{"id":2205,"date":"2021-12-27T11:43:14","date_gmt":"2021-12-27T02:43:14","guid":{"rendered":"https:\/\/www.hcfm.jp\/journal\/?p=2205"},"modified":"2021-12-27T11:43:14","modified_gmt":"2021-12-27T02:43:14","slug":"%e5%ae%97%e6%95%99%e7%9a%84%e3%81%aa%e8%a9%b1%e9%a1%8c%e3%81%ae%e7%89%b9%e5%be%b4","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=2205","title":{"rendered":"\u5b97\u6559\u7684\u306a\u8a71\u984c\u306e\u7279\u5fb4"},"content":{"rendered":"

\u2015\u6587\u732e\u540d\u2015
\nMcCord G, Gilchrist VJ, Grossman SD, et al. Discussing Spirituality With Patients: A Rational and Ethical Approach. The Annals of Family Medicine. 2004;2(4):356-361. doi:10.1370\/afm.71<\/p>\n

\u2015\u8981\u7d04\u2015<\/p>\n

Introduction
\n\u3000\u533b\u7642\u306b\u304a\u3051\u308b\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u306a\u554f\u3044\u304b\u3051\u306b\u3064\u3044\u3066\u306f\u3001\u8b70\u8ad6\u306e\u4f59\u5730\u304c\u3042\u308b\u3002\u60a3\u8005\u306e\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30ea\u30c6\u30a3\u3084\u5b97\u6559\u6027\u306f\u3001\u7f79\u60a3\u7387\u3084\u6b7b\u4ea1\u7387\u306e\u4f4e\u4e0b\u3001\u8eab\u4f53\u7684\u30fb\u7cbe\u795e\u7684\u5065\u5eb7\u306e\u5411\u4e0a\u3001\u3088\u308a\u5065\u5eb7\u7684\u306a\u30e9\u30a4\u30d5\u30b9\u30bf\u30a4\u30eb\u3001\u5fc5\u8981\u306a\u533b\u7642\u30b5\u30fc\u30d3\u30b9\u306e\u6e1b\u5c11\u3001\u5bfe\u51e6\u80fd\u529b\u306e\u5411\u4e0a\u3001\u5e78\u798f\u611f\u306e\u5411\u4e0a\u3001\u30b9\u30c8\u30ec\u30b9\u306e\u6e1b\u5c11\u3001\u75c5\u6c17\u306e\u4e88\u9632\u306a\u3069\u3068\u76f8\u95a2\u3059\u308b\u3053\u3068\u304c\u793a\u3055\u308c\u3066\u3044\u308b\u3002\u3053\u308c\u3089\u306e\u7814\u7a76\u306e\u591a\u304f\u306f\u6279\u5224\u3055\u308c\u3066\u3044\u308b\u304c\u3001\u307b\u3068\u3093\u3069\u306e\u533b\u5e2b\u306f\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30ea\u30c6\u30a3\u304c\u60a3\u8005\u306e\u8eab\u4f53\u7684\u30fb\u7cbe\u795e\u7684\u5e78\u798f\u306b\u30d7\u30e9\u30b9\u306e\u5f71\u97ff\u3092\u4e0e\u3048\u308b\u3068\u8003\u3048\u3066\u3044\u308b\u3002\u60a3\u8005\u306f\u533b\u5e2b\u3068\u306e\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u306a\u8a71\u3057\u5408\u3044\u3092\u671b\u307f\u3001\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u306a\u5065\u5eb7\u306f\u8eab\u4f53\u7684\u306a\u5065\u5eb7\u3068\u540c\u69d8\u306b\u91cd\u8981\u3067\u3042\u308b\u3068\u8003\u3048\u3066\u3044\u308b\u304c\u3001\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u306a\u8a71\u3057\u5408\u3044\u306f\u307b\u3068\u3093\u3069\u884c\u308f\u308