末期がん患者に対する作業療法士の関わり―～作業療法士の語りの質的内容分析～

Occupational therapy intervention for clients with terminal cancer: The qualitative analysis of occupational therapists' narratives

要旨：末期がん患者に対するOTRの関わりを体系的に分類するために，半構成的面接を行い内容を質的に分析した．その結果，「患者とその生活を知るための関わり」，「自己イメージ向上の支援」，「安全で安心な生活の支援」，「余暇・役割・社会的活動の遂行支援」，「人生の肯定的振り返りの支援」，「医療職との協働を促す」，「家族の絆再確認の支援」，「安定した家族介護の支援」，「グリーフケア」という3次カテゴリが得られた．OTRがこれらの併用により患者の状態変動に迅速に対応し，様々な問題に多面的に関わっていることが明らかになった．作業を通した関わりの特性を意図的に用いて患者の生活を支援することが，OTの専門性であるとの示唆が得られた．

　We carried out semi-structured interviews to clarify the intervention of occupational therapists for clients with terminal cancer. Nine categories were extracted: forming a relationship with patients to help them understand their lives, supporting improving the patients' self-image, supporting a safe and secure life, supporting leisure and social activities as well as their roles in society, supporting an affirmative retrospective of their personal life, supporting collaboration with medical professionals, supporting re-identification with family ties, supporting the family caring for sick relatives, and grief care. Results indicate that occupational therapists carried out some of these interventions concurrently in order to keep up with continuous changes in clients' conditions, and to intervene in various problems. We discovered characteristics of interventions using occupations, and the identity of occupational therapists to support clients' lives by being intentionally implicated in their own occupations.