高齢心不全症例に対して家族協働の疾病管理により趣味活動再開に至った1例—麻雀を経てグランドゴルフの再開に至るまで

A case of resuming hobbies through family collaboration in disease management for an older patient with heart failure: From mahjong to the resumption of ground golf

要旨：今回，心筋梗塞による心不全を呈した高齢男性を担当した．本事例に対し，心不全手帳に加えて，慢性閉塞性肺疾患患者でよく用いられる「アクションプラン」を作成し，事例と家族が協働して疾病管理ができるよう促した．その後の外来作業療法において，本事例の趣味である麻雀やグランドゴルフ動作を継続的にモニタリング評価しながら，高い心負荷とならないよう，趣味活動の再開を段階的に促した．その結果，発症から半年後の本例の作業機能障害は改善した．

　We cared for a man in his early 80s who presented with heart failure due to a myocardial infarction. In this case, in addition to using the heart failure handbook, we created an “action plan” often used for patients with respiratory disease. The action plan has the potential to enhance the early detection of symptom exacerbation and improve self-management skills in response to symptoms. We encouraged the patient and his family to collaborate in managing his disease. In the subsequent outpatient occupational therapy, we continuously monitored and evaluated the patient's hobbies of mahjong and ground golf activities and gradually encouraged the resumption of these hobbies while avoiding high cardiac load. As a result, the occupational dysfunction of this case improved 6 months after the onset of heart failure.