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Purpose : To quantitatively assess and clarify the relationships between eating behaviors, physical symptoms, and depression over 6 months postoperatively in patients who have undergone gastrectomy for gastric cancer. / Methods : Questionnaire surveys to post-gastrectomy patients on eating behavior, post-gastrectomy dysfunction (DAUGS), and depression (CES-D) were conducted five times during the 6 months after surgery (before discharge, and 2 weeks, 6 weeks, 3 months, and 6 months after surgery). The longitudinal changes of each item were analyzed using a repeated measure ANOVA, and the relationships between post-gastrectomy dysfunction and patient factors were analyzed using a two-way ANOVA. The relationships between depression and post-gastrectomy dysfunction were analyzed using correlations. / Results : The subjects were 64 post-gastrectomy patients. The mean age was 66.5 (SD 10.3) years and 40 were males. Forty-six patients had distal gastrectomy. Fifty-three were diagnosed as gastric cancer stage Ⅰ. The participantsʼ body weight had decreased by about 10% at 6 months after surgery (p＜.001). Although the patients who practiced eating behavior modifications such as food adjustment decreased from 80％ to 50％ at 6 months after surgery, food intake was recovered up to about 80% of the pre-operative intake. Post-gastrectomy dysfunction (DAUGS) was the worst at 2 weeks after surgery and improved significantly within 6 months (p ＜.05). The factors that were associated with significantly worse post-gastrectomy dysfunction were being employed and high depression groups. The post-gastrectomy dysfunction in the high depression group was worse than in the low depression group throughout the 6 months. / Conclusion : Post-gastrectomy dysfunction worsened immediately after discharge and was alleviated over 6 months, and a relationship between physical and depressive states was observed. Medical staff should be better to understand patientsʼ depressive state during hospitalization and continue to observe the post-gastrectomy dysfunction early postoperative period., 【目的】胃切除術を受けた胃癌患者の術後半年間における食行動，身体的状態およびうつ傾向の実態とそれらの関連を明らかにすることである． / 【方法】胃癌で胃切除術を受けた患者を対象に，食行動，術後機能障害（DAUGS），抑うつ（CES-D）に関する質問紙調査を，術後半年の間に5 回（退院前，術後2週間，6 週間，3ヶ月，6ヶ月）縦断的に実施した．各項目の経時的変化は反復測定分散分析を用い，患者要因と術後機能障害の関連は二元配置分散分析を用いて検討した．抑うつと術後機能障害の関連は，相関関係を用いて分析した． / 【結果】64 名の胃切除術後患者を対象とした．平均年齢66.5（SD10.3）歳，男性40 名であった．幽門側胃切除術46 名で，胃癌ステージⅠが53 名であった．体重は術後半年間で約10％減少した（p ＜.001）．術後半年経つと，食事量調整などの食行動を実践している人は8 割から全体の半数に減少したが，食事摂取量は術前の8 割程度に回復した．術後機能障害（DAUGS）は術後2 週間が最も強く，その後半年間で有意に改善した（p ＜.05）．患者要因によるDAUGS 得点の推移を見ると，就労群と高抑うつ群の機能がより障害されていた．高抑うつ群の術後機能障害の程度は，低抑うつ群と比べ，6 か月間を通じて重かった． / 【結論】胃切除後の機能障害は退院直後が最も悪く，6ヶ月間で軽快し，身体的状態と抑うつ状態が関係していることが明らかになった．医療者は，入院中から患者の抑うつ状態を把握し，術後早期からの胃切除術後機能障害の継続的な観察を行う必要がある．

Administration of oral agents is a standard postoperative adjuvant chemotherapeutic regimen in colorectal cancer patients. However, little is known about medication adherence of oral chemotherapy in Japanese patients. This study was aimed to elucidate the current status of medication adherence and identify the factors associated with low adherence to postoperative adjuvant chemotherapy in colorectal cancer patients. Among 81 enrolled patients receiving postoperative adjuvant chemotherapy,61 patients (oral anticancer agents alone: 33, combination of oral anticancer agents and IV administration: 28) were analyzed. Medication adherence (MMAS-8), and anxiety and depression(HADS) were evaluated longitudinally at 3 time-points (1-2, 3-4, 5-6 months) using questionnaires. Factors associated with low adherence were analyzed by multivariate logistic regression. The median medication adherence score and anxiety and depression score did not change significantly over the6-months of chemotherapy. At 1-2 months after initiation of treatment, low medication adherence was associated with treatment using oral anticancer agents alone (OR: 9.49) and depression (OR: 1.30). At5-6 months, treatment with oral anticancer agents alone was also associated with low adherence (OR: 6.39). / To maintain adherence, health care professionals should focus on patients who have higher risk for low adherence by monitoring those receiving oral chemotherapeutic agents alone and patients with depression. Thus, continuous educational and emotional support tailored each patient should be considered from the initiation of chemotherapy., 大腸がんの術後補助化学療法として経口抗がん剤を使用した療法は標準治療の一つとなっているが，日本において経口抗がん剤を用いた術後補助化学療法中の服薬アドヒアランスに関する報告は僅かである．本研究の目的は，経口抗がん剤を使用する術後補助化学療法を受ける大腸がん患者の服薬アドヒアランスの実態と服薬アドヒアランスの低下に関連する要因を明らかにすることである．61 名の患者（経口抗がん剤単独群33 名，経口抗がん剤に静注薬併用群28名）を対象として，6ヶ月間の術後補助化学療法の治療開始から3 時点（1〜2，3〜4，5〜6ヶ月後）において服薬アドヒアランス（MMAS-8 scores），不安と抑うつ（HADS）に関する質問紙調査を実施した．アドヒアランス低下に関連する要因の解析はロジスティック回帰分析を使用した．MMAS-8 scores によるアドヒアランスやHADS による不安と抑うつの術後6ヶ月間の経時的有意な変化は無かった．服薬アドヒアランスの低下に関連する要因は，治療開始1〜2ヶ月は経口抗がん剤単独による治療（OR：9.49）と抑うつ（OR：1.30）であった．治療開始5〜6ヶ月は経口抗がん剤単独治療（OR：6.39）が関与していた．本調査結果から，アドヒアランスを維持するためには，医療者はアドヒアランスの低下のリスクが高い経口抗がん剤単独治療を受ける患者や抑うつに焦点を当て，治療開始初期から継続的に教育的，精神的な支援を検討する必要があることが示唆された．

BACKGROUND: Implantable cardioverter‐defibrillators (ICD) have provided effective therapy for fatal arrhythmia. However, ICD patients are known to develop psychological problems, such as posttraumatic stress disorder (PTSD), if they have experienced potentially fatal arrhythmia and ICD shocks. Little is known about the factors influencing PTSD in ICD patients. HYPOTHESIS: Echocardiographic cardiac‐function parameters might relate to psychological problems, especially PTSD, in ICD patients. METHODS: A total of 128 outpatients with ICD implantation completed the Impact of Event Scale Revised (IES‐R) questionnaire as a measurement of PTSD. Demographic and clinical characteristic data were collected from medical records. RESULTS: The mean age of the ICD patients was 59 ± 16 years; 103 were male; and the mean left ventricular ejection fraction (LVEF) by echocardiography was 52.4% ± 18.3%. In the ICD patients, female sex and impaired LVEF were related to lower IES‐R scores or led to PTSD (P = 0.01 and P = 0.03, respectively). Impaired LVEF also worsened 2 symptoms of PTSD, intrusion (P = 0.02) and hyperarousal (P = 0.03). In patients with LVEF