51㫽ྲྀ⮫ᗋ⛉Ꮫ 12(1), 51-56, 2020ᆅᇦໟᣓࢣ࢔ࢩࢫࢸ࣒ᵓ⠏࡟ྥࡅ࡚㧗㱋⪅ࡢఫࡳⰋ࠸⾤࡙ࡃࡾ࡟ࡘ࠸࡚⪃࠼ࡿࠥᆅᇦ࡛⏕άࡍࡿ㧗㱋⪅ࡢࢫ࣮ࣃ࣮࣐࣮ࢣࢵࢺ࡟ᑐࡍࡿࢽ࣮ࢬࠥ  ㎷ᮧ⫕ 1, 2)  ▼ᶫᗣಙ 3)1) ࡧࢃࡇࣜࣁࣅࣜࢸ࣮ࢩࣙࣥᑓ㛛⫋኱Ꮫ సᴗ⒪ἲᏛ⛉2) ኱㜰㟁Ẽ㏻ಙ኱Ꮫ ་⒪೺ᗣ⛉Ꮫ㒊3) 㫽ྲྀᕷ་⒪┳ㆤᑓ㛛Ꮫᰯ సᴗ⒪ἲኈᏛ⛉Establishment of comprehensive community care system
to build an elderly-friendly townïNeeds of community-dwelling elderly individuals for supermarketsïHajime Tsujimura1, 2) Yasunobu Ishibashi3)1) Department of Occupational Therapy, Biwako Professional University of Rehabilitation
2) Faculty of Medical Science and Health-Promotion,
Osaka Electro-Communication University3) Department of Occupational Therapy, Education Department,
Tottori Medical Nursing Vocational Schoolせ᪨㫽ྲྀ┴ࡣ 4 ࡘࡢᕷ࡜ 15 ࡢ⏫ᮧ࠿ࡽᡂࡾ, 㧗㱋໬⋡ࡣ 31.6%࡛, ඲ᅜᖹᆒ࡜ẚ࡭ࡿ࡜㧗࠸ 1). ⌧ᅾ,௒ᚋࡲࡍࡲࡍ㧗㱋⪅ࡀቑ࠼ࡿࡇ࡜ࢆぢ㉺ࡋ࡚, ࠕᆅᇦໟᣓࢣ࢔ࢩࢫࢸ࣒ࠖࡢྲྀࡾ⤌ࡳࡀ㐍ࡵࡽࢀ࡚࠸ࡿࡀ, ࡑࢀࡒࢀࡢᆅᇦࡀ, ࡑࡢᆅᇦࡢࠕࣄࢺࠖࠕࣔࣀࠖࠕ࠾㔠ࠖࢆ࠸࠿࡟ຠ⋡ⓗ࣭ຠᯝⓗ࡟౑࠺࠿࡜࠸࠺ࡇ࡜ࡀ㔜せ࡜࡞ࡗ࡚ࡃࡿ.
㫽ྲྀ┴ࡢேཱྀࡣ඲ᅜ୍࡛␒ᑡ࡞ࡃ, ࠕࢹ࣮ࢱ࡛ࡳࡿࢫ࣮ࣃ࣮࣐࣮ࢣࢵࢺࠖࡢㄪ࡭࡟ࡼࡿ࡜, ⏕ά࡟Ḟ࠿ࡍࡇ࡜ࡀ࡛ࡁ࡞࠸ࢫ࣮ࣃ࣮࣐࣮ࢣࢵࢺ㸦௨ୗࢫ࣮ࣃ࣮㸧ࡢᗑ⯒ᩘࡶ᭱ୗ఩࡛࠶ࡾ, ௚┴࡟ẚ࡭࡚ࡶ㠀ᖖ࡟ᑡ࡞࠸ᾘ㈝άື࡛࠶ࡿ 2). ࠕ㈙࠸≀⾜ືࠖࡣ♫఍⤒῭ࡢάᛶ໬ࡢࡳ࡞ࡽࡎ, ே㛫࡟࡜ࡗ࡚ᵝࠎ࡞ㄆ▱ᶵ⬟ࢆ౑࠺▱ⓗάື࡜ࡶゝࢃࢀ 3), ㄆ▱⾜ື⒪ἲࡢࡦ࡜ࡘ࡛ࡶ࠶ࡿ. ࡋࡓࡀࡗ࡚, ᆅᇦࡢ㧗㱋⪅
ࡢࠕ㈙࠸≀⾜ືࠖࢆಁ㐍ࡍࡿࡇ࡜ࡣ, ᆅᇦࡢάᛶ໬ࡸ㧗㱋⪅ࡢ೺ᗣ࡟⧅ࡀࡿ࡜⪃࠼ࡽࢀࡿ.
