⎇ⓥ⑼㧔࿖┙㧕ᓼፉᄢቇᄢቇ㒮଻ஜ⑼ቇᢎ⢒ㇱ㧔࿖┙㧕‫਻ޣ‬Ꮊ࡮ᴒ✽ࡉࡠ࠶ࠢ‫ޤ‬1 ᄢቇችፒ⋵⋴⼔ᄢቇᄢቇ㒮⋴⼔ቇ⎇ⓥ⑼㧔౏┙㧕    










⾗ᢱ㧞
ࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯㧦ࠗࡦ࠲ࡆࡘ࡯ࠟࠗ࠼












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ࠗࡦ࠲ࡆࡘ࡯ࠟࠗ࠼㩷㩷㧭㧚㜞ᐲታ〣⋴⼔ࠦ࡯ࠬ‫⎇ޔ‬ⓥࠦ࡯ࠬߦ߆߆ࠊࠄߕ‫ޔ‬‫ޟ‬ඳ჻೨ᦼ⺖⒟㧔ୃ჻⺖⒟㧕ߦ߅޿ߡ‫ୃޔ‬჻㧔⋴⼔ቇ㧕ߩቇ૏ࠍ᝼ਈߐࠇࠆୃੌ↢߇ୃᓧߔߴ߈ 㪈㪇 ߩ⢻ജߣߘߩౝኈ‫ޠ‬߇⋴⼔♽ᄢቇ㒮ᢎ⢒ߩࠦࠕߣߥࠅ߁ࠆ߆ߦߟ޿ߡ‫ߏޔ‬ᗧ⷗ࠍ߅⡞߆ߖߊߛߐ޿‫ޕ‬㩷
ᐔᚑ 23 ᐕᐲߦታᣉߒߚ‫ޟ‬ඳ჻೨ᦼ⺖⒟㧔ୃ჻⺖⒟㧕ߦ߅޿ߡ‫ୃޔ‬჻㧔⋴⼔ቇ㧕ߩቇ૏ࠍ᝼ਈߐࠇࠆୃੌ↢߇ୃᓧߔߴ߈ 㪈㪇 ߩ⢻ജ‫ߦޠ‬㑐ߔࠆ⾰໧⚕⺞ᩏߦ߅޿ߡ‫ޔ‬᳞߼ࠄࠇࠆ࡟ࡌ࡞߇㜞޿‫ޔ‬㜞ᐲታ〣⋴⼔ࠦ࡯ࠬߥࠄᔅⷐߥ⢻ജߢ޽ࠆߣ⠨߃ࠆ߇‫⎇ޔ‬ⓥࠦ࡯ࠬߢߪ㔍ߒ޿ߣ޿߁ᗧ⷗߇ነߖࠄࠇ߹ߒߚ‫ߺ⚵ߡߒߣࠕࠦޔߚ߹ޕ‬ㄟ߻ߩߪ㔍ߒ޿߇‫⋡ޔ‬ᮡߣߒߡ߅޿ߡ߅޿ߚᣇ߇ࠃ޿ߣ޿߁ᗧ⷗߽޽ࠅ߹ߒߚߩߢ‫ߩߎޔ‬ὐࠍ⠨ᘦߒߡߏᗧ⷗
ࠍ߅⡞߆ߖߊߛߐ޿‫ޕ‬㩷+ ⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ࠆߊߟࠍࠬࡦ࠺ࡆࠛޔ‬ୃᓧߔߴ߈⢻ജߩౝኈ1.

⋴⼔ቇߩតⓥߔࠆߴ߈⺖㗴ߦߟ޿ߡ‫ޔ‬ኤ⍮ߒㅊ᳞ߔࠆ

㪉㪅␠ળߦ߅ߌࠆᣂߚߥ⺖㗴ࠍᗵ⍮ߒ‫ߩߘޔ‬ኻᔕߦߟ޿ߡᬌ⸛ߔࠆ㩷㪊㪅⋴⼔ߩᣂߚߥ໧޿‫⺖ޔ‬㗴ߦኻߒߡ‫⎇ޔ‬ⓥᣇᴺࠍ㚟૶ߒߡត᳞ߔࠆ㩷㪋㪅ᣂߚߥ⍮⼂߿వㅴ⊛ߥᛛⴚࠍត⚝ߒ‫ޔ‬ᵴ↪ߔࠆ㩷㪌㪅⋴⼔ታ〣ߢߩ໧㗴ࠍ⸃᳿ߔࠆߚ߼ߦ‫ޔ‬ᔅⷐߥࠛࡆ࠺ࡦࠬࠍ⎇ⓥߔࠆ㩷㪍㪅  㪜㪙㪧㧔Evidence-based practice㧕ࠍ♽⛔⊛ߦℂ⸃ߔࠆ㩷 ࠛࡆ࠺ࡦࠬࠍࠢ࡝࠹ࠖ࡯ࠢߒ‫⹏ޔ‬ଔ ߔࠆ㩷 ໧㗴ࠍ⸃᳿ߔࠆߚ߼ߩࠛࡆ࠺ࡦࠬࠍᬌ⚝ߔࠆ㩷++ ⋴⼔ߩኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ㧕ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆୃᓧߔߴ߈⢻ജߩౝኈ ⋴⼔੺౉ߦᔅⷐߥℂ⺰ࠍり૕࡮␠ળ࡮ᔃℂ࡮⚵❱ߥߤቇ㓙⊛ߥⷰὐ߆ࠄㆬᛯߒ‫ޔ‬⛔วߒߡᵴ↪ߔࠆ ୘ੱ෻ᔕ߿㓸࿅ജേ⊛ℂ⺰ࠍ୘ੱߩࠤࠕ㪆ኻᔕߦ↢߆ߔ㩷 ᦨᣂߩࠤࠕᛛⴚ߿ࠛࡆ࠺ࡦࠬߦၮߠ޿ߡ‫ࠍࠕࠤ⼔⋴ޔ‬ታ〣ߔࠆ㩷 ⋴⼔ߩࠛࡆ࠺ࡦࠬࠍታ〣ߦၮߠ޿ߡߟߊߞߡ޿ߊ㩷 ኻ⽎ߩ┙႐ߦߚߞߡ‫ޔ‬൮᜝⊛ߢ♽⛔⊛ߥࠕ࠮ࠬࡔࡦ࠻ࠍታᣉߔࠆ㩷 ⋴⼔ߩ୶ℂ✁㗔ߦၮߠ޿ߚ⋴⼔ታ〣ࠍ᥉෸ߔࠆ㩷 ⋴⼔ߩኻ⽎ࠍ߭ࠈߊᝒ߃ߟߟ‫ޔ‬ὶὐൻߒߚኻ⽎ߦᩮ᜚ߦၮߠ޿ߡ‫ࠆߔ౉੺⼔⋴ޔ‬㩷 ⋴⼔ߩኻ⽎ࠍో૕ߣߒߡᝒ߃ߡ ࠤࠕߩ႐߳௛߈߆ߌ‫ޔ‬ㆡಾߦ⋴⼔੺౉ߔࠆ㩷 ቇ㓙⊛ߥⷞὐߦၮߠ޿ߡ‫ޔ‬ᄙ᭽ߥᣇᴺߢࠤࠕߩ቟ోᕈࠍ⏕଻ߔࠆ㩷 ࠛࡆ࠺ࡦࠬࠍ૶޿ࠤࠕᡷༀࠍ⸘↹࡮ታᣉ࡮⹏ଔߔࠆ 㩷 ⋴⼔ታ〣ߦ߅޿ߡ‫⺑ޔ‬᣿⽿છࠍᨐߚߔ㩷 㩷 㩷 㩷 ੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍㅢߓ‫ޔ‬ஜᐽࠍଦㅴߐߖࠆᣇᴺࠍりߦઃߌࠆ ᖚ⠪ਛᔃߩࠤࠕߩߚ߼ߦઁ⡯⒳ߣ߽⺞ᢛ‫ޔ‬੤ᷤߒߟߟ‫ࠍࠕࠤ⼔⋴ޔ‬ታᣉߔࠆ㩷 ࠤࠕߩ⸘↹࡮ታᣉ࡮⹏ଔߦ߅޿ߡ∛᳇߿∔ᖚ▤ℂߩ⍮⼂ࠍ↪޿ࠆ㩷

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 ࠤࠕߩ⸘↹࡮ታᣉ࡮⹏ଔߦ߅޿ߡ∉ቇ⊛‫␠ޔ‬ળ⊛߅ࠃ߮ⅣႺ⊛࠺࡯࠲ࠍ↪޿ࠆ㩷 ࠤࠕߩ⸘↹࡮ታᣉ࡮⹏ଔߦ߅޿ߡቇ⠌߅ࠃ߮ᢎ⢒ේೣࠍㆡ↪ߔࠆ㩷 ᖱႎᛛⴚߩ೑↪ߦߟ޿ߡ‫ޔ‬ᖚ⠪ࠍᢎ⢒ߔࠆ㩷 ታ〣㪆ᢎ⢒㪆⎇ⓥߦ㓙ߒ⥄ࠄߩⴕὑࠍ⺑᣿ߒ‫౒ޔ‬หࠍផㅴߔࠆ㩷 ⋴⼔ታ〣࡮ᢎ⢒࡮⎇ⓥ߇߽ߚࠄߔ੺౉ലᨐࠍ੍᷹ߒ‫ߩ౉੺ޔ‬ㆡᱜࠍ್ᢿߔࠆ㩷+++⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡታ〣ߔࠆୃᓧߔߴ߈⢻ജߩౝኈ ኻ⽎ߦߣߞߡߩലᨐߛߌߢߥߊ⾌↪ኻലᨐ‫᦭⊛❱⚵ޔ‬ലᕈߥߤߩⷰὐࠍ฽߼ߡ⹏
ଔߔࠆ ᦨᣂߩᖱႎࠍᵴ↪ߒߡ㧔ታ〣ࠟࠗ࠼࡜ࠗࡦࠍ↪޿ߡ㧕‫ޔ‬ታ〣ߣࠤࠕߩⅣႺࠍᡷༀߔࠆ㩷 ࠤࠕߩࠪࠬ࠹ࡓࠍ⸳⸘ߒࠤࠕࠍᜬ⛯⊛ߦᡷༀߔࠆ㩷 ࠤࠕߩ⾰ࠍᡷༀߔࠆߚ߼ߦࠛࡆ࠺ࡦࠬࠍ↪޿ߡ⚵❱߿㓸࿅߳௛߈߆ߌࠆ㩷 ᖱႎࠪࠬ࠹ࡓ‫∉ߣ⸘⛔ޔ‬ቇߩේℂࠍ↪޿ߡ‫ߩࡓࠞ࠻࠙ࠕޔ‬ᡷༀ߿࡝ࠬࠢૐᷫߩߚ
߼ߩᚢ⇛ࠍ┙ߡࠆ㩷 ᡽╷⊛ߥⷰὐߢࠤࠕߩ⾰଻⸽߿࡝ࠬࠢࡑࡀࠫࡔࡦ࠻ࠍℂ⸃ߔࠆ㩷+8 ࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ࠆߔ࠻ࡦࡔࠫࡀࡑޔ‬㩷ขᓧߔߴ߈⢻ജߩౝኈ ⚵❱ߩ⪾⮮ࠍಽᨆߒ‫✭ࠍ⮮⪾ޔ‬๺ߔࠆߚ߼ߩᣇ⇛ࠍឭ᩺ߔࠆ ୘ߩࡑࡀࠫࡔࡦ࠻ߣ⚵❱ߩࡑࡀࠫࡔࡦ࠻ߩਔ஥㕙߆ࠄ‫ᝒߡߒߣࡓ࠹ࠬࠪࠍ⼔⋴ޔ‬߃ࠆ㩷 ᖚ⠪ਛᔃߩࠤࠕࠍታ〣ߔࠆߦ޽ߚࠅ‫ޔ‬ᔅⷐߣߥࠆઁ⡯⒳߿⾗ḮࠍᏎ߈ㄟߺߥ߇ࠄ
⚵❱ࠍ▤ℂߔࠆ㩷 ⚵❱ߦߣߞߡᔅⷐߥ੐ᨩࠍᢎ⢒ࡊࡠࠣ࡜ࡓߣߒߡ╷ቯߒ‫ޔ‬ታᣉߔࠆ㩷 ቟ోߢ᦭ലߥࠤࠕᛛⴚ߅ࠃ߮ᖱႎᛛⴚߩ೑↪ߦߟ޿ߡ‫ޔ‬ᢎ⢒ࡊࡠࠣ࡜ࡓࠍ⸳ቯߒ‫ޔ‬ታᣉߔࠆ㩷

8 ࠤࠕࠍផㅴߢ߈ࠆ႐߿ੱ⊛ⅣႺࠍᢛ߃‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆ㩷ୃᓧߔߴ߈⢻ജߩౝኈ ᣂߒ޿⍮⼂߿ࡕ࠺࡞ࠍታ〣ߦዉ౉ߔࠆߚ߼ߩᚻᴺࠍℂ⸃ߒ‫ߩߘޔ‬ታ⃻ߦะߌߡ࡝
࡯࠳࡯ࠪ࠶ࡊࠍ⊒ើߔࠆ ࠢ࡝࠹ࠖࠞ࡞ࠪࡦࠠࡦࠣ߿࡝ࡈ࡟࡚ࠢࠪࡦࠍขࠅ౉ࠇߚ࡝࡯࠳࡯ࠪ࠶ࡊࠍ⊒ើߔࠆ㩷 ᄌൻࠍଦߔ⍮⼂ߣᛛⴚࠍᵴ↪ߒߡ‫ߩࠕࠤޔ‬ᡷༀߦะߌߡ࡝࡯࠳࡯ࠪ࠶ࡊࠍ⊒ើߔ
ࠆ㩷

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 㓸࿅߿⚵❱ߩ႐ߩ࠳ࠗ࠽ࡒ࠭ࡓࠍ⺒ߺߥ߇ࠄ‫ޔ‬㓸࿅߿⚵❱ࠍേ߆ߔ㩷 ⋴⼔ߣක≮ࠨ࡯ࡆࠬߩឭଏߦᓇ㗀ࠍਈ߃ࠆࠤࠕߩᡷༀᣇᴺࠍਥዉߔࠆ㩷 ක≮࠴࡯ࡓߩਛߢ‫ઁޔ‬⡯⒳ߦኻߒߡ⋴⼔ߩᓎഀ߿ଔ୯ࠍ⴫⃻ߒ‫࡯࠳࡯࡝ߩࠕࠤޔ‬ࠪ࠶ࡊࠍ⊒ើߔࠆ㩷㩷
8+ ࠴࡯ࡓࠍᒻᚑߒ‫ޔ‬ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ㩷ୃᓧߔߴ߈⢻ജߩౝኈ ኾ㐷⡯㑆࠴࡯ࡓߣലᨐ⊛ߥㅪ៤㑐ଥࠍ▽ߊߚ߼ߦ‫ޔ‬੕޿ࠍዅ㊀ߒߚࠦࡒࡘ࠾ࠤ࡯ࠪ
࡚ࡦࠍߣࠆ ࠴࡯ࡓߩ⋴⼔Ꮷ߿ઁ⡯⒳ߦኻߒߡࠤࠕߩᗧ࿑߿ᔅⷐᕈࠍ⺑᣿ߒ‫ޔ‬ㅪ៤ߔࠆ㩷 ࡝࡯࠳࡯ࠪ࠶ࡊࠬࠠ࡞ࠍ↪޿ߡ‫ޔ‬ක≮࠴࡯ࡓߩઁߩࡔࡦࡃ࡯ࠍᢎ⢒ߒ‫ޔ‬ᜰዉߒ‫ޔ‬ഥ⸒ߔࠆ㩷 ⋴⼔ߣߒߡߩኾ㐷ᕈߣቇ㓙⊛ߥⷞὐࠍ߽ߞߡઁ⡯⒳ߣᨵエߦද௛ߔࠆ㩷 ක≮࠴࡯ࡓߦ߅޿ߡ⋴⼔Ꮷ߿ઁ⡯⒳ߩࠦࡦࠨ࡞࠹࡯࡚ࠪࡦࠍታᣉߔࠆ㩷 ⃻႐ߩ⋴⼔ߩ⺖㗴ࠍนⷞൻߒ‫ઁޔ‬⡯⒳ߣද௛ߒߡ⸃᳿ߦዉߊ㩷 ࠤࠕឭଏߩߚ߼ߦࠦ࡯࠺ࠖࡀ࡯࠲࡯ߩᓎഀࠍᜂ޿‫ߩࡓ࠹ࠬࠪޔ‬౞Ṗൻࠍផㅴߔࠆ㩷

8++

౏ⴐߩஜᐽߦะߌߡ‫੍ޔ‬㒐⊛ߥⷰὐࠍ〯߹߃ߡ‫ߩޘੱޔ‬ஜᐽჇㅴߦขࠅ⚵߻㩷ୃᓧߔߴ߈⢻ജߩౝኈ㪈㪅ஜᐽߦߟ޿ߡ‫ޔ‬ቇ㓙⊛ߥⷞὐ߆ࠄᝒ߃ࠆߣߣ߽ߦ‫ޔ‬ᄙ᭽ߥ࠺࡯࠲ࠍ⺒ߺขࠅಽᨆߔ
ࠆ㪉㪅ஜᐽߦ㑐ߔࠆᖱႎࠍ෼㓸࡮▤ℂߒ‫ߦࠕࠤޔ‬ᵴ↪ߔࠆᣇᴺࠍりߦઃߌࠆ㩷㪊㪅౏ⴐߩஜᐽ࡮ஜᐽჇㅴߣ޿߁ⷞὐ߆ࠄ‫⼔⋴ޔ‬ታ〣ࠍዷ㐿ߔࠆ㩷㪋㪅౏ⴐߩஜᐽ࡮ஜᐽჇㅴߣ޿߁ⷞὐ߆ࠄ‫ߩ⼔⋴ޔ‬᡽╷ࠍឭ᩺ߔࠆ㩷㪌㪅⋴⼔ߩኻ⽎ߦኻߒߡ‫߽ߦᤨࠆߥ߆޿ޔ‬ஜᐽჇㅴߣ޿߁ⷞὐ߆ࠄ௛߈߆ߌࠆ㩷㪍㪅‫∔ޟ‬ᖚࠍ੍㒐ߔࠆ‫ⷰ߁޿ߣޠ‬ὐߢ㓸࿅߳ߩஜᐽᢎ⢒ࠍታᣉߔࠆ㩷㪎㪅⋴⼔ߩኻ⽎ߦኻߒߡ‫∉ޔ‬ቇ⊛ߥ⍮⼂ࠍᵴ↪ߒߡࡐࡇࡘ࡟࡯࡚ࠪࡦ࡮ࠕࡊࡠ࡯࠴ࠍታ
〣ߔࠆ㩷

