Departmental Bulletin Paper バーバルコミュニケーションが困難な患者での生演奏による相互交流の可能性 ―統合失調症患者における検討を通して―
A possibility of intercommunication by real performance with patients who have difficulty in verbal communication ― Focusing on schizophrenic patients ―

雄鹿, 賢哉  ,  新山, 喜嗣  ,  OGA, Kenya  ,  NIIYAMA, Yoshitsugu

23 ( 2 )  , pp.129 - 137 , 2015-10-31 , 秋田大学大学院医学系研究科保健学専攻
統合失調症患者へ音楽活動を提供するにあたり, 「生演奏」と「録音演奏」との間での音楽聴取形態の違いに着目し, 「生演奏」によって, ノンバーバルな水準での治療者と患者の間での相互交流が形成されるか否かを検討した.対象は, 精神科病棟に入院中で, 本研究の目的と方法を説明した上で同意・署名を得られた, 明らかに認知機能障害や精神遅滞を有さない統合失調症患者53名とした.音楽形態における生演奏(セラピストによるエレクトーン演奏) と録音演奏(エレクトーン演奏を同装置から再生)との間の比較を主眼とし, 同じ3曲15分間を, それぞれの音楽形態で聴取した. 評価指標は, 心理状態の測定として気分調査票The Mood Inventory (以下MOOD) を行った.生演奏聴取前後を比較した結果, 生演奏聴取後の「爽快感」と, 「くつろいだ気分だ」の項目に有意な改善が得られた(P<0.01, 0.05). また生演奏では, 対象者が演奏のたびに拍手や声援をセラピストに送る様子が見られた. この結果から, 精神科作業療法における音楽活動を実践する際には, 生演奏はバーバルな水準での関与が困難な患者に対しても有効な, 治療導入時の手段やセラピストと患者間の関係作りとなりえる可能性があり, さらには外部からの感覚入力の手段としても有効であることが推測された.
The purpose of the present study was to examine the therapeutic effects of real performance (RP) inschizophrenic patients who have difficulty in verbal communication. This study compared the way thatsubjects listened to music in an RP setting and how they listened to recorded music (RM).The participants included 53 long-term patients who were hospitalized in recuperation wards, who hadbeen diagnosed with schizophrenia. Patients with unequivocal organic cognitive impairment or mentalretardation, and those who required ongoing occupational therapy were excluded from the study. All ofthe participants gave written informed consent to participate in the study.We compared the patients responses to RP and RM to examine the therapeutic effects of the differentways of listening to music. In the RP sessions, the involvement of the patient was passive, and mainlyconsisted of the therapist performing music while the patient listened. In the RM sessions, the involvementof the patient was also passive, and mainly consisted of the recorded music being played while the patientlistened. Both types of sessions lasted 15-minutes and used the same music. The patients underwent eitherRP or RM therapy once per week. We evaluated the psychological condition of the patients in the RP andRM groups using The Mood Inventory (MOOD).At the end of the therapy period, the participants of the RP group showed significant improvement in exhilarating feeling and feeling relaxed (P<0.01, P<0.05, respectively), and the participants applaudedand cheered their therapist. The present study showed that RP, which stimulates the senses of thepatients, can be effective as an induction therapy for promoting intercommunication between schizophrenicpatients who have difficulty in verbal communication and their therapist.

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