ᮏ◊✲ࡣ, 㧗㱋⪅ࡢࢫ࣮ࣃ࣮࡟ᑐࡍࡿࢽ࣮ࢬࢆᢕᥱࡍࡿࡇ࡜ࢆ┠ⓗ࡟, ࢔ࣥࢣ࣮ࢺㄪᰝࢆᐇ᪋ࡋࡓࡢ࡛ሗ࿌ࡍࡿ. 㫽ྲྀ⮫ᗋ⛉Ꮫ 12(1), 51-56, 2020
Abstract
Tottori Prefecture has four cities and 15 towns and villages. The percentage of the elderly in this prefecture ishigher (31.6%) than Japan’s average1). Tottori Prefecture has initiated “the comprehensive community caresystem,” considering growth in the number of older persons. To successfully conduct this program, regionallyeffective and efficient use of people, goods, and money are important.
Tottori Prefecture is the least populous prefecture of Japan. According to the data on food retail in Japan, thenumber of supermarkets, which are essential for daily life, is the fewest in this prefecture and consumption
activity is remarkably less than other prefectures2). Shopping, which stimulates socioeconomic activity, is also an
intellectual activity because it involves the use of several cognitive functions3), and thus, is regarded as a cognitive
behavioral therapy. The encouragement of community-dwelling elderly individuals to do shopping thus
revitalizes the community and promotes their health.
We performed a questionnaire on elderly people to understand their needs for supermarkets and report herein.
Tottori J. Clin. Res. 12(1), 51-56, 2020
Key words: 㧗㱋⪅, ᆅᇦໟᣓࢣ࢔ࢩࢫࢸ࣒, ㈙࠸≀⾜ື, KJ ἲ, ㄆ▱⾜ື⒪ἲ; elderly individuals,152

comprehensive rural care system, shopping, KJ method, cognitive behavioral therapy
ჟ. ◊✲᪉ἲ1. ᑐ㇟࡜ㄪᰝ᪉ἲ㫽ྲྀᕷෆ㸦௨ୗ, ᕷෆ㸧࡟࠶ࡿ฼⏝ᗘࡢ㧗࠸ࢫ࣮ࣃ࣮ࢆ≉ᐃࡍࡿࡓࡵ࡟, 㫽ྲྀ㥐๓࡟࡚㉁ၥ⣬ࡢ࢔ࣥࢣ࣮ࢺㄪᰝࢆ⾜࠸, ࢫ࣮ࣃ࣮2 ᗑ⯒㸦A ᗑ,B ᗑ㸧ࢆ≉ᐃࡋࡓ. ≉ᐃࡋࡓྛᗑ⯒࡟᮶ᗑࡋࡓ㧗㱋⪅ 25 ྡ, ィ 50 ྡ࡟ᑐࡋ, ↓グྡ㉁ၥ⣬ἲࡢ࢔ࣥࢣ࣮ࢺㄪᰝࢆᐇ᪋ࡋࡓ. ࡲࡓ, 2 ᗑ⯒ࡢ㐠Ⴀ㈐௵⪅ࢆᑐ㇟࡜ࡋࡓ㉁ၥ⣬ࢆ㒑㏦ࡋ, ࢔ࣥࢣ࣮ࢺ
ㄪᰝࢆᐇ᪋ࡋࡓ. ㄪᰝᮇ㛫ࡣ, 20XX ᖺ 11 ᭶ 22 ᪥࠿ࡽ⩣ᖺࡢ 3 ᭶ 25 ᪥࡜ࡋࡓ.