㪏㪅

੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍㅢߓ‫ޔ‬୘ੱ෸߮㓸࿅ߩஜᐽࠍଦㅴߐߖࠆᣇᴺࠍりߦઃߌࠆ㪐㪅⋴⼔ߩኻ⽎ߢ޽ࠆ㓸࿅ߦኻߒߡ‫ޔ‬ஜᐽჇㅴߦะߌߡ⋴⼔੺౉ߔࠆ㩷㪈㪇㪅 ᖚ⠪ߩஜᐽ⊛஥㕙߽ὶὐൻߒ‫∔ޔ‬ᖚࠍᛴ߃ߡ࿾ၞ␠ળߢ↢߈ࠆߚ߼ߩᡰេᣇᴺࠍり
ߦઃߌࠆ㩷

8+++

᡽╷߇ஜᐽߣ⋴⼔ߦ෸߷ߔᓇ㗀ࠍᛠីߒ‫ޔ‬ᡷༀߦะߌߡ᡽╷ࠍឭ⸒ߔࠆ

ୃᓧߔߴ߈⢻ജߩౝኈ ᴺᓞ࡮೙ᐲ࡮᡽╷߇⋴⼔ታ〣‫ޔ‬ஜᐽߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ ౏ⴐߩஜᐽ࡮ஜᐽჇㅴ߿⋴⼔ߩኾ㐷ᕈߩะ਄ߦะߌߡ‫ޔ‬᡽╷ࠍឭ᩺ߔࠆ㩷 ක≮᡽╷߇୘‫ޔ‬㓸࿅‫ߔࠄߚ߽ߦ❱⚵ޔ‬ᩰᏅ߿ਇᐔ╬ࠍᛠីߒ‫ߩߘޔ‬ᤚᱜߦะߌߡ⾗

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Ḯ࡮೙ᐲࠍᵴ↪ߔࠆ㩷 ⋴⼔ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯߇᡽╷ߦ෻ᤋߐࠇࠆࠃ߁ਥᒛߔࠆ㩷 ⸻≮ႎ㈽㧔ක≮⚻ᷣ㧕߇⋴⼔ࠤࠕឭଏᣇᴺ߿ࠕ࠙࠻ࠞࡓߦ෸߷ߔᓇ㗀ߦߟ޿ߡಽᨆ
ߒ‫ޔ‬ᡷༀ᩺ࠍឭ᩺ߔࠆ㩷+: ᄙ㕙⊛ߦᄙ᭽ߥ┙႐߆ࠄಽᨆߒ‫୶ޔ‬ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔୃᓧߔߴ߈⢻ജߩౝኈ ࿾ၞߩᯏ㑐㧛ኾ㐷⡯ߣද௛ߒߡ‫␠ޔ‬ળ⊛ᒙ⠪ߦኻߔࠆ୶ℂ⊛⺖㗴ߦะߌߡขࠅ⚵߻ ୘ੱ߿㓸࿅ߩᜬߟᢥൻ߅ࠃ߮୶ℂ⊛஥㕙ࠍℂ⸃ߒߚ਄ߢ‫ࠍࠕࠤޔ‬ታ〣ߔࠆ㩷 ᖚ⠪߿ኅᣖߩᠩ⼔ߩ┙႐߆ࠄ‫ޔ‬቟ోߥࠤࠕⅣႺࠍଦㅴߒ‫୶ޔ‬ℂ⊛ታ〣ࠍ᥉෸ߔࠆ㩷 ୶ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆᖚ⠪߿ኾ㐷⡯ࠍഥߌࠆߚ߼ߦ‫⑼ޔ‬ቇ߿୶ℂේೣࠍᵴ↪ߔࠆ㩷 ኾ㐷⡯⠪ߣߒߡ‫ޔ‬ක≮ឭଏߩ⾰ߩᡷༀߦኻߒ‫⺑ޔ‬᣿⽿છࠍᨐߚߔ㩷 ࠤࠕᛛⴚ߅ࠃ߮ᖱႎᛛⴚߩ૶↪ߦ㑐ߔࠆ୶ℂ⊛ේℂ߿ၮḰࠍℂ⸃ߔࠆ㩷: ⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ
㪈㪅ୃᓧߔߴ߈⢻ജߩౝኈ⋴⼔߿ක≮ߦ㑐ߔࠆ୘ੱߩືቇࠍ⊒ዷߐߖ‫⼔⋴ޔ‬ታ〣ߦ⛔วߔࠆ㩷㪉㪅⋴⼔ቇࠍขࠅᏎߊ⺖㗴ߦߟ޿ߡߩᗵฃᕈࠍ⎇߉Ẵ߹ߒ‫ޔ‬ਥ૕ᕈࠍᜬߞߡᡷༀߔࠆ㩷㪊㪅⥄ಽ⥄りߣห௥ߩ↢ᶦቇ⠌ࠍଦㅴߔࠆߚ߼‫߮ࠃ߅ޔ‬ታ〣ߦኾ㐷⊛⋴⼔ၮḰߣ⽿છࠍ⚵ߺㄟ߻ߚ߼ߩᣇ╷ࠍ⸳⸘ߔࠆ㩷㪋㪅ࠃࠅ⦟޿ࠤࠕࠍ᳿ቯߔࠆߚ߼↢ᶦቇ⠌ߩࡠ࡯࡞ࡕ࠺࡞ߦߥࠆ㩷㪌㪅ઁ⡯⒳ߦኻߒߡኾ㐷⡯ߢ޽ࠆ⋴⼔⡯ߩ߽ߩߩ⷗ᣇࠍ᣿⏕ߦ⴫⃻ߔࠆ㩷㩷㩷㧮㧚 ᧄ⎇ⓥߢឭ␜ߒߚ‫ޟ‬ඳ჻೨ᦼ⺖⒟㧔ୃ჻⺖⒟㧕ߦ߅޿ߡ‫ୃޔ‬჻㧔⋴⼔ቇ㧕ߩቇ૏ࠍ᝼ਈߐࠇࠆୃੌ↢߇ୃᓧߔߴ߈ 㪈㪇 ߩ⢻ജ‫ޠ‬એᄖߢ‫ޔ‬ᔅⷐߣᕁࠊࠇࠆ⢻ജ߇޽ࠇ߫‫ޔ‬ᩮ᜚ߣ౒ߦߘߩౝኈߦߟ޿ߡ߅⡞߆ߖߊߛߐ޿‫ޕ‬߹ߚ‫ޔ‬ᄢቇ㒮ୃੌᓟ‫⼔⋴ޔ‬ᢎ⢒⠪ߣߒߡߩᓎഀࠍᜂߞߡ޿ߊ႐ว߽޽ࠅ߹ߔ߇‫ߩߎޔ‬ὐߦ㑐ߒߡߩ⢻ജߩⷞὐ߇ឭ␜ߐࠇߡ߅ࠅ߹ߖࠎߢߒߚ‫ޕ‬ᢎ⢒⠪ߣߒߡߩ⢻ജࠍ␜ߔߎ
ߣߦߟ޿ߡߩߏᗧ⷗ߦߟ޿ߡ߽߅⡞߆ߖߊߛߐ޿‫ޕ‬








⾗ᢱ㧟
ࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯ෳട⠪ߦታᣉߒߚ
⋴⼔ቇߩඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߦ߅ߌࠆୃᓧߔߴ߈
⢻ജߩ⺞ᩏ↪⚕


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⋴⼔♽ᄢቇ㒮ߦ߅ߌࠆᢎ⢒ߩၮḰ╷ቯߣ⹏ଔߦ㑐ߔࠆ⺞ᩏ⎇ⓥ
ඳ჻೨ᦼ⺖⒟㧔ୃ჻⺖⒟㧕ߦ߅޿ߡ‫ୃޔ‬჻㧔⋴⼔ቇ㧕ߩቇ૏ࠍ᝼ਈߐࠇࠆୃੌ↢߇ୃᓧߔߴ߈⢻ജ߅ࠃ߮ߘߩ⢻ജߩౝኈߩᅷᒰᕈߦߟ޿ߡߩ⾰໧⚕⺞ᩏࠣ࡞࡯ࡊ⸛⼏ߢߩᬌ⸛ౝኈࠍ߽ߣߦ‫ߩ ޔ‬⢻ജߩ♖✵ࠍ࿑ࠆߣߣ߽ߦ‫ߩߘޔ‬⢻ജ߇ᜰߒ␜ߔߎߣߦߟ޿ߡߩ⺑᣿ࠍㅊ⸥ߒ߹ߒߚ‫ୃޔߚ߹ޕ‬ᓧߔߴ߈⢻ജߩౝኈࠍ  㗄⋡߆ࠄ 㗄⋡ߦ෩ㆬߒ߹ߒߚ‫ޕ‬એਅߦ‫ୃޔ‬ᓧߔߴ߈⢻ജ‫ߩߘ߮ࠃ߅ޔ‬⢻ജߩౝኈࠍߘࠇߙࠇ␜ߒߡ
߅ࠅ߹ߔ‫ޕ‬ߎߩୃᱜߒߚୃᓧߔߴ߈⢻ജ‫ߩߘ߮ࠃ߅ޔ‬⢻ജߩౝኈߦ㑐ߔࠆ‫ߦ߮ࠄߥ⃻⴫ޔ‬ౝኈߦ㑐ߒߡ‫ޔ‬‫ޟ‬หᗧߒߥ޿‫ޠ‬‫ޟ‬หᗧߔࠆ‫ޠ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫⹥ߩޠ‬ᒰߔࠆ▎ᚲߦ٤ࠍߏ⸥౉ߊߛ
ߐ޿‫ޕ‬‫᧦ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ߩޠ‬႐วߪ‫ߩߘޔ‬ℂ↱࡮ୃᱜ߽᩺ߏ⸥タߊߛߐ޿‫ୃޔ߅ߥޕ‬ᱜ೨ߩୃᓧߔߴ߈⢻ജ‫ߩߘ߮ࠃ߅ޔ‬⢻ജߩౝኈ߇⸥タߐࠇߚႎ๔ᦠ߇‫ޔ‬ᣣᧄ⋴⼔♽ᄢቇද⼏ળߩࡎ࡯ࡓࡍ࡯ࠫ㧔JVVRYYYLCPRWQTLRCEVKXKVKGUTGRQTV㧕ߩ‫ޟ‬ᐔᚑ  ᢥㇱ⑼ቇ⋭ ᄢቇߦ߅ߌࠆක≮ੱ㙃ᚑផㅴ╬ᆔ⸤੐ᬺႎ๔ᦠ‫ߏޔߢߩߔ߹޿ߑߏߦޠ‬ෳᾖߊߛߐ޿‫ޕ‬I.

⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ࠍࠬࡦ࠺ࡆࠛޔ‬ᵴ↪ߔࠆୃ჻⺖⒟ୃੌ↢ߪ‫⼔⋴ޔ‬ታ〣߿ࠤࠕឭଏߩ႐ߦ߅޿ߡ‫⇼ޔ‬໧ࠍ߽ߜត᳞ߔࠆᘒᐲߢ‫ޔ‬⸃᳿ߔߴ߈⋴⼔ߩ⺖㗴ࠍ⷗಴ߔߎߣ‫ߦࠄߐޔ‬ᣢሽߩ᭽‫ࠍࠬࡦ࠺ࡆࠛߩ࡞ࡌ࡟ߥޘ‬෼㓸‫ޔ‬⛔วߒ‫⎇ࠍࠄࠇߘޔ‬ⓥ߿ታ〣ߦᵴ↪ߒ‫⺖ޔ‬㗴⸃᳿ߦ❬޿ߢ޿ߊߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬

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‫᧦ ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ߩޠ‬ℂ↱࡮ୃᱜ᩺ 㧝㧚 ⋴⼔ታ〣ߢߩ໧㗴ࠍ⸃᳿ߔࠆߚ߼ߦ‫ޔ‬ᔅⷐߥࠛࡆ࠺ࡦࠬࠍត᳞ߔࠆ㧞㧚 ࠛࡆ࠺ࡦࠬ࡟ࡌ
࡞ࠍᛕ್⊛ߦ⺒⸃ߒ‫ޔ‬⹏ଔߔࠆ㧟㧚 'XKFGPEGDCUGF 
RTCEVKEG ࠍℂ⸃ߔࠆ




















㧠㧚 ᣂߚߥ⍮⼂߿వㅴ⊛ߥᛛⴚࠍត⚝ߒ‫ޔ‬
ᵴ↪ߔࠆ










⢻ ജ
+

⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ࡦ࠺ࡆࠛޔ‬ࠬࠍᵴ↪ߔࠆ

ୃᓧߔߴ߈⢻ജߩౝኈ

資料３



++ ⋴⼔ߩኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ㧕ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆୃ჻⺖⒟ୃੌ↢ߪ‫ߦࠬࡦ࠺ࡆࠛޔ‬ၮߠ޿ߡᦨᣂߥࠄ߮ߦᦨༀߩࠤࠕࠍᄙ⡯⒳ߣද௛
ߒߥ߇ࠄឭଏߒ‫⥄ޔ‬り߇ⴕ߁⋴⼔ߦኻߒߡ⺑᣿ߢ߈ߥߌࠇ߫ߥࠄߥ޿‫∛ޔߦࠄߐޕ‬᳇߿∔ᖚߩ⍮⼂ߦട߃‫∉ޔ‬ቇ⊛࠺࡯࠲߿␠ળ㨯ⅣႺ࠺࡯࠲߽↪޿ߥ߇ࠄ‫ޔ‬୘ੱ࡮ኅᣖߛߌߢ
ߥߊ‫ޔ‬㓸࿅࡮࿾ၞߦ߽⋡ࠍ߻ߌߚ⋴⼔ࠍᬌ⸛ߔࠆ‫ୃޕ‬჻⺖⒟ୃੌ↢ߪ‫ޔ‬ஜᐽߣ޿߁᭎ᔨ
ࠍ߭ࠈߊᷓߊᝒ߃‫∔ޔ‬ᖚࠍᛴ߃ߚኻ⽎߳ߩ௛߈߆ߌ߆ࠄ‫ߩޘੱޔ‬ஜᐽߩ଻ᜬ࡮Ⴧㅴߦะ
ߌߚขࠅ⚵ߺ߹ߢ‫ޔ‬ኻ⽎ߩ⁁ᘒߦᔕߓߚ⋴⼔ࠍᗧ࿑⊛ߦⴕ߁‫ୃߚ߹ޕ‬჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኻ⽎ߦᢎ⢒⊛ᡰេ߇ᔅⷐߥᤨߦߪ‫ޔ‬ℂ⺰߿ࠛࡆ࠺ࡦࠬߦၮߠ޿ߚ௛߈߆ߌࠍߔࠆߎߣ߇
᳞߼ࠄࠇࠆ‫ޕ‬

⢻ ജ
++

⋴⼔ߩኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ㧕ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆ

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ୃᓧߔߴ߈⢻ജߩౝኈ 㧝㧚 ᦨᣂߩࠤࠕᛛⴚ
߿ࠛࡆ࠺ࡦࠬߦၮߠ
޿ߡ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆ㧞㧚 ឭଏߐࠇߡ޿ࠆ
ක≮ߩ୶ℂᕈࠍ್ᢿ
ߒታ〣ߔࠆ㧟㧚 ୶ℂ⊛ߦㆡᱜߥᖱႎᛛⴚߩ೑↪ࠍଦㅴߔࠆ㧠㧚 ᄙ⡯⒳ߣߣ߽ߦ
ක≮ߩ቟ోᕈࠍ⏕⹺ߒ‫଻ޔ‬㓚ߔࠆ㧡㧚ኻ⽎ਛᔃߦ‫⼔⋴ޔ‬⡯߅ࠃ߮ ᄙ⡯⒳ߣߩ⺞ᢛࠍⴕ޿‫ޔ‬ද௛ߒߡࠤࠕߔࠆ 㧢㧚 ⋴⼔ߦߟ޿ߡߩ
⺑᣿ജࠍ߽ߜ‫ޔ‬ද௛ࠍផㅴߔࠆ㧣㧚 ੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍㅢߓ‫ޔ‬ஜᐽࠍ଻ᜬჇㅴߔࠆ


資料３



㧤㧚⋴⼔ߩኻ⽎ߦኻߒߡ‫∉ޔ‬ቇ⊛ߥ⍮⼂ࠍᵴ↪ߒߡࡐࡇࡘ࡟࡯࡚ࠪࡦ࡮ࠕࡊࡠ࡯࠴
ࠍታ〣ߔࠆ










Υ ⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦኻ ߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡขࠅ⚵߻  ୃ჻⺖⒟ୃੌ↢ߪ‫ᦨޔ‬ᣂߩᖱႎࠍᵴ↪ߒߡ‫⼔⋴ޔ‬ታ〣߿ࠤࠕⅣႺࠍᡷༀߔࠆߎߣ߇᳞
߼ࠄࠇࠆ‫ޕ‬หᗧ ᧦ઙઃหᗧ‫᧦ ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ߩޠ‬⢻ ജߒߥߔࠆ ߈ߢห
ℂ↱࡮ୃᱜ᩺ ᗧߔࠆ޿+++ ⋴⼔߇ឭଏߐࠇࠆኻ









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‫᧦ ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ߩޠ‬ℂ↱࡮ୃᱜ᩺ ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡขࠅ⚵߻ୃᓧߔߴ߈⢻ജߩౝኈ 㧝㧚 ⾌↪ኻലᨐ‫ ❱⚵ޔ‬⊛᦭ലᕈߥߤߩⷰὐ
ࠍ฽߼‫ޔ‬ኻ⽎ߦߣߞߡߩലᨐࠍ⹏ଔߔࠆ㧞㧚 ࠤࠕߩ⾰ࠍᡷༀߔࠆߚ߼ߦࠛࡆ࠺ࡦ
ࠬࠍ↪޿ߡ⚵❱߿㓸࿅߳௛߈߆ߌࠆ㧟㧚 ᖱႎࠪࠬ࠹ࡓ‫ ⛔ޔ‬⸘ߣ∉ቇߩ⍮⼂ࠍ↪
޿ߡ‫ߩࡓࠞ࠻࠙ࠕޔ‬ᡷༀ߿࡝ࠬࠢૐᷫߩߚ
߼ߩᚢ⇛ࠍ┙ߡࠆ㧠㧚 ᡽╷⊛ߥⷰὐߢࠤࠕߩ⾰଻⸽߿࡝ࠬ
ࠢࡑࡀࠫࡔࡦ࠻ࠍℂ⸃ߔࠆΦ ࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ࠕࠤޔ‬ⅣႺࠍᡷༀߔࠆ  ୃ჻⺖⒟ୃੌ↢ߪ‫⺖ࠆ޿ߡߓ↢ߦ❱⚵ޔ‬㗴ࠍಽᨆߒ‫߇ࠕࠤ޿⦟ࠅࠃޔ‬ឭଏߐࠇࠆࠃ߁
ߦࠤࠕⅣႺࠍ⺞ᢛߔࠆߎߣ߿ᢎ⢒⊛ߦ௛߈߆ߌࠆߎߣ߇᳞߼ࠄࠇࠆ‫ࠕࠤޕ‬ⅣႺࠍᡷༀߔ
ࠆߦߪ቟ోߢ᦭ലߥࠤࠕᛛⴚ߿ᖱႎᛛⴚߩ೑↪ߦߟ޿ߡ‫ޔ‬ኾ㐷⡯ߦኻߒᢎ⢒⊛ߦ௛߈߆ߌࠆߎߣ߽฽߹ࠇࠆ‫ޕ‬