c\u3066\u3044\u306a\u3044\u3068\u5831\u544a\u3055\u308c\u3066\u3044\u308b\u3002\u5916\u6765\u60a3\u8005\u3092\u5bfe\u8c61\u3068\u3057\u305f\u7814\u7a76\u3067\u306f\u300113\uff05\u304b\u308973\uff05\u306e\u60a3\u8005\u304c\u3001\u81ea\u5206\u306e\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u306a\u4fe1\u5ff5\u3084\u5b97\u6559\u7684\u306a\u4fe1\u5ff5\u3092\u533b\u5e2b\u306b\u77e5\u3063\u3066\u3082\u3089\u3044\u305f\u3044\u3068\u8003\u3048\u3066\u3044\u308b\u3053\u3068\u304c\u5206\u304b\u3063\u3066\u3044\u308b\u3002\u533b\u5e2b\u306e\u554f\u984c\u70b9\u3068\u3057\u3066\u306f\u3001\u78ba\u7acb\u3055\u308c\u305f\u5c02\u9580\u5206\u91ce\u3092\u96e2\u308c\u3066\u975e\u533b\u5b66\u7684\u306a\u8ab2\u984c\u3092\u63a8\u9032\u3059\u308b\u3053\u3068\u3001\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30ea\u30c6\u30a3\u306b\u95a2\u3059\u308b\u30c8\u30ec\u30fc\u30cb\u30f3\u30b0\u306e\u6b20\u5982\u3001\u533b\u5e2b\u304c\u30d1\u30b9\u30c8\u30e9\u30eb\u30fb\u30ab\u30a6\u30f3\u30bb\u30e9\u30fc\u3068\u3057\u3066\u6d3b\u52d5\u3059\u308b\u3053\u3068\u306e\u502b\u7406\u6027\u3001\u5371\u5bb3\u3092\u52a0\u3048\u308b\u53ef\u80fd\u6027\u3001\u6642\u9593\u7684\u5236\u7d04\u3001\u30d7\u30e9\u30a4\u30d0\u30b7\u30fc\u306e\u4fb5\u5bb3\u3001\u3069\u306e\u60a3\u8005\u304c\u8a71\u3057\u305f\u3044\u306e\u304b\u3092\u5224\u65ad\u3059\u308b\u3053\u3068\u306e\u96e3\u3057\u3055\u306a\u3069\u304c\u6319\u3052\u3089\u308c\u308b\u3002\u672c\u7814\u7a76\u3067\u306f\u3001\u533b\u5e2b\u304c\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u304a\u3088\u3073\u5b97\u6559\u7684\u4fe1\u5ff5\u306e\u5168\u4f53\u7684\u306a\u8a55\u4fa1\u3092\u60a3\u8005\u4e2d\u5fc3\u306b\u884c\u3048\u308b\u3088\u3046\u306b\u3059\u308b\u305f\u3081\u3001(1)\u5e45\u5e83\u3044\u81e8\u5e8a\u5834\u9762\u3067\u306e\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u306a\u8a71\u3057\u5408\u3044\u306e\u53d7\u3051\u5165\u308c\u3001(2)\u60a3\u8005\u304c\u81ea\u5206\u306e\u4fe1\u5ff5\u306b\u3064\u3044\u3066\u533b\u5e2b\u306b\u77e5\u3063\u3066\u307b\u3057\u3044\u3068\u601d\u3046\u7406\u7531\u3001(3)\u60a3\u8005\u304c\u3053\u306e\u60c5\u5831\u3092\u4f7f\u3063\u3066\u533b\u5e2b\u306b\u3057\u3066\u307b\u3057\u3044\u3053\u3068\u3001(4)\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u306a\u8a71\u3057\u5408\u3044\u3092\u671b\u3080\u53ef\u80fd\u6027\u306e\u9ad8\u3044\u60a3\u8005\u3092\u4e88\u6e2c\u3059\u308b\u30e2\u30c7\u30eb\u306b\u3064\u3044\u3066\u8abf\u67fb\u3057\u305f\u3002<\/p>\n