I. ࡣࡌࡵ࡟㏆ᖺ, ᝟ሗ㏻ಙᶵჾࡢⓎᒎ࡟ࡼࡾ, ᐙ㟁〇ရ࠿ࡽ㣗ᮦ࡟⮳ࡿࡲ࡛, ࢖ࣥࢱ࣮ࢿࢵࢺ➼࡛ᡭ㍍
࡟ᡭ࡟ධࢀࡿࡇ࡜ࡀ࡛ࡁࡿ᫬௦࡟࡞ࡗࡓ. ࡋ࠿ࡋ, ୍⯡ⓗ࡟, ᪥ࠎࡢ⊩❧࡟ᚲせ࡞㣗ᩱရ➼ࡣ,ᆅᇦࡢࢫ࣮ࣃ࣮ࢆ฼⏝ࡍࡿࡇ࡜ࡀከ࠸ 4). ᆅඖࡢࢫ࣮ࣃ࣮࡟ࡣ, ᆅඖ࡛࡜ࢀࡓ᪪ࡢ㔝⳯ࡸ㨶ࡀ୪ࡧ, ேࠎࡣ, ࡑࢀࢆぢࡓࡾゐࢀࡓࡾࡋ࡞ࡀࡽ, Ꮨ⠇ࢆឤࡌ, ࡼࡾ᪂㩭࡛Ᏻ౯࡞ࡶࡢࢆ㑅ࡪ. ࡑࡋ࡚,ࡇࡢ㣗ᮦࢆ࡝ࡢࡼ࠺࡟ㄪ⌮ࡋ࡚㣗࡭ࡼ࠺࠿࡜⪃࠼, ࡲࡓ᝷⳯኎ࡾሙ࡛ࡣ, ࡑࡢᙬࡾ࡟㣗ḧࢆἛ࠿
ࡏࡿ. ࡑࡋ࡚, ᆅᇦࡢே࡜ฟ఍࠸, ᗑဨࢆࡣࡌࡵᆅᇦࡢே࡜ࡢࢥ࣑ࣗࢽࢣ࣮ࢩࣙࣥࡢሙ࡜࡞ࡿ.
IADL㸦Instrumental Activity of Daily Living㸧ࡢ୍ࡘ࡛࠶ࡿࡇࡢࡼ࠺࡞ࠕ㈙࠸≀⾜ືࠖࡣ, 㐙⾜⬟ຊ࡜ࡋ࡚㧗ᗘ࡞⬟ຊࢆᚲせ࡜ࡋ 3), సᴗ⒪ἲ࡜ࡋ
࡚ᐇ᪋ࡉࢀホ౯ࡉࢀࡿࡶࡢ࡛࠶ࡿ. ࡋࡓࡀࡗ࡚,ᆅᇦࡢࢫ࣮ࣃ࣮࡛ࡢࠕ㈙࠸≀⾜ືࠖࡣ, 㧗㱋⪅ࡢ೺ᗣ⥔ᣢࡸ௓ㆤண㜵࡜ࡋ࡚㔜せ࡞ࡶࡢ࡛࠶ࡿ࡜࠸࠼ࡿ 3, 5, 6-7).
⌧ᅾ᥎㐍ࡉࢀ࡚࠸ࡿࠕᆅᇦඹ⏕♫఍ࠖࡢᐇ⌧ࡸ, ࠕᆅᇦໟᣓࢣ࢔ࢩࢫࢸ࣒ࠖࡢᵓ⠏࡟ࡣ, 㧗㱋⪅ࢆྵࡴᆅᇦࡢఫẸ࡟࠾࠸࡚ࡶ, ⮬Ⓨⓗ࡟೺ᗣࢆ⟶⌮ࡍࡿែᗘࢆࡶࡗ࡚೺ᗣ࡞⏕άࢆ㏦ࡿࡇ࡜ࡀồࡵࡽࢀ࡚࠸ࡿ. ࡑࡋ࡚, 㧗㱋࡟࡞ࡗࡓ࡜ࡋ࡚
ࡶᅾᏯ࡛೺ᗣ࡞⏕άࢆ⥔ᣢࡍࡿࡓࡵ࡟ࡣ, ࠕ㈙࠸
≀⾜ືࠖࡢࡼ࠺࡞ IADL ࡢ⮬❧ࡀ㘽࡟࡞ࡿ࡜⪃࠼ࡿ.
୍᪉, ຍ㱋࡟ࡼࡾ, ㌟యᶵ⬟ࡢኚ໬ࡣ㛵⠇③ࡸ➽ຊࡢపୗ࡟ࡼࡿ㐠ືჾ⣔࡟ጞࡲࡾ, ᚰ⫵ᶵ⬟, どຊࡸ⫈ຊ࡜࠸ࡗࡓឤぬჾᐁࡢኚ໬➼ࡀ㉳ࡇࡾ, ᚎࠎ࡟㧗㱋⪅ࡢ⏕ά⾜ື⠊ᅖࢆ⊃ࡵࡿ. ⌧ᅾ, ࡇ࠺࠸ࡗࡓ㧗㱋⪅ࡸ㞀ᐖ⪅ࡀእฟࡋࡸࡍ࠸⾤࡙ࡃࡾࡢࡓࡵ࡟, 㐨㊰ࡸ᪋タ➼ࡢࣂࣜ࢔ࣇ࣮ࣜ໬ࡀࡍࡍࡵࡽࢀ࡚࠸ࡿ 5, 7, 8, 9).
