Departmental Bulletin Paper 障害者の就労支援における作業療法士の役割 : 障害者就労移行支援事業所および継続支援事業所に勤務する作業療法士に対するインタビューの質的分析の結果より
Occupational Therapists’ Roles in Employment Support for Individuals with Disabilities : Interviews with Those Working in Job Change and Employment Support Facilities

藤田, さより  ,  建木, 健

 近年,障害者の就労支援体制の整備が進み,福祉領域である障害者の就労移行支援事業・就労継続支援事業所に勤務する作業療法士が増えつつある.しかしそれらの事業所において実際,作業療法士がどのような役割を担っているかを調査した報告は少ない.そこでそれら障害者の就労支援を行う事業所に勤務する作業療法士の役割はどのようなものであり,また他職種から作業療法士に対し期待され,任されている役割がどのようなものであるかを明らかにしたいと考え, 本研究を実施した.研究は,障害者就労支援事業・就労継続支援事業所に勤務する作業療法士に半構成的インタビューを行い,その内容について質的分析を行った.結果,抽出された作業療法士の役割は,【対象者に対する包括的な評価】,【根拠に基づき実践につなげる分析】,【障害特性に応じた幅広い対応・介入】であった.また他職種から作業療法士に対し期待され,任されている役割では,【対象者に対する包括的な評価】,【根拠に基づいた分析】,【対象者に応じた幅広く柔軟な対応・介入】,【福祉と医療との連携】であった.今後より質の高い就労支援の実施のために作業療法士は, 職業リハビリテーションに特化した評価力や分析力, 支援技術の向上が必要であると考える.
 With recent changes, such as revisions of related laws, the establishment of systems to provide employment support for individuals with disabilities has been promoted. Consequently, an increasing number of occupational therapists, whose main workplaces had previously been limited to medical domains, are currently working in facilities providing job change and employment support for such individuals as a welfare domain. However, their actual roles in such facilities have rarely been reported. This study aimed to clarify occupational therapists’ roles in facilities providing employment support for individuals with disabilities, other professionals’ expectations of them, and their actual duties. Semi-structured interviews were conducted with 15 occupational therapists working in Japanese facilities providing job change or employment support for individuals with disabilities, and the obtained data were qualitatively analyzed, with their consent. Narrative records were created using all interview contents to extract statements regarding occupational therapists’ roles in employment support for individuals with disabilities, other professionals’ expectations of them, and their actual duties. There were 3 categories related to occupational therapists’ roles: <comprehensive service user assessment>, <evidence-based analysis for support provision>, and <extensive management and intervention in accordance with the characteristics of disability>. As for other professionals’ expectations of them and their actual duties, there were 4 categories: <comprehensive service user assessment>, <evidence-based analysis>, <extensive and flexible management and intervention for each service user>, and <liaison between welfare and medicine>. In order to provide higher-quality employment support, it may be necessary for occupational therapists to improve their assessment, analytical, and support skills specific to vocational rehabilitation.

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