⢻ ജ
+8

ࠤࠕ߇ឭଏߐࠇߡ޿
ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍ
ಽᨆߒ‫ࠕࠤޔ‬ⅣႺࠍ
ᡷༀߔࠆ

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ߒߥ
޿

หᗧ
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ୃᓧߔߴ߈⢻ജߩౝኈ 

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‫᧦ ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ߩޠ‬ℂ↱࡮ୃᱜ᩺ 㧝㧚 ୘ߣ⚵❱ߩਔ஥㕙߆ࠄ‫࠹ࠬࠪࠍ⼔⋴ޔ‬ࡓߣߒߡᝒ߃ࠆ㧞㧚 ࠤࠕⅣႺߣߒߡߩ⚵❱ࠍಽᨆߒ‫⺖ޔ‬㗴⸃᳿ߩߚ߼ߩᣇ⇛ࠍឭ᩺ߔࠆ㧟㧚 ኻ⽎ਛᔃߩࠤࠕࠍታ〣ߔࠆߦᒰߚࠅ‫ޔ‬ᔅⷐߣߥࠆᄙ⡯⒳߿⾗ḮࠍᏎ߈ㄟߺߥ߇ࠄࠤ
ࠕⅣႺࠍᡷༀߔࠆ㧠㧚 ⚵❱ߩ⺖㗴ߦߟ޿ߡᢎ⢒⊛ߦ௛߈߆ߌࠆΧ㧚ࠤࠕࠍផㅴߢ߈ࠆ႐߿ੱ⊛ⅣႺࠍᢛ߃ࠆߚ߼ߦ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆ   ୃ჻⺖⒟ୃੌ↢ߪ‫ߩࠕࠤޔ‬ᡷༀߦะߌߡ‫ޔ‬㓸࿅߿⚵❱ߦ௛߈߆ߌ‫ޔ‬ᄌൻࠍ⿠ߎߔᓎഀ
ࠍᜂ߁ߎߣ߇᳞߼ࠄࠇࠆ‫ޔߦ߼ߚߩߘޕ‬ᔅⷐߥ⍮⼂࡮ᛛⴚࠍᵴ↪ߒ‫ࡦࠪ࡞ࠞࠖ࠹࡝ࠢޔ‬ࠠࡦࠣ߿࡝ࡈ࡟࡚ࠢࠪࡦࠍขࠅ౉ࠇߡ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬

⢻ ജ
8

ࠤࠕࠍផㅴߢ߈ࠆ႐
߿ੱ⊛ⅣႺࠍᢛ߃ࠆ
ߚ߼ߦ‫ࠪ࡯࠳࡯࡝ޔ‬࠶ࡊࠍ⊒ើߔࠆ
ୃᓧߔߴ߈⢻ജߩౝኈ 㧝㧚 ᣂߒ޿⍮⼂߿ࡕ࠺࡞ࠍታ〣ߦዉ౉ߔ
ࠆߚ߼ߩᚻᴺࠍℂ⸃ߒ‫ߩߘޔ‬ታ⃻ߦะߌߡ࡝࡯࠳࡯ࠪ࠶ࡊࠍ⊒ើߔࠆ㧞㧚 㓸࿅߿⚵❱ߩ႐ߩ࠳ࠗ࠽ࡒ࠭ࡓࠍಽ
ᨆߒ‫ޔ‬㓸࿅߿⚵❱ࠍേ߆ߔ㧟㧚 ᦨༀߩක≮ࠨ࡯ࡆࠬࠍឭଏߔࠆߚ߼
ߦࠤࠕߩᡷༀࠍਥዉ
ߔࠆ





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Ψ㧚ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ  ୃ჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኾ㐷⡯㑆ߩലᨐ⊛ߥㅪ៤㑐ଥࠍଦߔߚ߼ߦ‫⋧ޔ‬੕ߦቇ⠌ߔࠆⅣႺࠍ⺞ᢛߒߚࠅ‫⼔⋴ޔ‬⡯߿ᄙ⡯⒳߆ࠄߩ⋧⺣ߦᔕߓߚࠅߒߡ‫ޔ‬ᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫ߘޕ‬ߩ㓙ߦߪ‫ઁࠍ⼔⋴ޔ‬⡯⒳ߦ⺑᣿ߔࠆ⢻ജ߇᳞߼ࠄࠇࠆ‫ޕ‬

⢻ ജ
8+

ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ

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‫᧦ ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ߩޠ‬ℂ↱࡮ୃᱜ᩺ ୃᓧߔߴ߈⢻ജߩౝኈ 㧝㧚 ኾ㐷⡯㑆ߩലᨐ⊛ߥㅪ៤㑐ଥࠍ▽ߊߚ߼ߦ‫ޔ‬੕޿ࠍዅ㊀ߒߚࠦࡒࡘ࠾ࠤ࡯࡚ࠪࡦࠍߣࠆ㧞㧚 ⋴⼔Ꮷ߿ઁ⡯⒳ߦኻߒߡ⋴⼔ߩᗧ࿑߿ᔅⷐᕈࠍ⺑᣿ߒ‫ޔ‬ද௛ߔࠆ㧟㧚 ኻ⽎ߩ⺖㗴ࠍนⷞൻߒ‫ઁޔ‬⡯⒳ߣද௛
ߒߡ⸃᳿ߦዉߊ㧠㧚 ࠦ࡯࠺ࠖࡀ࡯࠲࡯ߩᓎഀࠍᜂ޿‫ޔ‬ද௛ߩ౞ṖൻࠍផㅴߔࠆΩ㧚⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ  ୃ჻⺖⒟ୃੌ↢ߪ‫ߩⴕ⃻ޔ‬ᴺᓞ㨯೙ᐲ࡮᡽╷߇ੱ‫ߩޘ‬ஜᐽ߿⋴⼔ߦߤߩࠃ߁ߥᓇ㗀ࠍ߽ߚࠄߒߡ޿ࠆ߆ࠍಽᨆߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫ߩߘޕ‬ಽᨆ⚿ᨐߦၮߠ߈‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ߇‫ߩߘޔ‬㓙ߦ⋴⼔ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯ⷰࠍ෻ᤋߒߚᣇ╷ࠍ⠨߃ࠆߎߣ߽᳞߼
ࠄࠇࠆ‫ޕ‬⢻ ജ
8++ ⃻ⴕߩᴺᓞ࡮೙ᐲ࡮

᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆ
ߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔ
ࠆ






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ୃᓧߔߴ߈⢻ജߩౝኈ 㧝㧚 ක≮᡽╷߇୘‫ޔ‬㓸࿅‫ߔࠄߚ߽ߦ❱⚵ޔ‬ᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍ⠨᩺ߔࠆ㧞㧚 ⋴⼔ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯߇᡽
╷ߦ෻ᤋߐࠇࠆࠃ߁
ᣇ╷ࠍ⠨߃ࠆ㧟㧚 ⸻≮ႎ㈽߿੺⼔଻㒾ߥߤߩ᡽╷࡮೙ᐲ߇ࠤࠕឭଏᣇᴺ߿ࠕ
࠙࠻ࠞࡓߦ෸߷ߔᓇ
㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ᩺ࠍឭ᩺ߔࠆ㧠㧚 ੱ‫ߩޘ‬ஜᐽჇㅴߣ޿߁ⷞὐ߆ࠄ‫⼔⋴ޔ‬ߩ᡽╷ࠍឭ᩺ߔࠆ

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Ϊ㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆᢎ⢒ⅣႺߠߊࠅߦขࠅ⚵߻  ୃ჻⺖⒟ୃੌ↢ߪ‫⼔⋴ޔ‬ኾ㐷⡯ࠍ⢒ߡࠆߚ߼ߩᢎ⢒⊛ᕁ⠨ࠍ߽ߟߎߣ߇ᔅⷐߢ޽ࠆ‫ޕ‬⢻ ജ
8+++ ⋴⼔ቇߩ⊒ዷߦነਈ

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‫᧦ ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ߩޠ‬ℂ↱࡮ୃᱜ᩺ ߢ߈ࠆᢎ⢒ⅣႺߠߊࠅߦขࠅ⚵߻
ୃᓧߔߴ߈⢻ജߩౝኈ 㧝㧚 ቇ⠌⠪ߩ࠾࡯࠭ࠍᛠីߒ‫ޔ‬ቇ⠌⠪ߦ޽ࠊߖߚᢎ⢒ᴺࠍℂ⸃ߔࠆ㧞㧚 ⋴⼔ቇߩ⸘↹⊛࡮ലᨐ⊛ߥᢎ⢒ᣇᴺࠍឭ᩺ߔࠆ
㧖‫ޟ‬Ϊ㪅⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆᢎ⢒ⅣႺߠߊࠅߦขࠅ⚵߻‫߁޿ߣޠ‬⢻ജߪ‫ࠬࠞ࡯ࠜࡈޔ‬ࠣ࡞࡯ࡊࠗࡦ࠲ࡆࡘ࡯ߩ⚿ᨐࠍ〯߹߃ߡㅊടߒߚ‫ޟ‬⢻ജ‫ޕߔߢޠ‬ㅊടߒߚ߶߁߇ࠃ޿‫ޟ‬⢻ജߩౝኈ‫ޔࠄߚߒ߹ࠅ޽߇ޠ‬ᩮ᜚ߣ౒ߦਅ⸥ߦߏ⸥タߊߛߐ޿‫ޕ‬㩷

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Ϋ㧚୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ  ୃ჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኻ⽎ࠍᠩ⼔ߔࠆߚ߼ߦ୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍ㜞߼ࠆߣߣ߽ߦ‫ޔ‬ࠤࠕᛛⴚ߿ᖱႎᛛⴚߩ૶↪ߦ㑐ߔࠆ୶ℂේೣ߿ၮḰࠍℂ⸃ߒߚ߁߃ߢታ〣ࠍⴕ޿‫ޔ‬ኾ㐷⡯ߣߒߡߩ୶ℂ⊛⽿ോࠍᨐߚߔߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬

⢻ ജ
+:

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୶ℂ⊛࡮ᢥൻ⊛ᗵฃ ᕈࠍᜬߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ

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‫᧦ ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ߩޠ‬ℂ↱࡮ୃᱜ᩺ ୃᓧߔߴ߈⢻ജߩౝኈ 

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㧝㧚 ୘ੱ࡮ኅᣖ࡮㓸࿅ ߩᜬߟᢥൻ߿⢛᥊ࠍᛠីߒ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆ ኻ⽎ߩᠩ⼔ߩ┙႐߆ࠄ‫ޔ‬቟ోߥࠤࠕⅣႺࠍଦㅴߒ‫୶ޔ‬ℂ⊛ታ〣ࠍ᥉෸ߔࠆ ୶ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆኻ⽎߿ኾ㐷⡯ࠍᡰេߔࠆߚ߼ߦ‫୶ޔ‬ℂߦ㑐ߔࠆℂ⺰ࠍᵴ↪ߔࠆά㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ  ୃ჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኾ㐷⡯ߣߒߡߩືቇࠍ⊒ዷߐߖ‫ࠍⷰ⼔⋴ޔ‬᣿⏕ߦ⴫⃻ߒ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫↢ޔߦࠄߐޕ‬ᶦࠍㅢߓߡቇ⠌ߒߡ޿ߊᆫ൓ࠍ߽ߜ‫ᦨޔ‬ᣂߩ⍮⷗ࠍᓧߡ⋴⼔ߦᵴ↪ߔࠆദജࠍ⛯ߌ‫⼔⋴ߩઁޔ‬⡯ߩᓎഀࡕ࠺࡞ߣߥࠆߎߣ߽᳞߼ࠄࠇࠆ‫ޕ‬

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⋴⼔ቇߩ⊒ዷߦነਈ
ߢ߈ࠆࠕࠗ࠺ࡦ࠹ࠖ
࠹ࠖࠍᒻᚑߔࠆ

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ߒߥ
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หᗧ
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‫᧦ ޟ‬ઙઃ߈ߢหᗧߔࠆ‫ߩޠ‬ℂ↱࡮ୃᱜ᩺ 









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ୃᓧߔߴ߈⢻ജߩౝኈ 㧝㧚 ⋴⼔߿ක≮ߦ㑐ߔࠆኾ㐷⡯ߣߒߡߩ
ືቇࠍ⊒ዷߐߖ‫⼔⋴ޔ‬ታ〣ߦ⛔วߔࠆ㧞㧚 ⋴⼔ቇࠍขࠅᏎ
ߊ⺖㗴ߦߟ޿ߡߩᗵ
ฃᕈࠍ㜞߼‫ޔ‬ਥ૕ᕈࠍᜬߞߡᡷༀߔࠆ㧟㧚 ࠃࠅ⦟޿ࠤࠕࠍ
᳿ቯߔࠆߚ߼ߦᦨᣂ
ߩ⍮⷗ࠍᓧߥ߇ࠄታ
〣ߔࠆࡕ࠺࡞ߦߥࠆ㧠㧚 ኾ㐷⡯ߣߒߡ⋴⼔ⷰࠍ᣿⏕ߦߔࠆ


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‫⎇ᧄޔઁߩߘع‬ⓥߦኻߔࠆߏ⾰໧࡮ߏᗧ⷗߇޽ࠇ߫‫߈ᦠ߅ޔ‬ਅߐ޿‫ޕ‬














‫ع‬࿁╵޿ߚߛ޿ߚౝኈߦߟ޿ߡ⏕⹺ߐߖߡ޿ߚߛߊ႐ว߽ߏߑ޿߹ߔߩߢ‫ޔ‬Ꮕߒᡰ߃ߥߌ
ࠇ߫᳁ฬࠍߏ⸥౉ߊߛߐ޿‫ޕ‬            ᓮ᳁ฬ㧔                㧕એ਄ߢ⚳ੌߢߔ‫ޕ‬࿁╵߳ߩߏදജ‫ޕߚߒ߹޿ߑߏ߁ߣ߇ࠅ޽ޔ‬








⾗ᢱ㧠
⋴⼔♽ᄢቇද⼏ળળຬᩞߦታᣉߒߚ
⋴⼔ቇߩඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ߦ߅ߌࠆୃᓧߔߴ߈
⢻ജߩ⺞ᩏ↪⚕





















資料４



⋴⼔♽ᄢቇ㒮ߦ߅ߌࠆᢎ⢒ߩၮḰ╷ቯߣ⹏ଔߦ㑐ߔࠆ⺞ᩏ⎇ⓥ
ඳ჻೨ᦼ⺖⒟㧔ୃ჻⺖⒟㧕ߦ߅޿ߡ‫ୃޔ‬჻㧔⋴⼔ቇ㧕ߩቇ૏ࠍ᝼ਈߐࠇࠆୃੌ↢߇ୃᓧߔߴ߈⢻ജ߅ࠃ߮ߘߩ⢻ജߩౝኈߩᅷᒰᕈߦߟ޿ߡߩ⾰໧⚕⺞ᩏA. ࿁╵⠪ߦߟ޿ߡ߅዆ߨߒ߹ߔ
Σ㪅 ᚲዻᄢቇߩ⸳⟎ᒻᘒߦ⹥ᒰߔࠆ⇟ภߦ٤ශࠍߟߌߡߊߛߐ޿‫ߦઁߩߘޕ‬٤ශࠍߟߌࠄ
ࠇߚᣇߪ‫ޔ‬㧔  㧕ౝߦ⸳⟎ᒻᘒࠍߏ⸥౉ਅߐ޿‫ޕ‬㪈㪅࿖┙ᄢቇᴺੱ㩷㪉㪅౏┙ᄢቇ࡮౏┙ᄢቇᴺੱ 㩷㪊㪅⑳┙ᄢቇ 㩷㪋㪅ߘߩઁ㧔                                 㧕㩷㸈㪅㩷 ᚲዻᄢቇ䈪⃻࿷ⴕ䈦䈩䈇䉎⋴⼔ቇ䈱ᄢቇ㒮ᢎ⢒䈮䈧䈇䈩⹥ᒰ䈜䉎⇟ภ䈮䂾ශ䉕䈧䈔䈩䈒䈣䈘䈇䇯㩷㪈㪅 ᄢቇ㒮ୃ჻⺖⒟ᢎ⢒㩷㪉㪅 ᄢቇ㒮ඳ჻⺖⒟㧔೨ᦼ࡮ᓟᦼ㧕ᢎ⢒㩷㪊㪅 ᄢቇ㒮ᢎ⢒⸳⟎Ḱ஻ਛ㩷㩷㸉㪅㩷 ⾆⎇ⓥ⑼䈪ୃ჻䋨⋴⼔ቇ䋩䉕᝼ਈ䈚䈩䈇䉁䈜䈎䇯⹥ᒰ䈜䉎⇟ภ䈮䂾ශ䉕䈧䈔䈩䈒䈣䈘䈇䇯㩷㩷 㩷 㩷 ᝼ਈ䈚䈩䈇䈭䈇႐ว䈲䇮᝼ਈ䈚䈩䈇䉎ቇ૏ฬ䉕⸥タ䈚䈩ਅ䈘䈇䇯㩷
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޿޿߃ ψୃ჻㧔   㧕㧨଀㧦 ୃ჻㧔଻ஜቇ㧕ߥߤ㧪㩷㩷㸊㪅㩷 ⾆⎇ⓥ⑼䈮ኾ㐷⋴⼔Ꮷᢎ⢒⺖⒟⹺ቯ䉕ฃ䈔䈩䈇䉎ኾ㐷㗔ၞ䈲䈅䉍䉁䈜䈎䇯⹥ᒰ䈜䉎⇟ภ䈮䂾ශ䉕䈧䈔䈩ਅ䈘䈇䇯㩷
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㸋㪅㩷 ⡯૏䈮䈧䈇䈩⹥ᒰ䈜䉎⇟ภ䋱䈧䈮䂾ශ䉕䈧䈔䈩䈒䈣䈘䈇䇯䈠䈱ઁ䈮䂾ශ䉕䈧䈔䉌䉏䈢ᣇ䈲䇮䋨㩷 㩷 䋩ౝ䈮⡯૏䉕䈗⸥౉ਅ䈘䈇䇯㩷㪈㪅ቇ㐳     㪉㪅  ⎇ⓥ⑼㐳    㪊㪅  ᢎ᝼     㪋㪅 㩷 ಎᢎ᝼     㪌㪅 㩷ߘߩઁ㧔        㧕㩷







