回復期リハビリテーション病棟における集団作業療法の心理社会機能への影響に関する検討―トイレ介助を必要とする患者に焦点化して─

Effects of occupational group therapy on psychosocial function in toileting-dependent patients at convalescent rehabilitation wards

要旨：回復期リハ病棟において，自尊心が損なわれる危険性の高いトイレ動作が自立に至らなかった患者を対象に，後方視的再考により集団OTの効果を比較検討した．対象者は，退院時にトイレ動作が自立に至らなかった集団OT参加者55名である．その結果，集団活動評価尺度とうつ・情動障害スケールに有意な向上や改善が認められた．このことから，心理社会機能の向上を目的とした回復期リハ病棟における集団OTでは次の二点が示唆された．第一は，個別の治療・指導・援助だけでは得られない心理社会機能への賦活効果が得られること，第二は，集団の場の提供により心理社会機能の援助を行うことの重要性である．

　Dependence on toileting is said to exert a negative influence on patients' self-esteem at convalescent rehabilitation wards. The aim of this study was to determine the effects of occupational group therapy (OGT) on patients who had not achieved independence in toileting at the time of discharge. Fifty-five participants in OGT were recruited for the study which used a one-group pretest-posttest design. Scores in all of the following three scales improved significantly: Group Activity Index, Japan Stroke Scale-Depression Scale (JSS-D) and Emotional Disturbance Scale (JSS-E). The findings suggest that OGT at convalescent rehabilitation wards which aimed to improve the patients' psychosocial function can positively influence the functions that cannot be obtained through individual sessions only. In addition, the findings indicate that it is important for occupational therapists to address patients' psychosocial function by providing OGT service.