回復期リハビリテーション病棟認知症併存患者の行動・心理症状がFIMに及ぼす影響—重回帰分析による過去起点コホート研究

Influence of BPSD of convalescent rehabilitation ward patients with concomitant dementia on the FIM: A retrospective cohort study using multiple regression analysis

要旨：本研究の目的は，回復期リハ病棟の認知症併存者を対象にBPSDのFIM向上への影響を明らかにし，BPSDへの作業療法介入の基礎資料を提供することとした．脳血管疾患136名と運動器疾患137名に対し，目的変数をmFIM利得，説明変数に6因子（年齢，発症後期間，入院時mFIM，入院時cFIM，入院時BMI，入院時NPI-NH合計点）を用いて重回帰分析を実施した．その結果，脳血管疾患，運動器疾患ともに，NPI-NHが阻害因子として抽出され，入院時BPSD有症者へはADL向上の観点からBPSDへ介入する必要性が示唆された．

　The purpose of this study is to clarify the effect of BPSD on FIM improvement in patients with comorbid dementia in convalescent rehabilitation wards and to provide a basis for occupational therapy intervention for BPSD. Multiple regression analysis was performed on 136 patients with cerebrovascular accident (CVA) and 137 patients with motor system disorders, using motor FIM gain as the objective variable and 6 factors(age, time since onset, BMI on admission, total mFIM score, total cFIM score, and total NPI-NH score on admission)as explanatory variables. The analysis indicates that NPI-NH was extracted as an inhibitory factor in improving ADL at CVA and motor system disorders patients, suggesting the need for BPSD intervention in terms of improving ADL in patients with BPSD at admission.