ࡋ࠿ࡋ࡞ࡀࡽ, 㧗㱋⪅࡟࡜ࡗ࡚, ⎔ቃᩚഛ࡜ྠᵝ, እ࡟ฟ࠿ࡅࡓ࠸࡜࠸࠺ពḧࡣ㔜せ࡛࠶ࡾ,┠ⓗࢆ㞴࡞ࡃ㐙⾜࡛ࡁࡓ, ฟ࠿ࡅ࡚ࡼ࠿ࡗࡓ࡜࠸࠺‶㊊ᗘ࡞࡝, ᚰ⌮㠃࡬ࡢ࢔ࣉ࣮ࣟࢳࡀ㔜せ࡟࡞ࡗ࡚ࡃࡿ࡜ᛮࢃࢀࡿ. ࠕᆅᇦໟᣓࢣ࢔ࢩࢫࢸ࣒ࠖࡣ, ᆅᇦࡢ≉ᛶ࡟ᛂࡌ࡚సࡾୖࡆ࡚࠸ࡃࡶࡢ
࡛࠶ࡾ, ┴ෆࡢ⮬἞య࡛ࡶᵝࠎ࡞ྲྀࡾ⤌ࡳࡀ㐍ࡵࡽࢀ࡚࠸ࡿ. ࡲࡓ, ࠕ㈙࠸≀⾜ືࠖ࡟㛵㐃ࡋࡓ◊✲ࡶࡉࢀ࡚࠸ࡿ. ࡑࡢ୰࡛ࡶ, ┴ෆ࡛ࡣ, ಴ᣢࡽ 5) ࡟ࡼࡗ࡚ࠕ㧗㱋⪅ࡢ㈙࠸≀㢖ᗘ࡜⏕άᶵ⬟ࡢ㛵㐃ᛶศᯒࠖࡢ◊✲ࡀࡉࢀ, ㈙࠸≀ࡢᶵ఍ࢆ⥔ᣢࡍࡿࡇ࡜ࡀ⚟♴ⓗ࡞ຠᯝࢆࡶࡓࡽࡍ࡜࠸࠺ሗ
࿌ࡀࡉࢀ࡚࠸ࡿ.
ࡑࡇ࡛, ᮏ◊✲࡛ࡣ, 㫽ྲྀᕷ࡟࠾ࡅࡿࢫ࣮ࣃ
࣮࡟㛵ࡍࡿ㧗㱋⪅ࡢࢽ࣮ࢬࢆㄪᰝࡋ࡚, 㧗㱋⪅ࡢ㈙࠸≀⾜ືࢆಁࡍ⎔ቃ࡟ࡘ࠸࡚⪃ᐹࡍࡿ.

2. ㉁ၥ⣬ࡢㄪᰝෆᐜ 㧗㱋⪅ࡢࢽ࣮ࢬࢆㄪᰝࡍࡿࡓࡵࡢᇶᮏᒓᛶࢆ
ᖺ㱋, ᛶู, ྠᒃᐙ᪘࡜ࡋ, ࢔ࣥࢣ࣮ࢺࡢ㉁ၥ㡯┠࡟ࡣ,㸦1㸧᮶ᗑᡭẁ, 㸦2㸧᮶ᗑ㢖ᗘ, 㸦3㸧᮶ᗑࡋࡓዎᶵ, 㸦4㸧㉎ධ㢖ᗘࡢ㧗࠸ၟရ, 㸦5㸧㉎ධࡍࡿၟရ࡟ࡼࡿᗑ⯒ࡢ㑅ูࡢ᭷↓ࢆၥ࠺ࡶࡢ࡜
ࡋࡓ. ࡲࡓ, 㸦6㸧
ࠕ㈙࠸≀ࡢ㝿, ࢫ࣮ࣃ࣮ෆࡢ࡝ࡢࡼ࠺࡞ᡤ࡟฼⏝ࡋࡸࡍࡉࢆឤࡌࡲࡍ࠿ࠖ, ࠕࡇࡕࡽࡢࢫ࣮ࣃ࣮ࢆ฼⏝ࡍࡿୖ࡛ᅔࡗࡓ⤒㦂ࡣ࠶ࡾࡲࡍ࠿ࠖ, ࠕᅔࡗࡓ⤒㦂ࡀ࠶ࡿሙྜࡣ, ࡝ࡢࡼ࠺࡟ኚ࠼ࡓࡽ฼⏝ࡋࡸࡍ࠸࡛ࡍ࠿ࠖ࡜࠸࠺⮬⏤ᅇ⟅
࡟ࡼࡿ㉁ၥᙧᘧ࡜ࡋࡓ.
