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本稿の目的は,主観的幸福感(生活への満足感,肯定的感情,否定的感情)のうち,肯定的感情と否定的感情を若年期,中年前期,中年期,中年後期という4つの年代に分け,性別によって差異があるかどうかを調べ,つぎに両感情を規定する要因を基本属性,主観的健康感,さらに文脈的変数を加えて検討することである。調査対象者は153カップル,それぞれの平均年齢は,若年期31.9歳,中年前期38.1歳,中年期49.3歳,中年後期57.2歳である。結果は以下のとおりであった。(1)中年前期と中年期では夫の肯定的感情は他の年代よりも低く,とくに肯定的感情における性差は中年期の夫と妻で大きかった。一方,どの年代においても妻の否定的感情は夫よりも高く,中年期と中年後期の妻にジェンダー効果が示唆された。(2)若年期にのみ主観的健康感は両感情に対して強い規定力を示し,健康感の他に若年期では子ども数が少ないことが肯定的感情を高め,中年期では妻であることが否定的感情を高めていた。(3)仕事ストレス項目は中年前期と中年期の肯定的感情と中年期の否定的感情に対して規定力を示した。一方,関係ストレス項目は中年前期の両感情と中年期の肯定的感情,若年期の否定的感情に強い規定力を示した。中年期は仕事や関係ストレス項目を考慮に入れても両感情の説明力は十分ではなく,パーソナリティ変数を含めて検討する必要があるだろう。

While the elderly are intensive health care users, little is known about their expectations of various medical facilities and physicians. We investigated their views on advAntages and disadvantages of different medical settings.We established four focus groups and surveyed elderly people living in a rural area accessible to local practitioner's offices, and community, regional, and university hospitals, The focus groups examined advantages and disadvantages of care from these facilities. A coding scheme was used to organize the data in thematic categories, In a mail survey, participants ranked the importance of specialty care; overall care; triage of patients; gentle personality; listening skills; and explanation skills, The data were analyzed for statistical differences between the various settings.Total of 41 elderly participated in focus groups, and 40 individuals (response rate 98%) returned statistical surveys. Advantages of care from a primary care doctor included continuity and physician accommodation of patients' preferences, while limited medical services and urgent access were disadvantages. Advantages of the community hospital included expanded medical facilities and having doctors easy to talk with, while disadvantages included lack of trust and frequent turnover. Advantages of larger facilities included extensive medical equipment, a broad range of departments and specialists, and more expert care. The survey revealed expectations for expert triage skills and familiarity with a doctor who is easy to talk with, particularly primary care doctor.These elderly subjects expect primary care and community doctors to be accessible and to exhibit excellent behavioral and communication skills, They expect more specialized and technical care in larger hospitals.