Departmental Bulletin Paper 「生活行為向上マネジメント」を利用した難病入院患者の作業療法の効果
Effects of Occupational Therapy using Management Tools to Manage for Daily Life Performance on Hospitalized Patients with Intractable Neurological Diseases

佐々木, 千波  ,  金城, 正治  ,  SASAKI, Chinami  ,  KINJO, Masaji

23 ( 2 )  , pp.177 - 183 , 2015-10-31 , 秋田大学大学院医学系研究科保健学専攻
入院している神経難病患者に生活行為向上マネジメントを用いて, 作業療法を実施した. 本研究ではその手法の導入効果を検証した. 対象者は15名とした. 検証に使った評価項目は, 身体機能, 認知, ADL, 健康関連QOL, 意欲,実行度, 満足度とした. この手法で選択された活動には, 「パソコンがしたい」や「ADL の自立」などがあった. 作業療法の実施期間は3カ月とした. 結果として, 神経難病の特性として進行性があるので, 上肢機能やADL の低下はあったが, 健康関連QOL (SF36) の向上が見られた. また, 他職員との連携や役割も明確になった. 対象者で症状の進行が早い場合は, 身体機能や健康関連QOL も低下することがあり, 進行に応じた対応も求められた. 生活行為向上マネジメントは, 作業活動の選択, 明確化, 職種の連携などプロセスが可視化でき, 難病疾患への導入の有効性が明確になった.
An occupational therapy program using tools to manage daily life was implemented among hospitalizedpatients with intractable neurological diseases. This study verified the effects of the intervention onthe physical functions, cognition, activities of daily living (ADL), quality of life (QOL ; with regard tohealth), willingness to participate, degree of practice and degree of satisfaction among 15 patients. Theactivities that were evaluated in the study included the patients willingness to use their personalcomputers and their ability to independently perform their ADLs. The patients underwent occupationaltherapy for a period of three months. As a result, although there were declines in their upper limbfunctions and ADLs due to the progressive characteristics of their intractable neurological diseases, theirresponses, with regard to their QOL (concerning health ; SF36) were observed to improve. Occupationaltherapist and the other staff could collaborated, and the role of other staff became clear. In cases wherepatients symptoms showed rapid progression, their physical functions and the QOL (concerning health)sometimes declined ; thus, it was necessary for the patients to respond in accordance with the progressionof their disease. The tools for managing daily life allowed for the processes of selection, clarifying of workactivities and coordination among jobs to be visualized ; thereby clarifying the effectiveness method of theintroduction of this program for patients with intractable diseases.

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