Thesis or Dissertation 回復期リハビリテーション病棟入院中のクライエントと担当作業療法士の相互理解のプロセス

坂根, 勇輝

pp.1 - 12 , 2017-03-25
Description
回復期リハビリテーション病棟入院中のクライエントと担当作業療法士が“希望する生活ができるようになる”ことをお互いが理解していくプロセスを探求し,理解することを目的に,Narrative-in-actionを用いた質的研究を行った.クライエントと担当作業療法士から構成される三組の研究参加者に参与観察とインタビューを行った.得られたデータをテーマ的ナラティブ分析した結果,相互理解のプロセスは,<予想外の事が起こって,“希望する生活ができるようになる”ことにっいての考えが揺れ動く>,<信頼関係を発展させるためにお互いに目標を調整する>,<共有できた経験を通してお互いに理解し合う>ことが,状況に応じて立ち現れたり,消えたりするプロセスであった.この結果より相互理解のプロセスの視点を含めたもう一つの作業療法プロセスの提案が示唆された.
Introduction: Studies into the mutual understanding between clients and occupational therapists have typically explored client and occupational therapist experiences separately. The aim of this study is to explore the processes of how clients and occupational therapists mutually understand the enablement of clients' daily life in convalescent rehabilitation. Methods: This qualitative research used a narrative-in-action method. Three pairs of clients and occupational therapists were separately interviewed preceding and following observation of an occupational therapy session. Three date-gatherings were conducted, one month apart in the last two months until hospital discharge, consisting of unstructured with open-ended questions and participant observations. Date-analysis was a thematic narrative analysis. One narrative composed of possible plots was then created to explain the process of creating mutual understanding between each client and occupational therapist. Results: Comparison among the three narratives let to identifying three common plots that express how mutual understanding emerges and disappears: Their ideas on enablement of clients' daily life waver by unexpected things happening, mutually adjusting goals in order to enhance trusting relationships, understanding each other through sharing experience. Discussion: These findings suggest that clients have a stake in and actively contribute to building trusting relationships, the importance of occupational experiences, the necessity to flexibly practice occupational therapy to unexpected things, and that the occupational therapy as a process of developing mutual understanding is iterative and non-linear.
首都大学東京, 2017-03-25, 修士(作業療法学)
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