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㧮. એਅߦ‫ޔ‬ඳ჻೨ᦼ⺖⒟㧔ୃ჻⺖⒟㧕ߦ߅޿ߡ‫ୃޔ‬჻㧔⋴⼔ቇ㧕ߩቇ૏ࠍ᝼ਈߐࠇ
ࠆୃੌ↢߇ୃᓧߔߴ߈  ߩ⢻ജߣߘߩౝኈࠍ␜ߒߡ߅ࠅ߹ߔ‫ޕ‬ୃᱜߒߚୃᓧߔߴ߈⢻ജ‫ߩߘ߮ࠃ߅ޔ‬⢻ജߩౝኈߦ㑐ߔࠆ‫ߦ߮ࠄߥ⃻⴫ޔ‬ౝኈߦ㑐ߒߡ‫ޔ‬‫ޟ‬หᗧߒߥ޿‫ޟޠ‬หᗧߔࠆ‫⹥ߩޠ‬ᒰߔࠆ▎ᚲߦ٤ශࠍߏ⸥౉ߊߛߐ޿‫ޟޕ‬หᗧߒߥ޿‫ޠ‬႐วߪ‫ߩߘޔ‬ℂ↱߽ߏ⸥タߊߛߐ޿‫ୃޔ߅ߥޕ‬ᱜ೨ߩୃᓧߔߴ߈⢻ജ‫ߩߘ߮ࠃ߅ޔ‬⢻ജߩౝኈ߇ ⸥ タ ߐ ࠇ ߚ ႎ ๔ ᦠ ߇ ‫ ޔ‬ᣣ ᧄ ⋴ ⼔ ♽ ᄢ ቇ ද ⼏ ળ ߩ ࡎ ࡯ ࡓ ࡍ ࡯ ࠫ
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ක≮ੱ㙃ᚑផㅴ╬ᆔ⸤੐ᬺႎ๔ᦠ‫ߏޔߢߩߔ߹޿ߑߏߦޠ‬ෳᾖߊߛߐ޿‫ޕ‬Σ㧚⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥߒ‫ࠍࠬࡦ࠺ࡆࠛޔ‬ᵴ↪ߔࠆୃ჻⺖⒟ୃੌ↢ߪ‫  ⼔⋴ޔ‬ታ〣߿ࠤࠕឭଏߩ႐ߦ߅޿ߡ‫⇼ޔ‬໧ࠍ߽ߜត᳞ߔࠆᘒᐲ
ߢ‫⸃ޔ‬᳿ߔߴ߈⋴⼔ߩ⺖㗴ࠍ⷗಴ߔߎߣ‫ߦࠄߐޔ‬ᣢሽߩ᭽‫ࠍࠬࡦ࠺ࡆࠛߩ࡞ࡌ࡟ߥޘ‬෼㓸‫⛔ޔ‬วߒ‫⎇ࠍࠄࠇߘޔ‬ⓥ߿ታ〣ߦᵴ↪ߒ‫⺖ޔ‬㗴⸃᳿ߦ❬޿ߢ޿ߊߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬

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‫ޟ‬หᗧߒߥ޿‫ޠ‬ℂ↱





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⋴⼔ߩ⺖㗴ࠍ⑼ቇ⊛ߦតⓥ+ߒ‫ࠍࠬࡦ࠺ࡆࠛޔ‬ᵴ↪ߔࠆ

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ୃᓧߔߴ߈⢻ജߩౝኈ
㧝㧚⋴⼔ታ〣ߢߩ໧㗴ࠍ⸃᳿ߔࠆߚ߼ߦ‫ޔ‬ᔅⷐߥࠛࡆ࠺ࡦࠬ
ࠍត᳞ߔࠆ
㧞㧚ࠛࡆ࠺ࡦࠬࠍᛕ್⊛ߦ⺒⸃ߒ‫⹏ޔ‬ଔߔࠆ 㧟㧚'XKFGPEGDCUGFRTCEVKEG

ࠍℂ⸃
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㧠㧚 ᣂߚߥ⍮⼂߿వㅴ⊛ߥᛛⴚࠍត⚝ߒ‫ޔ‬ᵴ↪ߔࠆ5‫⼔⋴ߪޠࠕࠤޟ‬⡯߇ᄙ⡯⒳ߣද௛ߒߡⴕ߁ታ〣‫⼔⋴ߪޠ⼔⋴ޟޔ‬⡯߇ⴕ߁ታ〣ߣߒߡឭ␜ߒߡ޿߹ߔ‫ޕ‬

6 ࠛࡆ࠺ࡦࠬ‫⑼ࠅ߹ߟޔ‬ቇ⊛ߦታ⸽ߐࠇߚᩮ᜚㧔⑼ቇ⊛ᩮ᜚㧕㧙ታ㛎߿⺞ᩏߥߤ⾰⊛⎇ⓥ߽฽߼ߚ⎇ⓥ⚿ᨐ߆ࠄዉ߆

ࠇߚ‫ⵣޟ‬ઃߌ‫ޠ‬㧙ߦၮߠ޿ߡ⋴⼔ታ〣߿ࠤࠕឭଏࠍⴕ߁ߎߣ߇᳞߼ࠄࠇߡ޿ࠆ‫ࠍࠬࡦ࠺ࡆࠛޕ‬ᵴ↪ߔࠆߦߪ‫ޔ‬ᓧߚࠛࡆ࠺ࡦࠬ߇ᅷᒰߢା㗬ߢ߈ࠆ߽ߩ߆ߤ߁߆ࠍ⷗ᭂ߼ࠆߎߣ߇ᔅⷐߢ޽ࠅ‫⎇ߥ߁ࠃߩߤޔ‬ⓥᣇᴺࠍ↪޿ߡ޿ࠆ߆‫޿ߡ޿↪ޔ‬
ࠆᣇᴺ߆ࠄ↢ߓࠆࡃࠗࠕࠬ㧔ㆬᛯࡃࠗࠕࠬ‫ޔ‬ᖱႎࡃࠗࠕࠬ‫ޔ‬੤⛊ࡃࠗࠕࠬߥߤ㧕ࠍߤߩࠃ߁ߦ೙ᓮߒߡ޿ࠆ߆ߥߤ‫ߘޔ‬ߩࠛࡆ࠺ࡦࠬ߇ߤߩࠃ߁ߦዉ߈಴ߐࠇߡ޿ࠆ߆ࠍ⏕⹺ߒ‫ߩࠬࡦ࠺ࡆࠛޔ‬ᅷᒰᕈ߿ା㗬ᕈߩ⒟ᐲࠍ⹏ଔߔࠆߣߣ߽ߦ‫ߘޔ‬ߩ࡟ࡌ࡞ߦၮߠ߈ߤߩࠃ߁ߦ⎇ⓥ⚿ᨐࠍណ↪ߔࠆ߆್ᢿߔࠆᔅⷐ߇޽ࠆ‫৻ࠄࠇߎޕ‬ㅪߩࠛࡆ࠺ࡦࠬߩ⠨߃ᣇࠍℂ⸃ߒߡ‫ޔ‬⋴⼔ߦᵴ↪ߔࠆࠛࡆ࠺ࡦࠬࠍត⚝࡮តⓥߒ⹏ଔߢ߈ࠆߎߣ߇ୃ჻⺖⒟ୃੌ↢ߦߪ᳞߼ࠄࠇࠆ‫ޕ‬





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Τ㧚⋴⼔ߩኻ⽎㧔୘ੱ࡮ኅᣖ࡮㓸࿅࡮࿾ၞ㧕ߦኻߒߡ‫ޔ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆୃ჻ୃੌ↢ߦ᳞߼ࠆ㜞ᐲߥ⋴⼔ߣߪ‫ޔ‬‫ޟ‬ㆡ⏕ߦᖱႎ್ᢿߒ‫߇ߣߎ߈ߴߔߥޔ‬ታ〣ߢ߈ࠆ‫ޠ‬ߣ޿߁ߎߣߢ޽ࠆ‫ߩࠄࠇߎޕ‬㜞ᐲߥ⋴⼔ࠍታ〣ߔࠆߦ޽ߚࠅ‫ୃޔ‬჻⺖⒟ୃੌ↢ߪ‫ࡆࠛޔ‬࠺ࡦࠬߦၮߠ޿ߡᦨᣂߥࠄ߮ߦᦨༀߩࠤࠕࠍᄙ⡯⒳ߣද௛ߒߥ߇ࠄឭଏߒ‫⥄ޔ‬り߇ⴕ߁⋴⼔ߦኻߒߡ⺑᣿ߢ߈ߥߌࠇ߫ߥࠄߥ޿‫∛ޔߦࠄߐޕ‬᳇߿∔ᖚߩ⍮⼂ߦട߃‫∉ޔ‬ቇ⊛࠺࡯࠲߿␠ળ㨯ⅣႺ࠺࡯࠲߽↪޿ߥ߇ࠄ‫ޔ‬୘ੱ࡮ኅᣖߛߌߢߥߊ‫ޔ‬㓸࿅࡮࿾ၞߦ߽⋡ࠍ߻ߌߚ⋴⼔ࠍᬌ⸛ߔࠆ‫ୃޕ‬჻⺖⒟ୃੌ↢ߪ‫ޔ‬ஜᐽߣ޿߁᭎ᔨࠍ߭ࠈߊᷓߊᝒ߃‫∔ޔ‬ᖚ߿㓚⎹ࠍᛴ߃ߚኻ⽎߳ߩ௛߈߆ߌ߆ࠄ‫ߩޘੱޔ‬ஜᐽߩ଻ᜬ࡮Ⴧㅴߦะߌߚขࠅ⚵ߺ߹ߢ‫ੱ৻ޔ‬߭ߣࠅ߇ᜬߟജࠍᒁ߈಴ߒ‫ޔ‬ኻ⽎ߩ⁁ᘒߦᔕߓߚ⋴⼔ࠍᗧ࿑⊛ߦⴕ߁‫ୃߚ߹ޕ‬჻⺖⒟ୃ
ੌ↢ߪ‫ޔ‬ኻ⽎ߦᢎ⢒⊛ᡰេ߇ᔅⷐߥᤨߦߪ‫ޔ‬ℂ⺰߿ࠛࡆ࠺ࡦࠬߦၮߠ޿ߚ௛߈߆ߌࠍߔ
ࠆߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬

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หᗧߔࠆୃᓧߔߴ߈⢻ജߩౝኈ
㧝㧚ᦨᣂߩࠤࠕᛛⴚ߿ࠛࡆ࠺

ࡦࠬߦၮߠ޿ߡ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆ㧞㧚ឭଏߐࠇߡ޿ࠆක≮ߩ୶

ℂᕈࠍ್ᢿߒታ〣ߔࠆ

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୶ℂ⊛ߦㆡᱜߥᖱႎᛛⴚ

ߩ೑↪ࠍଦㅴߔࠆ㧠㧚 ᄙ⡯⒳ߣߣ߽ߦක≮ߩ቟



































ోᕈࠍ⏕⹺ߒ‫଻ޔ‬㓚ߔࠆ㧡㧚ኻ⽎ਛᔃߦ‫⼔⋴ޔ‬⡯߅ࠃ߮ᄙ⡯⒳ߣ
ߩ⺞ᢛࠍⴕ޿‫ޔ‬ද௛ߒߡࠤࠕߔࠆ

㧢㧚⋴⼔ߦߟ޿ߡߩ⺑᣿ജࠍ߽ߜ‫ޔ‬ද௛ࠍផㅴߔࠆ
㧣㧚੐଀ಽᨆߣ⛔⸘ಽᨆߩ⍮⼂ࠍㅢߓ‫ޔ‬ஜᐽࠍ଻ᜬჇㅴߔࠆ
㧤㧚⋴⼔ߩኻ⽎ߦኻߒߡ‫∉ޔ‬ቇ⊛ߥ⍮⼂ࠍᵴ↪ߒߡ‫੍ޔ‬㒐⊛ⷰὐࠍ〯߹߃ߡஜᐽߩ଻ᜬ࡮Ⴧㅴߦขࠅ⚵߻





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Υ㧚⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡขࠅ⚵߻  ୃ჻⺖⒟ୃੌ↢ߪ‫ᦨޔ‬ᣂߩᖱႎࠍᵴ↪ߒߡ‫⼔⋴ޔ‬ታ〣߿ࠤࠕⅣႺࠍᡷༀߔࠆߎߣ߇᳞
߼ࠄࠇࠆ‫ޕ‬

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⋴⼔߇ឭଏߐࠇࠆኻ⽎߿႐ߦ

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ኻߒ‫ߩ⾰ޔ‬ᡷༀߦะߌߡขࠅ
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ୃᓧߔߴ߈⢻ജߩౝኈ
㧝㧚⾌↪ኻലᨐ‫᦭⊛❱⚵ޔ‬ലᕈߥߤߩⷰὐࠍ฽߼‫ޔ‬ኻ⽎ߦߣߞߡߩലᨐࠍ⹏ଔߔࠆ
㧞㧚ࠤࠕߩ⾰ࠍᡷༀߔࠆߚ߼

ߦࠛࡆ࠺ࡦࠬࠍ↪޿ߡ⚵❱߿㓸࿅߳௛߈߆ߌࠆ
㧟㧚ᖱႎࠪࠬ࠹ࡓ‫∉ߣ⸘⛔ޔ‬ቇߩ⍮⼂ࠍ↪޿ߡ‫ߩࡓࠞ࠻࠙ࠕޔ‬ᡷༀ߿࡝ࠬࠢૐᷫߩߚ߼ߩᚢ
⇛ࠍ┙ߡࠆ
㧠㧚᡽╷⊛ߥⷰὐߢࠤࠕߩ⾰଻⸽߿࡝ࠬࠢࡑࡀࠫࡔࡦ࠻ࠍ
ℂ⸃ߔࠆΦ㧚ࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿ࠪࠬ࠹ࡓࠍಽᨆߒ‫ࠕࠤޔ‬ⅣႺࠍᡷༀߔࠆ  ୃ჻⺖⒟ୃੌ↢ߪ‫⺖ࠆ޿ߡߓ↢ߦ❱⚵ޔ‬㗴ࠍಽᨆߒ‫߇ࠕࠤ޿⦟ࠅࠃޔ‬ឭଏߐࠇࠆࠃ߁
ߦࠤࠕⅣႺࠍ⺞ᢛߔࠆߎߣ߿ᢎ⢒⊛ߦ௛߈߆ߌࠆߎߣ߇᳞߼ࠄࠇࠆ‫ࠕࠤޕ‬ⅣႺࠍᡷༀߔ
ࠆߦߪ቟ోߢ᦭ലߥࠤࠕᛛⴚ߿ᖱႎᛛⴚߩ೑↪ߦߟ޿ߡ‫ޔ‬ኾ㐷⡯ߦኻߒᢎ⢒⊛ߦ௛߈߆ߌࠆߎߣ߽฽߹ࠇࠆ‫ޕ‬
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ࠤࠕ߇ឭଏߐࠇߡ޿ࠆ⚵❱߿

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‫ޟ‬หᗧߒߥ޿‫ޠ‬ℂ↱ࠪࠬ࠹ࡓࠍಽᨆߒ‫ࠕࠤޔ‬ⅣႺ
ࠍᡷༀߔࠆ
ୃᓧߔߴ߈⢻ജߩౝኈ
㧝㧚୘ߣ⚵❱ߩਔ஥㕙߆ࠄ‫ ⋴ޔ‬⼔ࠍࠪࠬ࠹ࡓߣߒߡᝒ߃ࠆ

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ࠤࠕⅣႺߣߒߡߩ⚵❱ࠍ

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ಽᨆߒ‫⺖ޔ‬㗴⸃᳿ߩߚ߼ߩᣇ⇛ࠍឭ᩺ߔࠆ
㧟㧚ࠤࠕࠍታ〣ߔࠆߚ߼ߦᔅ

ⷐߣߥࠆᄙ⡯⒳߿⾗ḮࠍᏎ߈ㄟߺߥ߇ࠄ‫ࠕࠤޔ‬ⅣႺߩᡷༀߦ
ขࠅ⚵߻
㧠㧚

⚵❱ߩ⺖㗴ߦߟ޿ߡᢎ⢒⊛ߦ௛߈߆ߌࠆ
Χ㧚ࠤࠕࠍផㅴߢ߈ࠆ႐߿ੱ⊛ⅣႺࠍᢛ߃ࠆߚ߼ߦ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆ   ୃ჻⺖⒟ୃੌ↢ߪ‫ߩࠕࠤޔ‬ᡷༀߦะߌߡ‫ޔ‬㓸࿅߿⚵❱ߦ௛߈߆ߌ‫ޔ‬ᄌൻࠍ⿠ߎߔᓎഀ
ࠍᜂ߁ߎߣ߇᳞߼ࠄࠇࠆ‫ޔߦ߼ߚߩߘޕ‬ᔅⷐߥ⍮⼂࡮ᛛⴚࠍᵴ↪ߒ‫ࡦࠪ࡞ࠞࠖ࠹࡝ࠢޔ‬ࠠࡦࠣ߿࡝ࡈ࡟࡚ࠢࠪࡦࠍขࠅ౉ࠇߡ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬


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ࠤࠕࠍផㅴߢ߈ࠆ႐߿ੱ⊛ⅣႺࠍᢛ߃ࠆߚ߼ߦ‫࡯࠳࡯࡝ޔ‬ࠪ࠶ࡊࠍ⊒ើߔࠆ

8



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ୃᓧߔߴ߈⢻ജߩౝኈ㧝㧚 ᣂߒ޿⍮⼂߿ࡕ࠺࡞ࠍታ
〣ߦዉ౉ߔࠆߚ߼ߩᚻᴺࠍℂ⸃ߒ‫ߩߘޔ‬ታ⃻ߦะߌߡ࡝࡯࠳
࡯ࠪ࠶ࡊࠍ⊒ើߔࠆ㧞㧚 㓸࿅߿⚵❱ߩ႐ߩജേࠍ
ಽᨆߒ‫ޔ‬㓸࿅߿⚵❱ࠍേ߆ߔ㧟㧚 ᦨༀߩක≮ࠨ࡯ࡆࠬࠍឭ
ଏߔࠆߚ߼ߦࠤࠕߩᡷༀࠍਥ
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Ψ㧚ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ  ୃ჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኾ㐷⡯㑆ߩലᨐ⊛ߥㅪ៤㑐ଥࠍଦߔߚ߼ߦ‫⋧ޔ‬੕ߦቇ⠌ߔࠆⅣႺࠍ⺞ᢛߒߚࠅ‫⼔⋴ޔ‬⡯߿ᄙ⡯⒳߆ࠄߩ⋧⺣ߦᔕߓߚࠅߒߡ‫ޔ‬ᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ‫ߘޕ‬ߩ㓙ߦߪ‫ઁࠍ⼔⋴ޔ‬⡯⒳ߦ⺑᣿ߔࠆ⢻ജ߇᳞߼ࠄࠇࠆ‫ޕ‬

