C型サービスモデル事業におけるリエイブルメントに基づく介入効果の検証

Model project for service C: Verification of intervention effectiveness based on reablement

要旨：本研究の目的は，C型サービスモデル事業におけるリエイブルメントに基づく介入効果を検証することである．事業対象者および要支援者18名に対し，介入は12週間，週1回リエイブルメントに基づく支援を実施した．アウトカムは，握力，TUG，5回立ち上がりテスト，5m歩行，老研式活動能力指標，SOPI，EQ-5D-5Lとした．介入効果は，ベイズ推定による一般化線形混合モデルを用いた．また効果検証にはMCIDを用いて介入効果が認められた指標との関係性を検討した．その結果，5回立ち上がりテスト，TUG，SOPIに効果を認め，MCIDの観点からも有効であることが明らかとなった．

　The purpose of this study was to verify the effects of interventions based on reablement in the Service C model business. The intervention was conducted over a 12-week period, once a week, targeting 18 participants, including service recipients and individuals requiring support. The intervention outcomes were measured using grip strength, the Timed Up and Go (TUG) test, the five-times sit-to-stand test, the 5-meter walk test, the Tokyo Metropolitan Institute of Gerontology Index of Competence, the Self-completed Occupational Performance Index (SOPI), and the EQ-5D-5L. To detect effects even with a small sample size, a generalized linear mixed model with Bayesian estimation was employed. Additionally, the Minimal Clinically Important Difference (MCID) was used to assess the relationship with the outcomes that showed significant intervention effects. As a result, significant improvements were observed in the five-times sit-to-stand test, TUG, and SOPI, and these improvements were also confirmed to be clinically meaningful based on MCID.