\u203b\u30d1\u30b9\u30c8\u30e9\u30eb\u30b1\u30a2\uff1d\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u30b1\u30a2\uff0b\u5b97\u6559\u7684\u30b1\u30a2\uff08\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u30b1\u30a2\u3092\u5e83\u7fa9\u306b\u304a\u3053\u306a\u3063\u3066\u3044\u3066\u5b97\u6559\u7684\u30b1\u30a2\u3092\u542b\u3080\u5834\u5408\u306f\u307b\u307c\u540c\u3058\u610f\u5473\uff09<\/p>\n

Method
\n\u3000\u8a13\u7df4\u3092\u53d7\u3051\u305f\u30ea\u30b5\u30fc\u30c1\u30a2\u30b7\u30b9\u30bf\u30f3\u30c8\u304c\u3001\u30aa\u30cf\u30a4\u30aa\u5dde\u5317\u6771\u90e8\u306b\u3042\u308b4\u3064\u306e\u5bb6\u5ead\u533b\u7814\u4fee\u65bd\u8a2d\u30681\u3064\u306e\u6c11\u9593\u30b0\u30eb\u30fc\u30d7\u8a3a\u7642\u6240\u306e\u5f85\u5408\u5ba4<\/strong>\u3067\u3001\u540c\u610f\u3057\u305f\u60a3\u8005\u3068\u540c\u4f34\u306e\u6210\u4eba\u3092\u5bfe\u8c61\u306b\u8cea\u554f\u7968<\/strong>\u3092\u5b9f\u65bd\u3057\u305f\u3002\u4eba\u53e3\u3084\u5730\u57df\u306e\u60c5\u5831\u3001\u672c\u4eba\u3068\u5bb6\u65cf\u306e\u4e00\u822c\u7684\u306a\u5065\u5eb7\u72b6\u6cc1\u3001SF-12\u3001\u533b\u7642\u306b\u95a2\u3059\u308b\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u306a\u4fe1\u5ff5\u3001\u5b97\u6559\u306e\u72b6\u6cc1\u3001\u304a\u3088\u3073\u533b\u5e2b\u304c\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u306a\u4fe1\u5ff5\u3084\u5b97\u6559\u7684\u4fe1\u5ff5\u306b\u3064\u3044\u3066\u8b70\u8ad6\u3059\u308b\u969b\u306e\u9069\u5207\u306a\u72b6\u6cc1\u3001\u7406\u7531\u3001\u304a\u3088\u3073\u671f\u5f85\u306b\u95a2\u3059\u308b\u53c2\u52a0\u8005\u306e\u8a55\u4fa1\u3092\u30a2\u30f3\u30b1\u30fc\u30c8\u8abf\u67fb\u3067\u5f97\u305f\u3002
\n\u3000\u53ef\u80fd\u306a\u9650\u308a\u591a\u304f\u306e\u4eba\u3092\u5bfe\u8c61\u3068\u3059\u308b\u305f\u3081\u3001\u672c\u8abf\u67fb\u3067\u306f\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30ea\u30c6\u30a3\u306e\u5b9a\u7fa9\u306f\u7279\u306b\u56de\u7b54\u8005\u306b\u4f1d\u3048\u306a\u304b\u3063\u305f\u3002\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30ea\u30c6\u30a3\u306b\u95a2\u3059\u308b\u3059\u3079\u3066\u306e\u8cea\u554f\u306f\u3001”\u7cbe\u795e\u7684\u307e\u305f\u306f\u5b97\u6559\u7684\u306a\u4fe1\u5ff5 spiritual or religious beliefs”\u3068\u3044\u3046\u8a00\u8449\u3067\u8868\u73fe\u3055\u308c\u305f\u3002Koenig\u306b\u3088\u308b\u3068\u30a2\u30e1\u30ea\u30ab\u4eba\u306e\u591a\u304f\u304c\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30ea\u30c6\u30a3\u3068\u5b97\u6559\u3092\u533a\u5225\u3057\u3066\u3044\u306a\u3044\u3068\u8003\u3048\u3089\u308c\u308b\u3002<\/strong><\/p>\n

RESULT