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8+

ኾ㐷ᕈߩ⋧㆑ࠍዅ㊀ߒߚ਄ߢᄙ⡯⒳㑆ߩද௛ࠍផㅴߔࠆ





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ୃᓧߔߴ߈⢻ജߩౝኈ
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ኾ㐷⡯㑆ߩലᨐ⊛ߥㅪ៤㑐ଥࠍ▽ߊߚ߼ߦ‫ޔ‬੕޿ࠍዅ㊀ߒߚࠦࡒࡘ
࠾ࠤ࡯࡚ࠪࡦࠍߣࠆ
㧞㧚⋴⼔Ꮷ߿ઁ⡯⒳ߦኻߒߡ

⋴⼔ߩᗧ࿑߿ᔅⷐᕈࠍ⺑᣿ߒ‫ޔ‬
ද௛ߔࠆ
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⡯⒳ߣද௛ߒߡ⸃᳿ߦዉߊ
㧠㧚ࠦ࡯࠺ࠖࡀ࡯࠲࡯ߩᓎഀ

ࠍᜂ޿‫ޔ‬ᄙ⡯⒳㑆ද௛ߩ౞ṖൻࠍផㅴߔࠆΩ㧚⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ  ୃ჻⺖⒟ୃੌ↢ߪ‫ߩⴕ⃻ޔ‬ᴺᓞ㨯೙ᐲ࡮᡽╷߇ੱ‫ߩޘ‬ஜᐽ߿⋴⼔ߦߤߩࠃ߁ߥᓇ㗀ࠍ߽ߚࠄߒߡ޿ࠆ߆ࠍಽᨆߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫ߩߘޕ‬ಽᨆ⚿ᨐߦၮߠ߈‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ߇‫ߩߘޔ‬㓙ߦ⋴⼔ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯ⷰࠍ෻ᤋߒߚᣇ╷ࠍ⠨߃ࠆߎߣ߽᳞߼
ࠄࠇࠆ‫ޕ‬

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⃻ⴕߩᴺᓞ࡮೙ᐲ࡮᡽╷߇ஜ

8++



ᐽߣ⋴⼔ߦਈ߃ࠆᓇ㗀ࠍಽᨆߒ‫⸃ޔ‬᳿╷ࠍឭ᩺ߔࠆ

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ୃᓧߔߴ߈⢻ജߩౝኈ
㧝㧚ੱ‫ߩޘ‬ஜᐽჇㅴߣ޿߁ⷞ

ὐ߆ࠄ‫ߩ⼔⋴ޔ‬᡽╷ࠍᬌ⸛ߔࠆ㧞㧚ක≮᡽╷߇୘‫ޔ‬㓸࿅‫❱⚵ޔ‬ߦ߽ߚࠄߔᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ╷ࠍ⠨᩺ߔࠆ
㧟㧚⋴⼔ኾ㐷⡯ߣߒߡߩ⠨߃߿ଔ୯߇᡽╷ߦ෻ᤋߐࠇࠆࠃ
߁ᣇ╷ࠍ⠨߃ࠆ㧠㧚⸻≮ႎ㈽߿੺⼔଻㒾ߥߤߩ᡽╷࡮೙ᐲ߇ࠤࠕឭଏᣇᴺ߿
ࠕ࠙࠻ࠞࡓߦ෸߷ߔᓇ㗀ࠍಽᨆߒ‫ޔ‬ᡷༀ᩺ࠍឭ᩺ߔࠆ





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Ϊ㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆᢎ⢒ⅣႺߠߊࠅߦขࠅ⚵߻  ୃ჻⺖⒟ୃੌ↢ߪ‫⼔⋴ޔ‬ኾ㐷⡯ࠍ⢒ߡࠆߚ߼ߩᢎ⢒⊛ᕁ⠨ࠍ߽ߟߎߣ߇ᔅⷐߢ޽ࠆ‫ޕ‬

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ቇ⠌߇ଦㅴߔࠆࠃ߁ߦ‫ޔ‬ᢎ 





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8+++ ⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆᢎ



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ୃᓧߔߴ߈⢻ജߩౝኈ
㧝㧚ቇ⠌⠪ߩ࠾࡯࠭ࠍᛠីߒ‫ ޔ‬ቇ⠌⠪ߦ޽ࠊߖߚᢎ⢒ᴺࠍℂ⸃ߔࠆ㧞㧚⋴⼔ቇߩ⸘↹⊛࡮ലᨐ⊛ߥᢎ⢒
ᣇᴺࠍឭ᩺ߔࠆ
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ᢎ⢒⊛㑐ࠊࠅࠍⴕ߁
㧠㧚

⢒ⅣႺࠍᢛ߃ࠆ
Ϋ㧚୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚߔ  ୃ჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኻ⽎ࠍᠩ⼔ߔࠆߚ߼ߦ୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍ㜞߼ࠆߣߣ߽ߦ‫ޔ‬ࠤࠕᛛⴚ߿ᖱႎᛛⴚߩ૶↪ߦ㑐ߔࠆ୶ℂේೣ߿ၮḰࠍℂ⸃ߒߚ߁߃ߢታ〣ࠍⴕ޿‫ޔ‬ኾ㐷⡯ߣߒߡߩ୶ℂ⊛⽿ോࠍᨐߚߔߎߣ߇᳞߼ࠄࠇࠆ‫ޕ‬
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୶ℂ⊛࡮ᢥൻ⊛ᗵฃᕈࠍᜬߞ+:ߡኾ㐷⡯ߣߒߡߩ⽿ോࠍᨐߚ
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ୃᓧߔߴ߈⢻ജߩౝኈ
㧝㧚୘ੱ࡮ኅᣖ࡮㓸࿅ߩᜬߟᢥ

ൻ߿⢛᥊ࠍᛠីߒ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆ㧞㧚቟ోߥࠤࠕⅣႺࠍଦㅴߒ‫୶ޔ‬ℂ⊛ታ〣ࠍ᥉෸ߔࠆ
㧟㧚୶ℂߦ㑐ߔࠆℂ⺰ࠍᵴ↪

ߒߡ‫୶ޔ‬ℂ⊛໧㗴ߦ⋥㕙ߒߡ޿ࠆኻ⽎߿ኾ㐷⡯ࠍᡰេߔࠆ









資料４





ά㧚⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆࠕࠗ࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ  ୃ჻⺖⒟ୃੌ↢ߪ‫ޔ‬ኾ㐷⡯ߣߒߡߩືቇࠍ⊒ዷߐߖ‫ࠍⷰ⼔⋴ޔ‬᣿⏕ߦ⴫⃻ߒ‫ࠍ⼔⋴ޔ‬ታ〣ߔࠆߎߣ߇᳞߼ࠄࠇࠆ‫↢ޔߦࠄߐޕ‬ᶦࠍㅢߓߡቇ⠌ߒߡ޿ߊᆫ൓ࠍ߽ߜ‫ᦨޔ‬ᣂߩ⍮⷗ࠍᓧߡ⋴⼔ߦᵴ↪ߔࠆദജࠍ⛯ߌ‫⼔⋴ߩઁޔ‬⡯ߩᓎഀࡕ࠺࡞ߣߥࠆߎߣ߽᳞߼ࠄࠇࠆ‫ޕ‬


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:

⋴⼔ቇߩ⊒ዷߦነਈߢ߈ࠆࠕ

ࠗ࠺ࡦ࠹ࠖ࠹ࠖࠍᒻᚑߔࠆ

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ୃᓧߔߴ߈⢻ജߩౝኈ
㧝㧚⋴⼔߿ක≮ߦ㑐ߔࠆኾ㐷⡯ߣߒߡߩືቇࠍ⊒ዷߐߖ‫⼔⋴ޔ‬ታ〣ߦ⛔วߔࠆ
㧞㧚⋴⼔ቇࠍขࠅᏎߊ⺖㗴ߦߟ޿ߡߩᗵฃᕈࠍ㜞߼‫ޔ‬ਥ૕ᕈࠍᜬ
ߞߡᡷༀߔࠆ
㧟㧚ࠃࠅ⦟޿ࠤࠕࠍ᳿ቯߔࠆߚ߼
ߦᦨᣂߩ⍮⷗ࠍᓧߥ߇ࠄታ〣ߔࠆࡕ࠺࡞ߦߥࠆ
㧠㧚ኾ㐷⡯ߣߒߡ⋴⼔ⷰࠍ᣿⏕ߦߔࠆ‫⎇ᧄޔઁߩߘع‬ⓥߦኻߔࠆߏ⾰໧࡮ߏᗧ⷗߇޽ࠇ߫‫߈ᦠ߅ޔ‬ਅߐ޿‫ޕ‬













એ਄ߢ⚳ੌߢߔ‫ޕ‬࿁╵߳ߩߏදജ‫ޕߚߒ߹޿ߑߏ߁ߣ߇ࠅ޽ޔ‬








⾗ᢱ㧡
‫ޟ‬##%0㧦ୃ჻ᢎ⢒ߩࠛ࠶࠮ࡦࠪࡖ࡞‫⻠ߩޠ‬Ṷ᭎ⷐ

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ᣣᧄߦ߅ߌࠆ⋴⼔♽ߩඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ୃੌ↢ߦ᳞߼ࠄࠇࠆ⢻ജ㧝㧚ㄭ⮮ᚱᳯ᳁‫ޟ‬AACN㧦ୃ჻ᢎ⢒ߩࠛ࠶࠮ࡦࠪࡖ࡞‫⻠ߏߩޠ‬Ṷࠃࠅ
ᐔᚑ 25 ᐕ 1 ᦬ 24 ᣣ㧔ᧁ㧕ߦ㜞⍮⋵┙ᄢቇߦ߅޿ߡ‫࠻࠶࡝ࡔ࡮࡞ࠛࡘࡒࠨޔ‬ᄢቇ⋴⼔ቇㇱߩㄭ⮮ᚱᕺ᳁ߦ‫ޔ‬AACN㧔ࠕࡔ࡝ࠞ⋴⼔ᄢቇද⼏ળ㧕ߩୃ჻⺖⒟ᢎ⢒ߩᧄ⾰⊛ⷐ⚛㧔The
Essential of Master’s Education in Nursing, 2011㧕ߦߟ޿ߡߏ⻠Ṷ޿ߚߛ޿ߚ‫ޕ‬ߏ⻠Ṷߩਛߢ‫ઁߪߢࠞ࡝ࡔࠕޔ‬࿖ߦᲧセߒක≮⾌߇㜞㛛ߒߡ޿ࠆߎߣ‫ޔ‬1999 ᐕߦ IOM
㧔Institute of Medicine㧕߇‫ޔ‬ක≮ࡒࠬߦࠃࠆᱫ੢ᢙ߿ක≮ࡒࠬߦࠃࠆࠦࠬ࠻╬ߦ㑐ߔࠆ࠺࡯࠲ࠍႎ๔ߒߚߎߣߢ‫ޔ‬ක≮ߦ߅ߌࠆᖚ⠪ߩ቟ో଻⸽߇ᄢ߈ߥ⺖㗴ߣߥߞߚߎߣ߇⺑᣿ߐࠇߚ‫ ߡߒߘޕ‬2001 ᐕߦߪ቟ో‫ޔ‬ലᨐ⊛‫ޔ‬ല₸߇⦟޿‫ޔ‬ᖚ⠪ਛᔃ‫౏ޔ࡯࡝ࡓࠗ࠲ޔ‬ᐔߢ޽ࠆߎߣࠍක≮ߩࠕ࠙࠻ࠞࡓߣߔࠆᣂߒ޿ࡋ࡞ࠬࠤࠕࠪࠬ࠹ࡓࠍᛂߜ಴ߒߚ‫ޕ‬ߐࠄߦ IOM ߪ‫ߩ⼔⋴ޟ‬዁᧪‫⼔⋴ޔߢ࠻࡯ࡐ࡟ߩޠ‬Ꮷߩᢎ⢒ࠪࠬ࠹ࡓࠍᡷༀߒ‫ࠅࠃޔ‬㜞ᐲߩᢎ⢒߿⸠✵ࠍᦨᄢ㒢ߦᵴ↪ߒߚ⋴⼔ታ〣ࠍߔࠆߴ߈ߢ޽ࠆߎߣ‫ޔ‬ක≮ࠪࠬ࠹ࡓߩᡷ㕟ߦߪઁߩක≮⠪ߣࡄ࡯࠻࠽࡯ߢ޽ࠆߎߣ‫ޔ‬IT ࠍᵴ↪ߒࠃࠅ⦟޿࠺࡯࠲߿ᖱႎߩ෼㓸ࠍⴕ޿‫ޔ‬⡯႐ⅣႺߩ᭴▽߿᡽╷ߩ┙᩺ࠍⴕ߁ߎߣ߇␜ߐࠇߚ‫ޕ‬
߹ߚ IOM ߩႎ๔ࠍฃߌߡ 2005 ᐕߦᆎ߹ߞߚ QSEN㧔Quality and Safety Education for
Nurses㧦⋴⼔Ꮷߩߚ߼ߩ⾰ߣ቟ోᢎ⢒㧕ߪ‫ޔ‬ක≮ࠪࠬ࠹ࡓߦ߅ߌࠆ⾰ࠍ⛮⛯⊛ߦᡷༀߒ‫ޔ‬቟ోࠍะ਄ߐߖࠆߚ߼ߦᔅⷐߥ⍮⼂‫ޔ‬ᛛⴚ‫ޔ‬ᘒᐲߩ 3 ஥㕙ࠍᜬߟ⋴⼔Ꮷࠍ⢒ߡࠆߎߣࠍ⋡ᮡߣߒߡ߅ࠅ‫ߩ߼ߚߩߘޔ‬ᢎ⢒ߦ߅ߌࠆၮḰ߿ࠦ࡯ࠬࠍቯ߼‫ߩࠞ࡝ࡔࠕޔ‬ᄢቇߢ߽ QSEN
ࠍࠞ࡝ࠠࡘ࡜ࡓߦขࠅ౉ࠇࠃ߁ߣߔࠆേ߈߇ᐢ߹ߞߡ߈ߡ޿ࠆ‫ޕ‬
LACE㧔Licensure, Accreditation, Certification and Education㧕ߪ‫ޔ‬㤗㈮⋴⼔Ꮷ㧔CRNA㧕
‫ޔ‬ഥ↥Ꮷ㧔CNM㧕‫࠻ࠬ࡝ࡖࠪࡍࠬࠬ࡯࠽࡞ࠞ࠾࡝ࠢޔ‬㧔CNS㧕‫࡯࠽࡚ࠪࠖ࠹ࠢ࡜ࡊࠬ࡯࠽ޔ‬㧔CNP㧕ߣ޿߁ 4 ߟߩᓎഀࠍߣࠆ APRN㧔㜞ᐲታ〣⋴⼔Ꮷ㧕ߦ㑐ߒߡߪ‫⋙ޔ⸵఺ޔ‬ᩏ‫⹺ޔ‬ቯ‫ޔ‬ᢎ⢒ߦߟ޿ߡ 4 ࿅૕߇หᗧߒߚ Consensus Model ࠍ૞ᚑߒߚ‫ޕ‬Consensus Model ߦ߅޿ߡ APRN ߪ‫ޔ‬ஜᐽߩჇㅴ߿ᖚ⠪ߩஜᐽ໧㗴ߩࠕ࠮ࠬࡔࡦ࠻‫⸻ޔ‬ᢿ‫⽿ߦ࠻ࡦࡔࠫࡀࡑޔ‬છ
ߣ⽿ോࠍ⽶߁ੱ‫⮎ߪߦ౉੺ߩߘޔߢޘ‬ℂቇ⊛ಣᣇ߿㕖⮎ℂቇ⊛੺౉ࠍ฽߻߽ߩߢ޽ࠆߣቯ
⟵ߐࠇ‫ޔ‬6 ߟߩᲣ㓸࿅㧔৻↢ࠍㅢߓߡߩኅᣖ࡮୘ੱ‫ޔ‬ᚑੱ㧙⠧ੱ‫ޔ‬ዊఽ‫ޔ‬ᣂ↢ఽ‫ޔ‬ᅚᕈߩஜᐽ࡮ᕈߦ㑐ㅪߒߚ‫ࠬ࡞ࡋ࡞࠲ࡦࡔ࡮␹♖ޔ‬㧕߇␜ߐࠇߚ‫ ߪ࡞࠺ࡕߩߎޕ‬2015 ᐕࠍቢోታᣉ
ߩ⋡ᮡߣߒߡ߅ࠅ‫ޔ‬ฦᢎ⢒ᯏ㑐ߢߪࠞ࡝ࠠࡘ࡜ࡓᄌᦝ߇ᬌ⸛ߐࠇߡ޿ࠆߣߎࠈߢ޽ࠆ‫ޕ‬ߎߩࠃ߁ߥ⢛᥊߆ࠄ‫ޔ‬AACN ߪኾ㐷ߦ㑐ࠊࠄߕᄢቇ㒮ᢎ⢒ߔߴߡߩၮ⋚ߢ޽ࠆ The
Essentials of Master’s Education for Advanced Practice Nursing㧔1996 ᐕ㧕ߢᄢቇ㒮⋴⼔ߩࠦࠕߣ APN ⥃ᐥࠦࠕࠍ␜ߒߡ޿ߚ߇‫ޔ‬2011 ᐕߦߪ 9 ߩᧄ⾰⊛ⷐ⚛ߦᄌᦝߐࠇߚ‫ޕ‬

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̪1996 ᐕ

㧦The Essentials of Master’s Education for Advanced Practice Nursingߢߪ‫ޔ‬ୃ჻⺖⒟ୃੌ↢ߩࠦࠕࠞ࡝ߩౝኈߪ‫ޔ‬㜞ᐲታ〣⋴⼔ߩࠦࠕࠞ࡝ߪ‫ޔ‬Σ㧚⎇ⓥΣ㧚㜞ᐲߩஜᐽ/ࡈࠖࠫࠞ࡞ࠕ࠮ࠬࡔࡦ࠻

Τ㧚ක≮ߩ᡽╷‫ޔ‬ㆇ‫⽷߮ࠃ߅ޔ‬ḮΤ㧚㜞ᐲߩ↢ℂቇߣ∛ᘒ↢ℂቇ  A. ක≮᡽╷Υ㧚㜞ᐲߩ⮎ℂቇ  B. ක≮ឭଏࠪࠬ࠹ࡓߩㆇ༡
  C. ක≮⽷ḮΥ㧚୶ℂΦ㧚ኾ㐷⡯ߩᓎഀ㐿⊒Χ㧚⋴⼔ታ〣ߩℂ⺰⊛ၮ⋚Ψ㧚ੱߩᄙ᭽ᕈߣ␠ળ⊛໧㗴Ω㧚ஜᐽჇㅴߣ∔∛੍㒐

