作業療法士が重症心身障害児の作業に焦点を当てた目標を設定するプロセス—SCATを用いたデプス・インタビューの分析を通して

Occupational therapists' process for setting occupation-based goals for severely disabled children: Analysis of in-depth interviews using Steps for Coding and Theorization (SCAT)

要旨：本研究目的は，重症心身障害児を対象に作業に焦点を当てた目標設定を行う作業療法士（以下，OT）のプロセスと背景基盤を検証することであった．5名のOTにデプス・インタビューを実施し，Steps for Coding and Theorization（SCAT）で分析した．結果，目標設定プロセスにおいて，家族との対話や作業遂行観察を通じた段階的な合意形成を重視していた．その背景には，人間作業モデルや作業科学の理論枠組み，カナダ作業遂行測定の評価学習経験が影響していた．本研究は，作業に焦点を当てた目標設定の基盤を明らかにし，臨床実践や教育の向上に貢献する知見を提供した．

　This study aimed to explore the process and underlying framework of occupation-focused goal setting by occupational therapists (OTs) working for children with profound mental and physical impairments. In-depth interviews were conducted with five OTs, and data were analyzed using Steps for Coding and Theorization (SCAT). The results indicated that OTs emphasized stepwise consensus-building through dialogue with families and observation of clients' occupational performance in the goal-setting process. Additionally, theoretical frameworks such as the Model of Human Occupation and Occupational Science, along with training in assessments such as the Canadian Occupational Performance Measure, influenced their approach. This study clarifies the foundation of occupation-focused goal setting and provides insights that contribute to improving clinical practice and education in occupational therapy.