\n\u3000921\u540d\uff08\u60a3\u8005798\u540d\u3001\u4ed8\u6dfb\u3044\u4eba123\u540d\uff09\u304c\u30a2\u30f3\u30b1\u30fc\u30c8\u306b\u7b54\u3048\u3001492\u540d\u304c\u62d2\u5426\u3057\u3001\u56de\u7b54\u7387\u306f65%<\/strong>\u3060\u3063\u305f\u3002\u56de\u7b54\u8005\u306e\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u306ftable1\u306b\u793a\u3059\u3002SF-12\u306e\u8eab\u4f53\u7684\u8981\u7d20\u306e\u30b5\u30de\u30ea\u30fc\u30b9\u30b3\u30a2\uff08\u5e73\u5747\u5024\uff1d47.0\uff09\u304a\u3088\u3073\u7cbe\u795e\u7684\u8981\u7d20\u306e\u30b5\u30de\u30ea\u30fc\u30b9\u30b3\u30a2\uff08\u5e73\u5747\u5024\uff1d48.0\uff09\u306f\u3001\u56de\u7b54\u8005\u306e\u5065\u5eb7\u72b6\u614b\u304c\u7c73\u56fd\u306e\u4e00\u822c\u4eba\u53e3\u306e\u5e73\u5747\u5024\uff08\u8eab\u4f53\u768450.1\u3001\u7cbe\u795e\u768450.0\uff09\u3068\u6bd4\u8f03\u3057\u3066\u6709\u610f\u5dee\u306f\u306a\u304b\u3063\u305f\u3002\u30ea\u30b5\u30fc\u30c1\u30a2\u30b7\u30b9\u30bf\u30f3\u30c8\u306f\u3001\u53c2\u52a0\u3092\u62d2\u5426\u3057\u305f\u4eba\u306e\u5e74\u9f62\u3092\u63a8\u5b9a\u3057\u305f\u3002\u3053\u306e\u63a8\u5b9a\u306b\u3088\u308b\u3068\u300160\u6b73\u4ee5\u4e0a\u306e\u65b9\u306e\u53c2\u52a0\u62d2\u5426\u7387\u304c\u9ad8\u304f\u306a\u3063\u305f<\/strong>\u3002
\n\u56de\u7b54\u8005\u306e17\uff05\u306f\u81ea\u5206\u306e\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u306a\u4fe1\u5ff5\u306b\u3064\u3044\u3066\u8cea\u554f\u3055\u308c\u305f\u304f\u306a\u3044\u3068\u7b54\u3048\u300163\uff05\u306f\u72b6\u6cc1\u306b\u5fdc\u3058\u3066\u8cea\u554f\u3055\u308c\u305f\u3044\u3068\u7b54\u3048\u300120\uff05\u306f\u5e38\u306b\u81ea\u5206\u306e\u4fe1\u5ff5\u306b\u3064\u3044\u3066\u533b\u5e2b\u306b\u77e5\u3063\u3066\u3082\u3089\u3044\u305f\u3044\u3068\u7b54\u3048\u305f\u3002\u307e\u305f\u3001\u4ee5\u524d\u306b\u533b\u5e2b\u304b\u3089\u8cea\u554f\u3092\u53d7\u3051\u305f\u3053\u3068\u304c\u3042\u308b\u3068\u7b54\u3048\u305f\u4eba\u306f\u308f\u305a\u304b9\uff05\u3067\u300118\uff05\u306f\u8cea\u554f\u3055\u308c\u305a\u306b\u533b\u5e2b\u306b\u4f1d\u3048\u305f\u3068\u7b54\u3048\u307e\u3057\u305f\u3002<\/strong>
\n\u3000\u81ea\u5206\u306e\u4fe1\u5ff5\u306b\u3064\u3044\u3066\u300c\u3044\u3064\u3082\u300d\u3082\u3057\u304f\u306f\u300c\u3068\u304d\u3069\u304d\u300d\u533b\u5e2b\u306b\u77e5\u3063\u3066\u3082\u3089\u3044\u305f\u3044\u3068\u601d\u3046\u3068\u7b54\u3048\u305f\u56de\u7b54\u8005\u306b\u306f\u3001\u533b\u7642\u5834\u9762\u306e\u30ea\u30b9\u30c8\u3092\u63d0\u793a\u3057\u3001\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30ea\u30c6\u30a3\u306b\u95a2\u3059\u308b\u4f1a\u8a71\u304c\u6b53\u8fce\u3055\u308c\u308b\u304b\u3069\u3046