̪2011 ᐕᡷቯ㧦The Essentials of Master’s Education in Nursing ߩ Essential ߪ‫ޔ‬Σ㧚⑼ቇߣࡅࡘ࡯ࡑ࠾࠹ࠖࠍၮ⋚ߣߒߚታ〣Τ㧚⚵❱⊛࡮૕♽⊛࡝࡯࠳࡯ࠪ࠶ࡊ
Υ㧚⾰ᡷༀߣ቟ోᕈ
Φ㧚ቇ໧ߩታ〣߳ߩォ឵ߣ⛔วΧ㧚ᖱႎᛛⴚߣක≮ᛛⴚΨ㧚ක≮᡽╷ߣᠩ⼔(ࠕ࠼ࡏࠞࠪ̆)Ω㧚ᖚ⠪߿㓸࿅ߩஜᐽ᳓Ḱߩะ਄ࠍ߼ߑߒߚኾ㐷⡯㑆දജΪ㧚⥃ᐥ⊛੍㒐ߣ㓸࿅ߩஜᐽ㧔population health㧕ߦၮߠ޿ߚஜᐽჇㅴ
Ϋ㧚ୃ჻⺖⒟ୃੌ࡟ࡌ࡞ߩ⋴⼔ታ〣

 2011 ᐕߩࠛ࠶࠮ࡦࠪࡖ࡞ߢߪ‫ޔ‬‫ޟ‬Σ㧚⑼ቇߣࡅࡘ࡯ࡑ࠾࠹ࠖࠍၮ⋚ߣߒߚታ〣‫ߢޠ‬ℂ⺰⊛ߥ߽ߩ߇฽߹ࠇߚ‫ޕ‬‫ޟ‬Τ㧚⚵❱⊛࡮૕♽⊛࡝࡯࠳࡯ࠪ࠶ࡊ‫ޔࡊ࠶ࠪ࡯࠳࡯࡝޿⦟ߩ⾰ޔߪߢޠ‬ࠪࠬ࠹ࡓߩ⠨߃ᣇ߆ࠄߩ࡝࡯࠳࡯ࠪ࠶ࡊࠍ⠨߃‫ޔ‬ታ〣ߒߡ޿ߌࠆ⢻ജߦ㑐ߔࠆᢎ⢒߇ᔅⷐߢ޽ࠆߣߐࠇߚ‫ޟޕ‬Υ㧚⾰ᡷༀߣ቟ోᕈ‫ޔߪߢޠ‬IOM ߿ QSEN ߩᓇ㗀ࠍฃߌ‫ߩ⾰ߩࠕࠤޔ‬ะ਄ߣ቟ో߇ࠢࡠ࡯࠭ࠕ࠶ࡊߐࠇߚ‫ޕ‬‫ޟ‬Φ㧚ቇ໧ߩታ〣߳ߩォ឵ߣ⛔ว‫⎇ޔߪޠ‬ⓥߩᵴ↪ߢ޽ࠆ߇‫ߪߦࠇߘޔ‬ታ㓙ߦ⎇ⓥࠍⴕ޿ᣂߒ޿⍮⼂ࠍ⊒⷗ߒߡ޿ߊߎߣߣ‫⎇ޔ‬ⓥ⚿ᨐߩᵴ↪ߣ߇฽߹ࠇߡ޿ࠆ‫ޕ‬‫ޟ‬Χ㧚ᖱႎᛛⴚߣක≮ᛛⴚ‫ޔߪޠ‬IT ࠹ࠢࡁࡠࠫ࡯ߩㅴᱠߢක≮ࠨ࡯ࡆࠬߩ
ឭଏ߇ᄌࠊߞߡ߈ߡ޿ࠆߎߣ߇ᓇ㗀ߒߡ޿ࠆ‫ޕ‬‫ޟ‬Ψ㧚ක≮᡽╷ߣᠩ⼔ ࠕ࠼ࡏࠞࠪ̆ ‫ޔߪޠ‬ᡷ⸓೨ߩࠛ࠶࠮ࡦࠪࡖ࡞ߦ߽฽߹ࠇߡ޿ߚ߇‫߇࡯ࠪࠞࡏ࠼ࠕࠅࠃޔ‬ᒝ⺞ߐࠇ‫ޔ‬ක≮ߦ㑐ߔ

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ࠆ⥄ಽߩᗧ⷗ࠍ߽ߞߡ⊒⴫ߔࠆߎߣ߿‫ޔ‬ᠩ⼔ࠍߔࠆߣ޿߁ߎߣ‫ޔ‬᡽╷᳿ቯߦ߽ᓇ㗀ࠍਈ߃ࠆࠃ߁ߥߎߣ߇ᔅⷐߣߐࠇߡ޿ࠆ‫ޟޕ‬Ω㧚ᖚ⠪߿㓸࿅ߩஜᐽ᳓Ḱߩะ਄ࠍ߼ߑߒߚኾ㐷⡯㑆දജ‫ޔߪޠ‬㓸࿅ߣ୘ੱߩࠕ࠙࠻ࠞࡓࠍᡷༀߢ߈ࠆࠃ߁ߥኾ㐷⡯㑆ߩද௛߇ߢ߈ࠆߎߣߢ‫ޔ‬
IOM ߩ‫ߩ⼔⋴ޟ‬዁᧪‫ ߢ࠻࡯ࡐ࡟ߩޠ‬InteŕProfessional Education ߇ᢎ⢒ߩਛߢᒝߊᛂߜ
ߛߐࠇߚߎߣ߇ᓇ㗀ߒߡ޿ࠆ‫ޕ‬‫ޟ‬Ϊ㧚⥃ᐥ⊛੍㒐ߣ㓸࿅ߩஜᐽ㧔RQRWNCVKQPJGCNVJ㧕ߦၮߠ޿ߚஜᐽჇㅴ‫ޔߪߢޠ‬㓸࿅߳ߩኻᔕ‫ޔ‬ᄢዪ߆ࠄ࿖᳃ߩஜᐽࠍ⷗ࠆⷞὐ߇␜ߐࠇߡ޿ࠆ‫ޕ‬‫ޟ‬Ϋ㧚ୃ჻⺖⒟ୃੌ࡟ࡌ࡞ߩ⋴⼔ታ〣‫⥃ޔߪޠ‬ᐥߢታ㓙ߦᓎഀࠍߣߞߡ‫ޔ‬ታ⠌ߒߡ޿ߊߎߣ߇฽
߹ࠇߡ޿ࠆ‫ޕ‬ ߎߩࠃ߁ߦ 2011 ᐕߩࠛ࠶࠮ࡦࠪࡖ࡞ߦ߅޿ߡߪ‫ߩ⾰ߩࠕࠤޔ‬ะ਄ߣኻ⽎ߩ቟ోࠍ଻㓚ߔࠆߚ߼ߦ‫⎇ޔ‬ⓥᚑᨐࠍታ〣ߦᵴ↪ߒߡ޿ߊߎߣ‫ޔ‬ᖱႎᛛⴚࠍലᨐ⊛ߦᵴ↪ߔࠆߎߣ‫ޔ‬ኾ㐷⡯㑆ߢද௛ߔࠆߎߣ‫⊒ࠍࡊ࠶ࠪ࡯࠳࡯࡝ޔ‬ើߔࠆߎߣߩᔅⷐᕈ߇␜ߐࠇߡ޿ࠆ‫ߦࠄߐޕ‬ኻ⽎߇୘߆ࠄ㓸࿅߹ߢᐢ߇ࠅࠍ߽ߜ‫ߩࠇߙࠇߘޔ‬ኻ⽎ࠍᠩ⼔ߔࠆߚ߼ߦߪ‫ޔ‬᡽╷ߦ߽㑐ਈߔࠆᔅⷐ߇޽ࠆߣ޿߃ࠆ‫ޕ‬ ᣣᧄߦ߅޿ߡඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ୃੌ↢߇ୃᓧߔߴ߈⢻ജࠍᬌ⸛ߔࠆ㓙ߦߪ‫ޔ‬IOM ߦߥࠄ޿ᣣᧄߩක≮ߩࠕ࠙࠻ࠞࡓ߿቟ోߦ㑐ߔࠆ࠺࡯࠲ࠍ〯߹߃ࠆߎߣ‫ޔ‬QSEN ߩක≮ࠪࠬ࠹ࡓߦ߅ߌࠆ⾰ࠍᡷༀߒ‫ޔ‬቟ోࠍะ਄ߐߖࠆߚ߼ߦᔅⷐߥ⍮⼂‫ޔ‬ᛛⴚ‫ޔ‬ᘒᐲߩⷞὐ߇฽߹
ࠇߡ޿ࠆ߆ࠍᬌ⸛ߔࠆߎߣ߇⺖㗴ߢ޽ࠆߣ⠨߃ࠆ‫ޕ‬㧞㧚ୃ჻ᢎ⢒ߩࠛ࠶࠮ࡦࠪࡖ࡞ߦࠃࠆᢎ⢒ߩ⾰ߩ଻㓚㧝㧕ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ୃੌ↢߇ୃᓧߔߴ߈⢻ജࠍ᳿ቯߔࠆࡊࡠ࠮ࠬߦߟ޿ߡ
AACN ߩࠛ࠶࠮ࡦࠪࡖ࡞ߪࠕࡔ࡝ࠞߦ߅ߌࠆක≮ߩ⺖㗴ࠍ〯߹߃‫ߩ⾰ߩࠕࠤޔ‬ะ਄ࠍ⋡ᜰߒ‫⼔⋴ޔ‬ᢎ⢒⠪‫⥃ޔ‬ᐥኅ‫⎇ޔ‬ⓥ⠪ࠄ߇⼏⺰ࠍ㊀ߨߡ᳿ቯߐࠇߚ߽ߩߢ޽ࠆ‫ߡߴߔߚ߹ޕ‬ߩୃ჻⺖⒟ߩᢎ⢒ࠍฃߌߚ⋴⼔Ꮷߦᔅⷐߥⷐ⚛ࠍ᛽಴ߒߚ߽ߩߢ޽ࠅ‫⥃ޔ‬ᐥߢታ〣ߔࠆ⋴⼔Ꮷߩߺߥࠄߕ‫⎇ޔ‬ⓥ‫ޔ‬ᢎ⢒ߣ᭽‫ߥޘ‬ᓎഀߦ߅޿ߡஜᐽߩჇㅴ߿ක≮ߩ⾰ะ਄ߩߚ߼ߦᔅ
ⷐߥ⍮⼂߿ᛛⴚ‫ޔ‬ᘒᐲ߇⴫ࠊߐࠇߚ߽ߩߢ޽ࠆ‫ߚ߹ޕ‬ක≮ࠍขࠅᏎߊ⺖㗴‫ޔ‬ᛛⴚߩㅴᱠ‫ޔ‬ᄙ᭽ᕈߩჇടߦ߽ኻᔕߒߡᧄ⾰⊛ⷐ⚛ߩ⷗⋥ߒߪ࿑ࠄࠇߡ߅ࠅ‫⃻ޔ‬࿷ߩᣣᧄߩඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ୃੌ↢ߦߣߞߡ߽ୃᓧߔߴ߈ⷐ⚛ߣߒߡ᳞߼ࠄࠇࠆౝኈ߇฽߹ࠇߡ޿ࠆߣ⠨߃ࠆ‫ޕ‬ㄭ⮮᳁ߩᜰ៰ߦ߽޽ࠆࠃ߁ߦ‫ޔ‬ᣣᧄߩ⃻⁁ࠍ〯߹߃‫ߩ⾰ߩࠕࠤޔ‬ᡷༀߦߟߥ߇ࠆࠃ߁‫ޔ‬ᢎ⢒ᯏ㑐‫⎇ޔ‬ⓥ⠪‫⥃ޔ‬ᐥኅߣᗧ⷗੤឵߿⼏⺰ࠍⴕ޿‫ࠍࠬࠨࡦ࠮ࡦࠦޔ‬ᓧࠆࡊࡠ࠮ࠬࠍ〯ࠎߢ‫ޔ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ୃੌ↢ߦ᳞߼ࠄࠇࠆ⢻ജࠍ᣿⏕ߦߒߡ޿ߊߎߣ߇㊀ⷐߢ޽ࠆ‫ޕ‬㧞㧕ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ୃੌ↢߇ୃᓧߔߴ߈⢻ജࠍࠞ࡝ࠠࡘ࡜ࡓߦ⚵ߺ౉ࠇࠆᣇᴺߦߟ޿ߡ ㄭ⮮᳁߆ࠄߪࠨࡒࡘࠛ࡞࡮ࡔ࡝࠶࠻ᄢቇߩࠦ࡯ࠬࠍ଀ߦ‫ ߣࡓ࡜ࡘࠠ࡝ࠞޔ‬Essential ߩ㑐ㅪࠍ⺑᣿޿ߚߛ޿ߚ‫ޕ‬ౕ૕⊛ߦߪ‫ࡓ࡜ࡘࠠ࡝ࠞޔ‬਄ߩฦࠦ࡯ࠬߣ EssentialΣ㨪Ϋ߅ࠃ߮ 3Psࠍࡑ࠶ࡇࡦࠣߒ‫ޔ‬ฦࠦ࡯ࠬߢ EssentialΣ㨪Ϋߩߤࠇ߇᛼ߐ߃ࠄࠇߡ޿ࠆ߆ࠍ⏕⹺ߒߡ޿ߊ

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ߣߩߎߣߢ޽ߞߚ‫ޔ߫߃଀ޕ‬ᢎ⢒ߩฦࡊࡠࠣ࡜ࡓߢቯ߼ࠆ⋡ᮡߦߪ‫ߢࡓ࡜ࠣࡠࡊߩߘޔ‬૗ࠍⷞὐߣߒ‫ޔ‬૗ࠍߔࠆߩ߆‫ࠍࠇߘޔ‬ቇ߱ߦߪߤߩࠃ߁ߥౝኈߩࠦ࡯ࠬ߇ᔅⷐߢ޽ࠆ߆ࠍ⠨߃ߡ޿ߊߎߣߦߥࠆ߇‫ ߣࠬ࡯ࠦߦᤨߩߘޔ‬Essential ߩࡑ࠶ࡇࡦࠣࠍⴕ߁ߎߣߢ Essential߇ᛮߌ⪭ߜࠆߎߣ߇ߥ޿ࠃ߁ߦ⏕⹺߇ߢ߈ࠆ‫ߺ⚵ߡߞࠃߦࠬ࡯ࠦޕ‬ㄟ߹ࠇߡ޿ࠆ Essentialߪ⇣ߥࠆ߇‫ోࡓ࡜ࡘࠠ࡝ࠞޔ‬૕ࠍㅢߔߣ‫ ߩߡߴߔޔ‬Essential ߇⚵ߺㄟ߹ࠇߡ޿ࠆߎߣߢ‫ޔ‬ୃ჻ᢎ⢒ߢߩ⾰߇ᜂ଻ߐࠇߡ޿ࠆ‫ޕ‬ ᧄ⺞ᩏߦࠃߞߡ‫ޔ‬ඳ჻೨ᦼ㧔ୃ჻㧕⺖⒟ୃੌ↢߇ୃᓧߔߴ߈⢻ജ߇᣿⏕ߦߥࠇ߫‫ࠇߘޔ‬ࠄߩ⢻ജߔߴߡࠍࠞ࡝ࠠࡘ࡜ࡓߢ଻㓚ߒߡ޿ߊߎߣ߇ᔅⷐߣߥࠆ‫ࡊߩߤޔߪߦ߼ߚߩߘޕ‬ࡠࠣ࡜ࡓߢߤߩ⢻ജߩୃᓧࠍ⋡ᜰߔߩ߆‫ߦࠄߐޔ‬ฦ⑼⋡ߢౕ૕ߦߤߩࠃ߁ߥᣇᴺߢᢎ⢒ߔࠆߎߣߢ‫ߩߤޔ‬⢻ജߩୃᓧ߇ᦸ߼ࠆߩ߆ࠍࡑ࠶ࡇࡦࠣߩᚻᴺࠍ↪޿ߥ߇ࠄ࠴ࠚ࠶ࠢߒ‫ୃޔ‬ᓧߔߴ߈⢻ജߣ࡝ࡦࠢߒߚࠞ࡝ࠠࡘ࡜ࡓߩ᭴▽ࠍㅴ߼ߡ޿ߊᔅⷐ߇޽ࠆ‫ޕ‬

資料５

AACN䋺
ୃ჻ᢎ⢒䈱䉣䉾䉶䊮䉲䊞䊦䉰䊚䊠䉣䊦䊶䊜䊥䉾䊃ᄢቇ⋴⼔ቇㇱ
Fusae Kondo Abbott (ㄭ⮮ᚱᕺ䋩⢛᥊• ක≮⾌䈱㜞㛛• ᖚ⠪䈱቟ో: QSEN (http://qsen.org/)• ක≮䈱⾰• ᣂ䈚䈇ᴦ≮䇮ᬌᩏ• ක≮䈫ᢎ⢒䈱႐䈮䈍䈔䉎IT䈱ᵴ↪
• DNP• IOM: ⋴⼔䈱዁᧪䋨2012䋩(http://www.iom.edu/~/media/Files/Report%20Files/2010/The-Future-ofNursing/Future%20of%20Nursing%202010%20Report%20Brief.pdf)• ኾ㐷⡯㑆ද௛䈱ᢎ⢒(http://www.aacn.nche.edu/education/pdf/APRNReport.pdf)

資料５ᖚ⠪䈱቟ో䊶ක≮䈱⾰䈫⸻≮ႎ㈽• 1999ᐕ IOM 䈱ႎ๔ ක≮ࡒࠬߦࠃࠆᱫ੢ᢙ㧦ᐕ㑆48,000 - 98,000 ක≮䊚䉴䈱䉮䉴䊃䋺ᄢ∛㒮䈪ᐕ㑆⚂5⊖ਁ䊄䊦 ౉㒮ᖚ⠪25ੱ䈮䋱ੱ䈱ഀว䈪ක≮੐᡿䈮ㆣㆄ• 2005ᐕ Pay For Performance (P4P) Initiatives 䈇䈇⚿ᨐ䈮ႎ㈽䉕䋭䊜䊂䉟䉬䉝• 2008ᐕ PresentP
t on Ad
Admission䋨౉㒮ᤨ䈮⹺䉄䉌䉏䉎䋩i i 䋨౉㒮ᤨ䈮⹺䉄䉌䉏䉎䋩 ౉㒮ᓟ䈱⾰䈱ૐ䈇ක≮䉰䊷䊎䉴䈪ႎ㈽䉕ᓧ䉎䈖䈫䉕㒐䈓䈖䈫䈏⋡⊛䋲䋱਎♿䈱ᣂ䈚䈇䊓䊦䉴䉬䉝䉲䉴䊁䊛
Institute of Medicine 䋨IOM, 2001)• ක≮䈱䉝䉡䊃䉦䊛