ᗑ⯒㐠Ⴀ㈐௵⪅࡬ࡢ㉁ၥ⣬࡛ࡢ㒑㏦ㄪᰝࡣ⮬⏤ᅇ⟅࡜ࡋࡓ. ⮬⏤ᅇ⟅ࡢෆᐜࡣ, ࠕᗑෆ࡟ࣂࣜ࢔ࣇ࣮ࣜ࡞࡝ࡢタഛࡀ࠶ࡾࡲࡍ࠿. ࡑࢀࡣ, ࡝ࡢࡼ࠺࡞ሙᡤ࡛, ࡝ࡢࡼ࠺࡞┠ⓗ࡛タ⨨ࡉࢀࡲࡋࡓ࠿ࠖ, ࠕᗑෆࡢၟရࡢ㓄⨨ࡣ࡝ࡢࡼ࠺࡟Ỵࡵࡽࢀ࡚࠸ࡲࡍ࠿ࠖ, ࠕၟရࡢ㈍኎౯᱁ࡣ࡝ࡢࡼ࠺࡟
Ỵࡵࡽࢀ࡚࠸ࡲࡍ࠿ࠖ, ࠕၟရࡢ㝞ิࡢ㝿࡟ࡣ࡝ࡢࡼ࠺࡞ᕤኵࢆࡋ࡚࠸ࡲࡍ࠿ࠖ, ࠕ㧗㱋⪅࡬ࡢ᥋ᐈࡢ㝿࡟ᕤኵࡋ࡚࠸ࡿࡇ࡜ࡣ࠶ࡾࡲࡍ࠿ࠖ, ࠕ㧗㱋⪅࡟ྥࡅ࡚, ࡝ࡢࡼ࠺࡞ࢧ࣮ࣅࢫࢆᐇ᪋ࡉࢀ࡚࠸ࡲࡍ࠿ࠖ, ࠕ௒ᚋ, 㧗㱋⪅࡟ᑐࡋ࡚ᒎ㛤ࡋࡓ࠸ࢧ࣮ࣅࢫࡣ࠶ࡾࡲࡍ࠿ࠖ࡜ࡋࡓ.
3. ࢹ࣮ࢱศᯒ᪉ἲᕷෆᅾఫࡢ㧗㱋⪅ࡀᕷෆ࡛฼⏝ࡍࡿ㢖ᗘࡢ㧗࠸ࢫ࣮ࣃ࣮ࡢ≉ᐃ࡛ࡣ, ᇶᮏᒓᛶ㸦ᖺ㱋, ᛶู,ྠᒃ⪅㸧࡟ࡘ࠸࡚༢⣧㞟ィ࡛ฎ⌮ࢆ⾜ࡗࡓ.
A ᗑ, B ᗑ࡛㧗㱋⪅ࢆᑐ㇟࡜ࡍࡿ↓グྡ㉁ၥ
⣬࡟ࡘ࠸࡚ࡣ༢⣧㞟ィ࡛ฎ⌮ࢆ⾜࠸, ⮬⏤ᅇ⟅࡟ࡘ࠸࡚ࡣ KJ ἲ࡛ࡲ࡜ࡵࡓ. ᗑ⯒㐠Ⴀ⟶⌮⪅ࢆᑐ㇟࡜ࡍࡿ㉁ၥ⣬ࡢ㒑㏦ㄪᰝ࡟ࡘ࠸࡚ࡣ, KJ ἲ࡛ࡲ࡜ࡵࡓ.
4. ೔⌮ⓗ㓄៖A ᗑ, B ᗑࡢྠព༠ຊ, ಶே᝟ሗࡢྲྀࡾᢅ࠸ࡢྜពࢆᚓࡓ࠺࠼࡛, A ᗑ, B ᗑ࡟᮶ᗑࡋࡓㄪᰝ༠ຊࡢពᛮࡢ࠶ࡿᑐ㇟⪅࡟, ㄪᰝ᪉ἲ, ༏ྡᛶࡢಖ2