\u304b\u3092\u5c0b\u306d\u305f(table2)\u3002\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u306a\u8a71\u304c\u6700\u3082\u6b53\u8fce\u3055\u308c\u308b\u72b6\u6cc1\u306f\u3001\u547d\u306b\u304b\u304b\u308f\u308b\u72b6\u614b\u3001\u91cd\u7be4\u306a\u75c5\u6c17\u3001\u611b\u3059\u308b\u4eba\u306e\u6b7b\u3067\u3042\u3063\u305f\u3002\u6b53\u8fce\u3055\u308c\u306a\u3044\u5834\u9762\u3068\u3057\u3066\u306f\u3001\u5065\u5eb7\u8a3a\u65ad\u3084\u691c\u8a3a\u306e\u969b\u306e\u554f\u8a3a\u3001\u8efd\u3044\u75c5\u6c17\u306e\u53d7\u8a3a\u306a\u3069\u304c\u6319\u3052\u3089\u308c\u305f\u3002<\/strong>
\n\u3000\u4fe1\u4ef0\u306b\u3064\u3044\u3066\u300c\u3044\u3064\u3082\u300d\u3082\u3057\u304f\u306f\u300c\u3068\u304d\u3069\u304d\u300d\u533b\u5e2b\u3068\u8a71\u3057\u5408\u3044\u305f\u3044\u3068\u7b54\u3048\u305f\u4eba\u306f\u3001\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u306a\u4fe1\u5ff5\u306b\u3064\u3044\u3066\u533b\u5e2b\u306b\u77e5\u3063\u3066\u3082\u3089\u3044\u305f\u3044\u7406\u7531\u3068\u3057\u3066\u300187\uff05\u304c\u81ea\u5206\u306e\u4fe1\u4ef0\u304c\u75c5\u6c17\u3078\u306e\u5bfe\u51e6\u6cd5\u306b\u3069\u306e\u3088\u3046\u306a\u5f71\u97ff\u3092\u4e0e\u3048\u3066\u3044\u308b\u304b\u3092\u533b\u5e2b\u306b\u7406\u89e3\u3057\u3066\u3082\u3089\u3044\u305f\u3044\u3068\u8003\u3048\u3066\u304a\u308a\u300185\uff05\u304c\u81ea\u5206\u3092\u4eba\u3068\u3057\u3066\u3088\u308a\u3088\u304f\u7406\u89e3\u3057\u3066\u3082\u3089\u3044\u305f\u3044\u3068\u8003\u3048\u3066\u304a\u308a\u300183\uff05\u304c\u81ea\u5206\u306e\u610f\u601d\u6c7a\u5b9a\u3092\u533b\u5e2b\u306b\u7406\u89e3\u3057\u3066\u3082\u3089\u3044\u305f\u3044\u3068\u8003\u3048\u3066\u3044\u305f<\/strong>(table3)\u3002\u601d\u3044\u3084\u308a\u306e\u63d0\u4f9b\u3001\u73fe\u5b9f\u7684\u306a\u5e0c\u671b\u306e\u5968\u52b1\u3001\u75c5\u6c17\u306b\u306a\u3063\u305f\u3068\u304d\u306e\u30b1\u30a2\u306e\u4ed5\u65b9\u306e\u30a2\u30c9\u30d0\u30a4\u30b9\u3001\u6cbb\u7642\u6cd5\u306e\u5909\u66f4\u3001\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u30fb\u30ab\u30a6\u30f3\u30bb\u30e9\u30fc\u306e\u7d39\u4ecb\u306a\u3069\u306f50\uff05\u4ee5\u4e0a\u304c\u652f\u6301\u3057\u305f\u3002\u533b\u5e2b\u3068\u4e00\u7dd2\u306b\u7948\u308b\uff0833\uff05\uff09\u3001\u533b\u5e2b\u306b\u300c\u305f\u3060\u805e\u3044\u3066\u3082\u3089\u3046\u300d\uff0822\uff05\uff09\u306f\u3001\u597d\u307e\u308c\u306a\u3044\u884c\u52d5\u3067\u3042\u3063\u305f\u3002