–቟ో
–ലᨐ⊛
–ല₸䈏䉋䈇
–ᖚ⠪ਛᔃ–䉺䉟䊛䊥䊷䈪䈅䉎䈖䈫–౏ᐔ䈪䈅䉎䈖䈫

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IOM: ⋴⼔䈱዁᧪(http://www.iom.edu/~/media/Files/Report%20Files/2010/The-Future-ofNursing/Future%20of%20Nursing%202010%20Report%20Brief.pdf)• ⋴⼔Ꮷ䈲ᢎ⢒䉇⸠✵䉕ᦨᄢ㒢䈮ᵴ↪䈚䈢⋴⼔ታ〣䉕䈜䉎䈼䈐䈪䈅䉎䇯䉕䈜䉎䈼䈐䈪䈅䉎
• 䉴䊛䊷䉵䈮ᢎ⢒䊧䊔䊦䉕਄䈕䈩䈇䈎䉏䉎䉋䈉䈮䈚䈢ᢎ⢒䉲䉴䊁䊛䈱ᡷༀ䉕ㅢ䈛䈩䇮⋴⼔Ꮷ䈲䉋䉍㜞ᐲ䈱ᢎ⢒䉕ขᓧ䈜䉎䈼䈐䈪䈅䉎䇯• 䉝䊜䊥䉦䈮䈍䈔䉎ක≮䉲䉴䊁䊛䈱ᡷ㕟䈮㑐ਈ䈚䈩䇮⋴⼔Ꮷ䈲䇮කᏧ䉇䈠䈱ઁ䈱ක≮⠪䈫䈫䉅䈮䊐䊦䊌䊷䊃䊷䈭䊷䈪䈅䉎䈼䈐䈪䈅䉎䇯• ലᨐ⊛䈭⡯႐ⅣႺ䈱᭴▽䉇᡽╷䈱┙᩺䈮䈲䇮䉋䉍䉋䈇䊂䊷䉺䊷෼㓸䉇ᡷༀ䈘䉏䈢ᖱႎ䈱䉟䊮䊐䊤䉴䊃䊤䉪䉼䊞䊷䈏ᔅⷐ䈫䈭䉎䇯

IOM: ኾ㐷⡯ද௛䈱⢻ജ䋨http://www.aacn.nche.edu/education-resources/ipecreport.pdf䋩

• ୘䇱䈱ኾ㐷ᕈ䈮䈎䈎䉒䉍䈭䈒䇮䈜䈼䈩䈱ක≮䈱ኾ㐷⡯䈏䉅䈧⢻ജ:䈱ኾ㐷⡯䈏䉅䈧⢻ജ1) ᖚ⠪ਛᔃ䈱䉬䉝䊷䈱᧦㗄2) ኾ㐷⡯㑆䈱ද௛䉼䊷䊛䈪௛䈒3) 䉣䊎䊂䊮䉴䈮ၮ䈨䈒ታ〣䈱ណ↪
4) ຠ⾰ᡷༀ䈱䉝䊒䊨䊷䉼䈱ㆡ↪
ຠ⾰ᡷༀ
䊒
ㆡ↪
5) 㪠㪫䈱ᵴ↪

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QSEN
• Quality and Safety Education for Nurses䋨⋴⼔Ꮷ䈱䈢䉄䈱⾰䈫቟ో䈱ᢎ⢒䋩–http://qsen.org/about-qsen/–2005 䈮䉴䉺䊷䊃–ർ䉦䊨䊤䉟䊅ᄢቇ䇮 Robert WoodJohnson Foundation䇮AACN䈮䉋䉎ද௛• ో૕⋡ᮡ– ක≮䉲䉴䊁䊛䈮䈍䈔䉎⛮⛯⊛䈭⾰䈱ᡷༀ䉇቟ో䉕ะ਄䈘䈞䉎䈢䉄䈮ᔅⷐ䈭⍮⼂䇮ᛛⴚ䇮ᘒᐲ䉕䉅䈦䈢዁᧪䈱⋴⼔Ꮷ䉕⢒䈩䉎䈫䈇䈉⺖㗴䈮ኻಣ䈜䉎䈖䈫QSEN• QSEN Informational Video, part 1– http://www.youtube.com/watch?v=HnksQ
O7oi_Q• QSEN Informational Video, part 2– http://www.youtube.com/watch?v=ALzIlm2b2U

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APRN Consensus Model䋺LACE•

LACE䋺Licensure, Accreditation, Certification and
Education– Licensure䋭Li఺⸵ ታ〣䈱ᮭ㒢䉕ਈ䈋䉎఺⸵:– Accreditation䊷⋙ᩏ: ቇ૏䉇⹺ቯ䉕᝼ਈ䈜䉎࿅૕䈫䈚䈩⹺䉄䉌䉏䈩䈇䉎ᯏ㑐䈮䉋䉎ᱜᑼ䈭⋙ᩏ䈫ᛚ⹺– Certification䊷⹺ቯ: ኾ㐷⡯䈫䈚䈩ቯ䉄䉌䉏䈢ၮḰ䈮ว䈦䈢⍮⼂䇮ᛛⴚ䉇⚻㛎䉕᦭䈜䉎䈫ᱜᑼ䈮ᛚ⹺䈘䉏䉎– Education䋭ᢎ⢒: ᄢቇ㒮ᢎ⢒䇮䉁䈢䈲ᄢቇ㒮තᓟ䈱⹺ቯ䈱䊒䊨䉫䊤䊛䈪APRN䌳䈱ᱜᑼ䈭ᢎ⢒䉕ⴕ䈉(APRN Joint Dialogue Group Report, July 7, 2008)

APRN Consensus Model䋺LACE• APRN䈱⛔৻⷗⸃䊝䊂䊦䈱ታ〣ᯏᐨAPRNs䋺– 㤗㈮⋴⼔Ꮷ (CRNA)– ഥ↥ᇚ (CNM)– 䉪䊥䊆䉦䊦䊅䊷䉴䉴䊕䉲䊞䊥䉴䊃 (CNS)– 䊅䊷䉴䊒䊤䉪䊁䉾䉲䊢䊅䊷 (CNP)• APRN䈱ቯ⟵– ஜᐽ䈱Ⴧㅴ䉇ᖚ⠪䈱ஜᐽ໧㗴䈱䉝䉶䉴䊜䊮䊃䇮⸻ᢿᢿ䇮䊙䊈䉳䊜䊮䊃䈮⽿છ䈫⽿ോ䉕⽶䈉ੱ䇱䈪䇮䈠䈱䊈䉳䊜 䊃 ⽿છ䈫⽿ോ䉕⽶䈉ੱ䈠੺౉䈮䈲⮎ℂቇ⊛ಣᣇ䉁䈢䈲㕖⮎ℂቇ⊛੺౉䉕฽䉃䉅䈱䈪䈅䉎䇯(APRN Joint Dialogue Group Report, July 7, 2008)

資料５

APRN Consensus Model䋺LACE• APRN䈱ᢎ⢒䈫⹺ቯ䈱䉮䊮䊃䊨䊷䊦䉕䈜䉎䈖䈫䋺⋴⼔ᢎ⢒⠪䇮⹺ቯ࿅૕䇮఺⸵䈱⹺น– ኻ⽎㓸࿅䈮ㆡ䈚䈢⢻ജ– 䋶䈧䈱ኻ⽎㓸࿅:• ৻↢䉕ㅢ䈛䈩䈱ኅᣖ䊶୘ੱ• ᚑੱ䊷⠧ੱ• ዊఽ• ᣂ↢ఽ• ᅚᕈ䈱ஜᐽ䊶ᕈ䈮㑐ㅪ䈚䈢• ♖␹䊶䊜䊮䉺䊦䊓䊦䉴(APRN Joint Dialogue Group Report, July 7, 2008)

APRN Consensus Model䋺LACE• ቢోታᣉ䈱⋡ᮡ䋺 2015– ᢎ⢒ᯏ㑐䈪䈱ᄌᦝ䈲䋲䋰䋱䋵ᐕ䉁䈪䈮ቢੌ䈚䈩䈍䈒䈖䈫– 䉦䊥䉨䊠䊤䊛䈱ᄌᦝ䈏ቇ↢䈱ᚑ❣⸽᣿䈮᣿␜䈘䉏䈩䈇䉎䈖䈫 – 3Ps(APRN Joint Dialogue Group Report, July 7, 2008)

資料５

Model of Master’s Nursing Curriculum• ୃ჻⺖⒟䈱⋴⼔䈱䉮䉝:– ኾ㐷㗔ၞ䈱㆑䈇䈮㑐ଥ䈭䈒䇮䈜䈼䈩䈱ୃ჻䈱ቇ↢䈮䈫 䈩ᔅ㗇䈫䈭䉎ၮ␆⊛䈭䉦䊥䉨 䊤䊛↢䈮䈫䈦䈩ᔅ㗇䈫䈭䉎ၮ␆⊛䈭䉦䊥䉨䊠䊤䊛• ⋥ធ⊛䉬䉝䈱䉮䉝:– 㜞ᐲ䈭䊧䊔䊦䈪⋥ធ⊛䈭䉬䉝䉕ᖚ⠪䈮ឭଏ䈜䉎䈢䉄䈮ᔅ㗇䈫䈭䉎ౝኈ• ᯏ⢻㗔ၞ䈱䉮䊮䊁䊮䊃:– 㜞ᐲ䈭䊧䊔䊦䈪䈱⋴⼔䈱ᓎഀ䈫ᯏ⢻䉕⋡ᜰ䈚䈢⋴⼔ኾ㐷⡯࿅૕䉇⹺ቯ࿅૕䈮䉋䉍ቯ⟵䇮ᛚ⹺䈘䉏䈢⥃ᐥ䈫⻠⟵䈮䉋䉎ቇ⠌⚻㛎
(http://www.aacn.nche.edu/education/pdf/APRNReport.pdf)

ᣣᧄ⋴⼔♽ᄢቇද⼏ળ 䋨㪉㪇㪈㪉䋩 ⋴⼔♽ᄢቇ㒮䈮䈍䈔䉎ᢎ⢒䈱ၮḰ╷ቯ䈫⹏ଔ䈮㑐䈜䉎⺞ᩏ⎇ⓥ 䋨⾗ᢱ㪈㪄䌰 䋶䋩資料５⋥ធ䉬䉝䈱ታ〣 ኻ 㑆ធ⊛䉬䉝䈱ታ〣• ⋥ធ䉬䉝䉕ឭଏ䈜䉎㜞ᐲ⋴⼔ታ〣䉕⋡ᜰ䈜ୃ჻䈱䊒䊨䉫䊤䊛䈲䈜䈼䈩䇮ᰴ䈱䋳䈧䈱ᄢቇ㒮䊧䊔䊦䈱䉮䊷䉴䉕ឭଏ䈚䈭䈔䉏䈳䈭䉌䈭䈇:– ↢ℂቇ/∛ᘒ↢ℂቇ– 䊓䊦䉴䉝䉶䉴䊜䊮䊃– ⮎ℂቇ• තᓟ䈮㪘㪧㪩㪘㪥䈱ᓎഀ䉕䈫䉎䈖䈫䉕ᦼᓙ䈘䉏䉎ቇ↢䈲䇮䋲䋰䋰ᐕ䈱⛔৻⷗⸃䊝䊂䊦䈮᣿␜䈘䉏䈢ၮḰ䉕ḩ䈢䈜䋳䈧䈱⁛┙䈚䈢൮᜝⊛䈭ᄢቇ㒮䊧䊔䊦䈱䉮䊷䉴䉕ጁୃ䈚䈩䈇䈭䈔䉏䈳䈭䉌䈭䈇(http://www.aacn.nche.edu/education/pdf/APRNReport.pdf)

ᣣᧄ⋴⼔♽ᄢቇද⼏ળ 䋨㪉㪇㪈㪉䋩 ⋴⼔♽ᄢቇ㒮䈮䈍䈔䉎ᢎ⢒䈱ၮḰ╷ቯ䈫⹏ଔ䈮㑐䈜䉎⺞ᩏ⎇ⓥ 䋨⾗ᢱ㪈㪄䌰 㪎䋩資料５ᣣᧄ⋴⼔♽ᄢቇද⼏ળ 䋨㪉㪇㪈㪉䋩 ⋴⼔♽ᄢቇ㒮䈮䈍䈔䉎ᢎ⢒䈱ၮḰ╷ቯ䈫⹏ଔ䈮㑐䈜䉎⺞ᩏ⎇ⓥ 䋨⾗ᢱ㪈㪄䌰 㪐䋩ᣣᧄ⋴⼔♽ᄢቇද⼏ળ 䋨㪉㪇㪈㪉䋩 ⋴⼔♽ᄢቇ㒮䈮䈍䈔䉎ᢎ⢒䈱ၮḰ╷ቯ䈫⹏ଔ䈮㑐䈜䉎⺞ᩏ⎇ⓥ 䋨⾗ᢱ㪈㪄䌰 㪈㪈䋩資料５ᣣᧄ⋴⼔♽ᄢቇද⼏ળ 䋨㪉㪇㪈㪉䋩 ⋴⼔♽ᄢቇ㒮䈮䈍䈔䉎ᢎ⢒䈱ၮḰ╷ቯ䈫⹏ଔ䈮㑐䈜䉎⺞ᩏ⎇ⓥ 䋨⾗ᢱ㪈㪄䌰 㪈㪊䋩ᣣᧄ⋴⼔♽ᄢቇද⼏ળ 䋨㪉㪇㪈㪉䋩 ⋴⼔♽ᄢቇ㒮䈮䈍䈔䉎ᢎ⢒䈱ၮḰ╷ቯ䈫⹏ଔ䈮㑐䈜䉎⺞ᩏ⎇ⓥ 䋨⾗ᢱ㪈㪄䌰 㪈㪌䋩資料５ᣣᧄ⋴⼔♽ᄢቇද⼏ળ 䋨㪉㪇㪈㪉䋩 ⋴⼔♽ᄢቇ㒮䈮䈍䈔䉎ᢎ⢒䈱ၮḰ╷ቯ䈫⹏ଔ䈮㑐䈜䉎⺞ᩏ⎇ⓥ 䋨⾗ᢱ㪈㪄䌰 㪈㪏䋩ᣣᧄ⋴⼔♽ᄢቇද⼏ળ 䋨㪉㪇㪈㪉䋩 ⋴⼔♽ᄢቇ㒮䈮䈍䈔䉎ᢎ⢒䈱ၮḰ╷ቯ䈫⹏ଔ䈮㑐䈜䉎⺞ᩏ⎇ⓥ 䋨⾗ᢱ㪈㪄䌰 㪈㪐䋩資料５ᣣᧄ⋴⼔♽ᄢቇද⼏ળ 䋨㪉㪇㪈㪉䋩 ⋴⼔♽ᄢቇ㒮䈮䈍䈔䉎ᢎ⢒䈱ၮḰ╷ቯ䈫⹏ଔ䈮㑐䈜䉎⺞ᩏ⎇ⓥ 䋨⾗ᢱ㪈㪄䌰 㪉㪈䋩ᣣᧄ⋴⼔♽ᄢቇද⼏ળ 䋨㪉㪇㪈㪉䋩 ⋴⼔♽ᄢቇ㒮䈮䈍䈔䉎ᢎ⢒䈱ၮḰ╷ቯ䈫⹏ଔ䈮㑐䈜䉎⺞ᩏ⎇ⓥ 䋨⾗ᢱ㪈㪄䌰 㪉㪊䋩資料５⋴⼔䈮䈍䈔䉎ୃ჻䊧䊔䊦䈪䈱ᢎ⢒䈫⥃ᐥታ〣• තᬺ↢䈱ਛ䈮䈲᭽䇱䈭႐䈪⋥ធ⊛䈭䉬䉝䉕ឭଏ䈜䉎䉅䈱䉅಴䈩䈒䉎䈣䉐䈉䈚䋨䉪䊥䊆䉦䊦䊅䊷䉴䊥䊷䉻䊷䉇⋴⼔ᢎ⢒⠪䋩䇮䉁䈢䇮㓸࿅䉇䉲䉴䊁䊛䇮⚵❱䈮ὶὐ䉕䈅䈩䈢㑆ធ⊛䈭ᓎഀ䉕ㆬ䈹⠪䉅಴䈩䈒䉎䈣䉐䈉䋨⋴⼔䉇ஜᐽ䊒䊨䉫䊤䊛䈱▤ℂ䇮IT, ౏ⴐⴡ↢䇮⥃ᐥ⎇ⓥ䉮䊷䊂䉟䊈䊷䉺䋩. 䈖䈱ᢥᦠ䈮ㅀ䈼䉌䉏䈢䋹䈧䈱ᧄ⾰⊛䉮䉝㗔ၞ䈮䈍䈔䉎⢻ജ䉕⢒䈩䉎䈖䈫䈮ㅊട䈚䈩䇮୘䇱䈱තᬺ↢䈲䈠䉏䈡䉏䈱⋡ᜰ䈜ኾ㐷㗔ၞ䈮䈍䈔䉎䉮䉴䊪䊷䉪䉕ጁୃ䈜䉎䇯䈖䈱䉮䊷䉴䊪䊷䉪䈮䈲䇮䈖䈖䉕 ୃ䈜䈮ㅀ䈼䉌䉏䈢䈢ᧄ⾰⊛ⷐ⚛䉕䉋䉍ᷓ䈒ቇ䈹䉅䈱䈮䉎䈎䉅䈚䉏䈭䈇䈚䇮䉁䈢䈲䇮ㅊട䇮⵬⿷䈱ታ〣⊛䈭ቇ䈶䈮䈭䉎䈎䉅䈚䉏䈭䈇䇯䋱䋹䋹䋶ᐕ䈎䉌䋲䋰䋱䋱ᐕ䈻䈱ᄌᦝ
ᬌ⸛੐㗄
䉼䊞䊧䊮䉳
䉳

資料５

Semester 1
N600
N608

3 units
3 units

Theoretical Foundations for Health Professionals
Leadership, Management and Organizational Behavior
in Healthcare

Semester 2
N612
Healthcare Finance
N602
Analysis of Health Policy Issues
Elective course

3 units
3 units
3 units

Semester 3
N603
N607

Epidemiology and Bio-Statistics
Program Evaluation and Quality Improvement

3 units
3 units

Research Methods
Case Management

3 units
6 units

Synthesis Requirement
Practice and Seminar

3 units
3 units
36 units

Semester 4
N601
N620/620L
Semester 5
N605/606
N621L

Total

䊙䉾䊏䊮䉫
Essential I

Essenti
al II

N608

V

V

N601

V

Essential III

Essential IV

Essenti
al V

V

N603

V

N607

V

V

N612

V

V

N620

V

V

Essential VII

Essential VIII

Essenti
al IX

V

V
V

V

V
V

V
V

V
V

V

V

V

V

V

V

V

V

N620L

V

V

V

V

V

V

N621L

V

V

V

V

V

V

V

V

V

V

N606
N623/
L

3Ps

V

V

N602

Essenti
al VI

V

V

N624

V

N625

V

V

V
V

V

V

資料５

Semester 1
N608
N601

3 units

Leadership, Management and Organizational Behavior in
Healthcare
Research Methods

3 units

Semester 2
N603
Epidemiology and Bio-Statistics
N602
Analysis of Health Policy Issues
N623/623L Advanced Health Assessment for Nurse Case Managers

3 units
3 units
3 units

Semester 3
N612
N624
N625

3 units
2 units
2 units

Healthcare Finance
Advanced Pathophysiology for Nurse Case Managers
Advanced Pharmacological Management for Nurse CaseManagers

SSemester 4
N607
Program Evaluation and Quality Improvement
N620/620L Case Management
Semester 5
N605/606 Synthesis Requirement
N621L
Practice and Seminar

3 units
6 unitsTotal

3 units
3 units
37 units

School of Nursing
COURSE TITLE:CREDITS:

N623/N623L: Advanced Health Assessment for Nurse Case Managers
3 units ((including
g 1 unit Lab))FACULTY:
Office Hours:
Contact:
Email:DAY AND TIME:DESCRIPTION:

This course focuses on the strategies and skills needed to assess individuals throughout the life span in acase managementgsetting.
g The expectedpoutcome is competencypy in advanced health assessment as a Nurse
Case Manager. The analysis of assessment data, based on developmental and ethnic variation, is
integrated into the case management clinical decision making process.
Advanced health/physical assessment includes the comprehensive history, physical and psychologicalassessment of signs and symptoms, pathophysiologic changes, and psychosocial variations of the client:
the individual, family, or community. If the client is an individual, the assessment should occur within thecontext of the family and community and should incorporate cultural and developmental variations andneeds of the client. The purpose of this comprehensive assessment is to develop a thorough understandingof the client in order to determine appropriate and effective health care including health promotion
strategies.