\n\u3000\u30ed\u30b8\u30b9\u30c6\u30a3\u30c3\u30af\u56de\u5e30\u30e2\u30c7\u30eb\u306e\u7d50\u679c\u3092table4\u306b\u793a\u3059\u3002\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u306a\u8a71\u3057\u5408\u3044\u3092\u671b\u3080\u50be\u5411\u304c\u5f37\u304b\u3063\u305f\u306e\u306f\u300130\u301c64\u6b73\u306e\u56de\u7b54\u8005\uff08\u30aa\u30c3\u30ba\u6bd4\uff3bOR\uff3d\uff1d2.1\uff09\u3001\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u306a\u4fe1\u5ff5\u304c\u533b\u7642\u4e0a\u306e\u6c7a\u5b9a\u306b\u5f71\u97ff\u3059\u308b\u3068\u8a55\u4fa1\u3057\u305f\u56de\u7b54\u8005\uff08OR\uff1d3.0\uff09\u3001\u75c5\u6c17\u306e\u6642\u306b\u4fe1\u5ff5\u304c\u5e0c\u671b\u3092\u4e0e\u3048\u308b\u3068\u7b54\u3048\u305f\u56de\u7b54\u8005\uff08OR\uff1d4.5\uff09\u30011\u301c5\u306e\u30b9\u30b1\u30fc\u30eb\u3067\u81ea\u5206\u3092\u3088\u308a\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u3060\u3068\u8a55\u4fa1\u3057\u305f\u56de\u7b54\u8005\uff08\u3053\u306e\u30b9\u30b1\u30fc\u30eb\u304c1\u30dd\u30a4\u30f3\u30c8\u4e0a\u304c\u308b\u3054\u3068\u306bOR\uff1d1.3\uff09\u3067\u3042\u3063\u305f\u3002<\/strong>
\n\u3000\u30a2\u30f3\u30b1\u30fc\u30c8\u306b\u306f3\u3064\u306e\u81ea\u7531\u5f62\u5f0f\u306e\u8cea\u554f\u304c\u3042\u3063\u305f\u3002\u300c\u3042\u306a\u305f\u306e\u5b97\u6559\u7684\u30fb\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u7684\u4fe1\u5ff5\u304c\u3001\u3042\u306a\u305f\u81ea\u8eab\u3084\u3042\u306a\u305f\u306e\u8eab\u8fd1\u306a\u4eba\u304c\u95a2\u308f\u308b\u533b\u7642\u4e0a\u306e\u6c7a\u5b9a\u306b\u5bfe\u51e6\u3059\u308b\u65b9\u6cd5\u306b\u5f71\u97ff\u3092\u4e0e\u3048\u305f\u7d4c\u9a13\u3084\u72b6\u6cc1\u3092\u601d\u3044\u6d6e\u304b\u3079\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059\u304b\u300d\u3068\u3044\u3046\u8cea\u554f\u306b\u5bfe\u3057\u3066\u3001377\u540d\u306e\u56de\u7b54\u8005\u304c\u3067\u304d\u308b\u3068\u7b54\u3048\u3001340\u540d\uff0841\uff05\uff09\u304c\u4f8b\u3092\u6319\u3052\u307e\u3057\u305f\u3002\u3053\u308c\u3089\u306e\u56de\u7b54\u306e\u5927\u90e8\u5206\u306f\u3001\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u306a\u4fe1\u5ff5\u304b\u3089\u306e\u30b5\u30dd\u30fc\u30c8\u3092\u898b\u3064\u3051\u305f\u3068\u3044\u3046\u5074\u9762\u304c\u3042\u308a\u307e\u3057\u305f\u3002\u307e\u305f\u300185\u4eba\u306e\u56de\u7b54\u8005\u304c\u300c\u7948\u308a\u300d\u3092\u5177\u4f53\u7684\u306b\u6319\u3052\u3066\u3044\u307e\u3059\u3002\u907f\u598a\u3001\u4e2d\u7d76\u3001\u51fa\u751f\u524d\u691c\u67fb\u306a\u3069\u306e\u6cbb\u7642\u6cd5\u306e\u6c7a\u5b9a\u306b\u3064\u3044\u3066\u306f\u300122\u4eba\u304c\u8a00\u53ca\u3057\u3066\u304a\u308a\u3001\u624b\u8853\u306f8\u4eba\u3001\u6295\u85ac\u306f5\u4eba\u3001\u8f38\u