資料５

OBJECTIVES:
At the conclusion of the course, the learner will be able to:
1.
2.
3.
4.
5.
6.
7.
8.

Week
1&
Week
2

Demonstrate sound critical thinking and clinical decision making;Develop a comprehensive data base, including complete functional
assessment, healthh l h history,hi
physicalh i l examination,i iappropriateidiagnostic
dii
testing, and psychosocial system assessment;
Perform a risk assessment of the client including the assessment oflifestyle and other risk factors;
Identify signs and symptoms of common mental illnesses;
Perform basic laboratory tests and interpret other laboratory anddiagnostic data;
Relate assessment findings to underlying pathology or physiologic changes;
Cooperate in reaching a differential diagnosis based on the assessment
data and the trajectory of a disease; andDevelop an effective and appropriate plan of care for clients of all agesthat takes into consideration life circumstance and cultural, ethnic, anddevelopmental variations, as well as end-of-life issues.

Theory Content

CourseLab
Lab
CourseObjectives Hours Content Objectives

1.Overview of case management practice:Case management models
Roles and functions of case managers ineach model
A. Model• Acute care
• Post-acute: LTAC
• Rehab• Long-term: SNF• Military and VA system• DM / care management /population management/wellness• Public health/community-based• Physician groups• Home health/hospice/infusion
therapy
B. Payer-based• Commercial• Public• Self-Pay• Workers compensation• Other third party payors



Obj 1,
2, 8

資料５

Week 3

2. Newman's model: holistic view



Obj
1, 2

Week 4& Week5

3 Physiological assessment:
3.
• Familial (genomics)• Interpretation of diagnostic
test results• Trajectory of illness andmedical treatment plan



Obj
1,
2,
5,
6, 7

Week 6

4. Functional assessment
 Orem's self-care deficit
theoryh ADLs IADLs



Obj
1,
2, 4

21 hours

Compre 
hensive
physicalassessment

Week 7 5. Psycho-social assessment&• Family systems theory
Week 8• Family and social support
system• Caregiver issues



Obj
1, 2,
4

3 hours

Week 9 6. Cultural assessment• Health belief model• Cultural assessment tools• Religious and spiritual belief
systems



Obj
1, 2

3 hours

Week
10



Obj
1, 2

3 hours

7. Financial assessment• Insurance coverage• Personal finance• Third party liability

Obj 1,
2, 3, 4,5, 7, 8Functional assessment
9 Functional
assessment
tools

Obj
1, 2,
3, 4,
7, 8



Focusedinterview:
Psychosocial
assessment

Obj
1, 2,
3, 7,
8



Focusedinterview:
Culturalassessment

Obj
1, 2,
3, 7,
8

資料５

Week
11

8. Environmental assessment• Home environment• Work/employment settings• Eco-maps• Transportation



Obj
1, 2

3 hours 

Focusedinterview:
Financialassessment



Obj
1, 2,
3, 7,
8

Week
12 &
Week
13

9. Support for client decision making 
process• Choosing treatment options• End-of-life decision

Obj
1, 8

3 hours Interview:
Environmental assessment

Obj
1, 8

Week
14 &
Week
15

10. Develop CM plans• Triggers
gg for CM interventions

Obj
1,, 2,,
6, 7,
8

6 hours Communicati
on: Decision
makingsupportObj
1,, 2,,
8

School of Nursing
COURSE TITLE:

N624: Advanced Pathophysiology for Nurse Case Managers

CREDITS:

2 units

FACULTY:
Office Hours:
Contact:
Email:DAY AND TIME:DESCRIPTION:

This course provides the theoretical framework for understanding disease processes and physiologicalaberrations in all ages, including chronic illness and population health. Emphasis will be placed on theapplication of pathophysiology in the identification of common disease processes, clinical syndromes, andthe trajectory and management of illness throughout a lifespan.

資料５

OBJECTIVES:
At the conclusion of the course, the learner will be able to:

1.
2.
3.
4.
5.
6.
7.
8.

Apply current pathophysiological theory and research in the
management of clients of all ages;
Discuss current pathophysiological theory related to commonlyoccurring health problems;
Synthesize and apply current research-based knowledge regarding
pathological changes in selected disease states;
Describe the developmental physiology, normal etiology, pathogenesis,
and clinical manifestations of commonly found/seen altered healthstates;Demonstrate understanding of the cultural and ethnic variations and of
the effects of genomics in pathophysiological processes;
Analyze physiologic responses to illness and treatment modalities;
Demonstrate an understanding of the effects of disease on the patientand family; andDemonstrate the ability to communicate and relate to patients and theirfamilies in an empathetic, facilitating manner.

Schedule of Classes
Content
Unit 1

Unit 2
Unit 3

Unit 4CourseObjectives
Obj 1

1. Medical necessity: Severity of illness• Definition: Medicare, Medicaid• InterQual Criteria• Milliman USA• Workers Compensation
 Clinical Pathways
2. InterQual training
3. Trajectory of illness and medical treatment plan: 6 common
diseases/health conditions (Care trails, pathways, & clinicalguidelines)• ACS• COPD• CKD• DM• CVA/Stroke• Pneumonia

Obj 1, 2, 3
Obj 1, 2, 3, 4,
5

4. Level of care determination:• Acute: Acute care hospitals, Inpatient acuterehabilitation, LTAC
 Post-acute: SNF, hospice, home health, free-standing
rehabilitation units, specialty pharmacy



Obj 7

資料５

Unit 5 5. Facilitate agreement with plan of care:• Pt/family• Providers• Payors



Obj 7

h
conditionsdin diseased
Unit 6 6. Six common chronic
management (DM)• ACS
• COPD• CKD• DM• Asthma• Complex chronic conditionsObj, 1, 2, 3, 4, 5

Unit 7 7. Chronic Care Model

Obj 1, 6, 7

Unit 8 8. Observation: DM practice (5 hours)

Obj 6, 7, 8

School of Nursing
COURSE TITLE:

N625: Advanced Pharmacological Management for Nurse Case Managers

CREDITS:

2 units

FACULTY:
Office Hours:
Contact:
Email:DAY AND TIME:DESCRIPTION:

The focus of advanced pharmacological management for nurse case managers is clinical therapeutics, andit builds on prior knowledge of drug classifications, actions, interactions and side effects. The course
concentrates learning on medications that are used in case management practice. Emphasis is placed onlearning the clinical use of drugs in the management of specific illnesses throughout a lifespan; to include
therapeutic dosages, clinical endpoints, patient monitoring plans and patient education.
Health-related information and medication compliance issues are of foremost concern throughout thecourse. This course builds on a sound foundation of pharmacology to facilitate comprehensive disease
management.

資料５

OBJECTIVES:
At the conclusion of the course, the learner will be able to:
1. Comprehend the pharmacotherapeutics of broad categories of drugs;
2. Analyze the relationship between pharmacologic agents andphysiologic/pathologicpyg /pg responsesp
across a lifespan;p ;3. Understand the motivations of clients in seeking prescriptions and thewillingness to adhere to prescribed regimens;
4. Understand safe and appropriate use of pharmacologic agents for the
management of client health problems, based on client variations, theproblem being managed, and cost effectiveness;
5. Apply principles of adverse drug reactions and drug interactions toproactive dose modification or drug avoidance;
6 Demonstrate
6.
D
t t effective
ff ti patient
ti t teachingt hi techniquest h itot optimize
ti i theth useof medications and to enhance patient compliance; and7. Develop a case management plan for clients of all ages to evaluateclient medication based on individual variations, including treatment
options and financial resources.

Schedule of Classes
Content
Unit 1

1. Medical Necessity: Intensity of services• InterQual Criteria• Milliman USA• Workers Compensation• Clinical Pathways

Course Objs


Obj 2

Unit 2

2. Trajectory of illness and medical treatment plan



Obj 2

Unit 3

3. Formularies• Inpatient• Outpatient• Generic/Brand names
4. Financial management

Obj 1, 5

Unit 4
Unit 5
Unit 6

Unit 7

Obj 6

5. Safe medication management:• Reconciliation on the continuum• Polypharmacy
6. Adherence to medical regimen• Transtheoretical Model of Behavior Change• Self-efficacy theory

Obj 4, 5, 6



Obj 3, 6

7. Observation (5 hours)• Specialty pharmacy• Transitions of care
• Outpatient medication management program

Obj 6, 7資料５

COURSE NUMBER:

N6xx

COURSE TITLE:

Theoretical Foundations in Advanced Nursing Practice

COURSE UNITS:

3 Semester Units

PREREQUISITES:

Admission to the Samuel Merritt University (SMU) Program of
Nurse Anesthesia or the Family Nurse Practitioner (FNP) Program

FACULTY OF RECORD:

Jane M. Perlas, DNP, APRN, NP-C
3100 Summit Street, Room 3462
(510) 869-6511 ext 3798
jperlas@samuelmerritt.edu
Office Hours: By Appt.

DAY AND TIME:
Every other week in-class meeting (physical campus attendance andonline meetings). The number of days and times for physical campus attendance will be
determined each semester by the faculty of record (FOR).
COURSE DESCRIPTION: This course provides an opportunity to explore the principles,
practice, scientific inquiry and the integration of contemporary theories in advanced practicenursing (APN). Learners will analyze selected theoretical frameworks and their application toclinical practice. Foundational theories specific to the domains of clinical practice, informatics,
patient safety and ethics will be examined. The principles of interdisciplinary education andpractice are also emphasized.

COURSE OBJECTIVESAt the completion of this course the student will be able to:
1. Actively participate in the discussion of selected nursing
theories (e.g., translational nursing, integrative APN,etc.).
2. Appraise the role of the APN in the translation of new
knowledge into clinical practice.
3. Analyze and critique relevant theories and research in
the field of informatics.
4 Evaluate
4.
E l t theth ththeoreticalti l ffoundationd ti ffor patient
ti t safety
f t iinclinical practice.
5. Identify and integrate ethical and legal principles in APN
using a case-based approach.

資料５

Assignments (rubrics for each assignment will be provided in advance)% of Grade

Communication technology and Informatics theory essay

15%

Communication technology and Informatics theory presentation

10%

Biophyschosocial Model Group Presentation

20%

Completion of Module 1 and Module 2 of the National Patient Safety
Foundation Patient Safety Curriculum. Log-in/password information to thesemodules will be provided*

10%

Due
Date

Active participation in “Ethical Dilemmas” and “Patient Safety Introduction”
15%
simulation sessions (3-hours per session, per student, in assigned small groups
in the Health Sciences Simulation Center)
Personalized action plan for ongoing patient safety learning (in required
format as described in separate document) that spans the number of months
that the student is enrolled in the clinical curriculum

10%Completion of a wiki article to contribute to the class wiki on fundamental
theories and concepts of health care ethics

10%

Completion of posts on discussion board and forums in the LMS as directed on 10%
course schedule* If SMU is unable to arrange for student access to the online NPSF modules of the NPSF Patient Safety
Curriculum, an equivalent, online alternative will be established

Curricular mapping summary (CLO: Course Learning Objective)
CLO # Program Learning Outcome(PNA)

Program Learning Outcome(FNP)

Institutional
Learning
OutcomeCriticalThinking

AACN
Master’s
Essential
Essential I1

PLO 3a: Critical thinking
through application of theory
to practice in decisiondecision
making/problems solving

5. Produce quality work that
demonstrates graduate level
scholarly work and canwithstand peer review.

2

PLO 3a (see above)
PLO 4a: Effective
communication with allindividuals influencing patientcare

2. Consult and refer within aninterdisciplinary
practice model.

CriticalThinking

EssentialVII3

2. Consult and refer within aninterdisciplinary
practice model.

Information
Tech

Essential V

4

3. Collaborate with patientsand families to provide
evidence-based primary carethat is theoretically sound.

Information
Tech

Essential V

資料５

5

PLO 4b: Communication
skills via utilization of all
forms during the deliveryof care3. Collaborate with patients andfamilies to provide
evidence-based primary carethat is theoretically sound.

Information tech Essential V6

PLO 3b & 3c: CriticalThinking via planned carebased on soundprinciples & researchbased evidence

1. Provide family-oriented
primary healthcare:a. Elicit a detailed and accurate
history, perform theappropriate physical exam,record pertinent data,
and develops and implements
plan of care.
b. Perform and/or order andinterpret relevant
diagnostic studies.
c Perform appropriate officec.
procedures.
d. Provide health promotion
and disease prevention.

ClinicalCompetence

Essential I

7

PLO 1e: Safe patient care 1e. Integrates cultural
through compliance with considerations in the provision
JC & NPSF safety goalsof primary care.

ClinicalCompetenceCommunication

Essential
III, VI

8

PLO 1e & 1f: Safe
patient care throughimplementation of
CRM principles

9

PLO 5b & 5c:
1. Provide family-oriented primary
EthicsProfessional role ashealthcare:demonstrated bya. Elicit a detailed and accurate history,
responsible/accounta perform the appropriate physical exam,
ble practice &record pertinent data, and develops
practice with integrity and implements plan of care.
b. Perform and/or order and interpret
relevant diagnostic studies.
c. Perform appropriate officeprocedures.
d. Provide health promotion anddisease prevention.
e. Integrates cultural considerations in
the provision of primary care
care.
PLO 5c: practice with 4. Assume a leadership role in the
Ethicsprofession at local, state, national andintegrity
PLO 3a: Criticalinternational level.
thinking throughapplication of theory
to practice indecision-making/problems solving

10

3. Collaborate with patients andfamilies to provide
evidence-based primary care that istheoretically sound.

ClinicalCompetenceCommunication,
Leadership

Essential
III, VI

Essential
II

Essential
II

資料５

3

4

5

ModuleWeek #

Schedule of Classes
General course topic(Specific topic will beidentified for final
syllabus)

1

1

Introduction tocourse & generall
theory concepts

Barker (2009), Chapters 18, 19,
29 21,
29,
21 & 22- F2F lecture: 1.5 hours- Online
O li didiscussion
i postingti

2

2

Informatics

Barker (2009) Chapter 17
Current Journal articles will beassigned

F2F Lecture

3

Informatics

Current journal articles will beassigned

Online Discussion Board(DB) Posting

4

Informatics

Current journal articles/online
resources will be assigned

Online Lecture
Materials/Podcast
DB Postings

5

Informatics

Current journal articles/online
resources will be assigned

Communication technology
and Informatics Theory
Presentations and Essay due

Reading/Prep

Learning Activity
F2F = on campus orsynchronous online session

6

Biopsychosocial Current Journal Articles will be assigned
Model (BPSM)

DB Posting

7

BPSM

DB Posting
In class case studies

8

BPSM

9

EthicsBaker (2008). Chapters 27 & 28
Current journal articles will be assigned- F2F lecture (2.0 hrs.) Ethics
Expert ї case-based
seminar discussions- Forum post assignmentson ethical dilemmas

10

Ethics- Online resources will be assigned(includes videos)- Ethics simulation sessions
in assigned groups (3.0hours)

11

Ethics- References/Resources as determinedb llearnerby- Complete wiki article (perb i ) includes
i l d review
i off
rubric);peer’s article

12

Patient Safety-

Online work:- NPSF Module 1- NPSF Module 2

Current Journal Articles will be assigned

BPSM Group Presentation-

Log into/Register for the NPSF
Patient Safety Curriculum (or online
equivalent); Reading for each
module is indicated within module
Selected chapters Sherwood &Barnsteiner (2012)

資料５

13

Patient Safety- Read Nance (2008) - all chapters- Journal articles will be assigned- F2F session (2.0 hrs.) Guest
Lecturer: Patient Safety Expert їcase-based seminar discussions- Videos (TEDTalk, NPSF) will beassigned - Forum post
assignments on each topic

14

Patient Safety-- F2F session (3.0 hr. experiencefor each student in assigned
groups): Patient Safety Focusedsimulation sessions-

Selected chapters, Sherwood &Barnsteiner (20120)
Current journal articles onhuman factors and nontechnical skills will be assigned䊙䉾䊏䊮䉫䋺CM 䊒䊨䉫䊤䊛䈠䈱ઁ䈮⠨ᘦ䈚䈭䈔䉏䈳䈇䈔䈭䈇䈖䈫• SMU 䈱䉮䉝䉮䊮䊏䊁䊮䉲䊷䈫䉝䉡䊃䉦䊛• 䊒䊨䉫䊤䊛䈱⋡ᮡ• ኾ㐷࿅૕䈱ၮḰ: 䉬䊷䉴䊙䊈䉳䊜䊮䊃– ANA Credentialing Center• http://www.nursecredentialing.org/Certification/NurseSpecial
tiesCategory/CaseManagement– American Case Management Association• http://www.acmaweb.org/section.asp?sID=22– Case Management Society of America• http://www.cmsa.org/Individual/MemberResources/Standard
sofPracticeforCaseManagement/tabid/69/Default.aspx

資料５

Samuel Merritt University Core Learning
Competencies and Outcomes

資料５









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https://doi.org/10.32283/rep.9b1fb879