8840\u306f5\u4eba\u3067\u3057\u305f\u3002\u6b7b\u306b\u76f4\u9762\u3057\u305f\u3068\u304d\u306e\u4fe1\u4ef0\u306e\u5f79\u5272\u306b\u3064\u3044\u3066\u306f\u3001\u591a\u304f\u306e\u56de\u7b54\u8005\u304c\u8a00\u53ca\u3057\u3066\u3044\u307e\u3059\u304c\u3001\u751f\u547d\u7dad\u6301\u88c5\u7f6e\u3092\u5c0e\u5165\u3059\u308b\u304b\u898b\u9001\u308b\u304b\u306e\u5224\u65ad\u306b\u3064\u3044\u3066\u306f\u300146\u4eba\u306e\u56de\u7b54\u8005\u304c\u5177\u4f53\u7684\u306b\u8a00\u53ca\u3057\u3066\u3044\u307e\u3059\u30022\u3064\u76ee\u306e\u81ea\u7531\u5f62\u5f0f\u306e\u8cea\u554f\u3001\u300c\u3042\u306a\u305f\u306e\u533b\u7642\u4e0a\u306e\u6c7a\u5b9a\u306b\u5f71\u97ff\u3092\u4e0e\u3048\u308b\u3088\u3046\u306a\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u7684\u3001\u5b97\u6559\u7684\u306a\u4fe1\u5ff5\u304c\u3042\u308a\u307e\u3059\u304b\uff1f267\u4eba\u306e\u56de\u7b54\u8005\u304c\u300c\u306f\u3044\u300d\u3068\u7b54\u3048\u3001235\u4eba\uff0888\uff05\uff09\u304c\u4f8b\u3092\u6319\u3052\u307e\u3057\u305f\u3002\u56de\u7b54\u306e\u307b\u3068\u3093\u3069\u306f\u3001\u300c\u5e38\u306b\u795e\u306e\u5c0e\u304d\u3092\u6c42\u3081\u308b\u300d\u306a\u3069\u306e\u4e00\u822c\u7684\u306a\u30b3\u30e1\u30f3\u30c8\u3067\u3057\u305f\u304c\u3001\u4e2d\u7d76<\/strong>\u53cd\u5bfe\u306e\u610f\u898b\u304c46\u4ef6\u3001\u7d42\u672b\u671f\u306e\u6c7a\u65ad<\/strong>\u306b\u3064\u3044\u306638\u4ef6\u3001\u7948\u308a\u306b\u3064\u3044\u306626\u4ef6\u3001\u8f38\u8840<\/strong>\u3092\u62d2\u5426\u3059\u308b\u3068\u7b54\u3048\u305f\u4eba\u304c9\u4ef6\u3042\u308a\u307e\u3057\u305f\u30023\u3064\u76ee\u306e\u81ea\u7531\u8a18\u8ff0\u306e\u8cea\u554f\u306f\u3001\u30a2\u30f3\u30b1\u30fc\u30c8\u306e\u6700\u5f8c\u306b\u3001\u8cea\u554f\u3084\u30b3\u30e1\u30f3\u30c8\u3092\u6c42\u3081\u308b\u3082\u306e\u3067\u3057\u305f\u3002\u305d\u306e\u7d50\u679c\u300113\u4ef6\u306e\u56de\u7b54\u304c\u3042\u308a\u307e\u3057\u305f\u304c\u3001\u3044\u305a\u308c\u3082\u91cd\u8981\u306a\u60c5\u5831\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002<\/p>\n

DISCUSSION
\n\u3000\u4eca\u56de\u306e\u7d50\u679c\u306f\u5148\u884c\u7814\u7a76\u3068\u3082\u3088\u304f\u4e00\u81f4\u3059\u308b\u3002
\n\u3000\u4eca\u56de\u306e\u7814\u7a76\u3067\u306f\u3001\u4eba\u3005\u304c\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u306a\u60c5\u5831\u3092\u533b\u5e2b\u306b\u3069\u306e\u3088\u3046\u306b\u4f1d\u3048\u3001\u305d\u308c\u304c\u533b\u7642\u306b\u3069\u306e\u3088\u3046\u306a\u5f71\u97ff\u3092\u4e0e\u3048\u308b\u306e\u304b\u3092\u660e\u3089\u304b\u306b\u3057\u305f\u3053\u3068\u304c\u5927\u304d\u306a\u8ca2\u732e\u3067\u3042\u308b\u3002\u6700\u3082\u91cd\u8981\u306a\u30c6\u30fc\u30de\u306f\u3001\u300c\u7406\u89e3\u300d\u3001\u300c\u601d\u3044\u3084\u308a\u300d\u3001\u300c\u5e0c\u671b\u300d\u3067\u3042\u308b\u3053\u3068\u304c\u308f\u304b\u3063\u305f\u3002\u3053\u306e\u7814\u7a76\u306e\u3082\u3046\u4e00\u3064\u306e\u8ca2\u732e\u306f\u3001\u8a71\u3057\u5408\u3044\u3092\u671b\u3080\u4eba\u306e\u4e88\u6e2c\u56e0\u5b50\u3092\u691c\u8a0e\u3057\u305f\u3053\u3068\u3060\u3002\u4ee5\u4e0b\u306e4\u3064\u306e\u4e88\u6e2c\u56e0\u5b50\u304c\u898b\u3064\u304b\u3063\u305f\u3002(1)\u75c5\u6c17\u306e\u6642\u306b\u5e0c\u671b\u3092\u4e0e\u3048\u308b\u4fe1\u5ff5\u3092\u6301\u3063\u3066\u3044\u308b\u3001(2)\u533b\u7642\u4e0a\u306e\u6c7a\u5b9a\u306b\u5f71\u97ff\u3092\u4e0e\u3048\u308b\u4fe1\u5ff5\u3092\u6301\u3063\u3066\u3044\u308b\u3001(3)\u5e74\u9f62\u304c30\u301c64\u6b73\u3067\u3042\u308b\u3001(4)\u81ea\u5206\u3092\u3088\u308a\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u3067\u3042\u308b\u3068\u8a55\u4fa1\u3057\u3066\u3044\u308b\u3002\u3053\u308c\u3089\u306e\u8981\u7d20\u306b\u57fa\u3065\u3044\u305f\u7c21\u5358\u306a\u30a2\u30f3\u30b1\u30fc\u30c8\u304c\u3001\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u306a\u8a55\u4fa1\u3092\u69cb\u6210\u3059\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3002
\n\u3000\u4eca\u5f8c\u306e\u7814\u7a76\u3067\u306f\u3001\u53d7\u8a3a\u6642\u306b\u65e5\u5e38\u7684\u306b\u8cea\u554f\u3092\u884c\u3046\u3053\u3068\u304c\u60a3\u8005\u3068\u533b\u5e2b\u306e\u53cc\u65b9\u306b\u3069\u306e\u3088\u3046\u306a\u5f71\u97ff\u3092\u4e0e\u3048\u308b\u304b\u3092\u8abf\u67fb\u3057\u3001\u305d\u306e\u53d7\u3051\u5165\u308c\u53ef\u80fd\u6027\u3092\u5224\u65ad\u3059\u308b\u3053\u3068\u304c\u8003\u3048\u3089\u308c\u308b\u3002
\n\u3000\u3053\u306e\u7814\u7a76\u3067\u306f60\u6b73\u4ee5\u4e0a\u306e\u4eba\u306f\u53c2\u52a0\u3092\u62d2\u5426\u3059\u308b\u50be\u5411\u304c\u3042\u308b\u3053\u3068\u304c\u793a\u5506\u3055\u308c\u305f\u304c\u3001\u5148\u884c\u7814\u7a76\u3082\u542b\u3081\u3066\u53c2\u52a0\u3092\u62d2\u5426\u3059\u308b\u3001\u3064\u307e\u308a\u30b9\u30d4\u30ea\u30c1\u30e5\u30a2\u30eb\u306a\u8a71\u3057\u5408\u3044\u3092\u907f\u3051\u3046\u308b\u7406\u7531\u306f\u5206\u304b\u3063\u3066\u3044\u306a\u3044\u3002<\/strong><\/p>\n

\"\"<\/a><\/p>\n

\"\"<\/a><\/p>\n

\"\"<\/a><\/p>\n

\"\"<\/a><\/p>\n

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\n2021\u5e748\u670811\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

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