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Japanese Occupational Therapy Research Volume 30, Issue 1 （February 2011）

作業療法 30巻1号（2011年2月発行）

Japanese English

◆研究論文

集団活動における作業工程の進め方の違いが認知症者の精神・心理機能へ及ぼす影響―回復期リハビリテーション病棟における介入研究─ Differing occupational group therapy processes and their effectiveness on the mental and cognitive function of elderly suffering from dementia: An intervention study in a specialized rehabilitation ward 磯直樹 ¹ , 内村ふみ子 ¹ , 鶴田明穂 ² , 田平隆行 ³ , 長尾哲男 ³ Naoki Iso ¹ , Fumiko Uchimura ¹ , Akiho Tsuruda ² , Takayuki Tabira ³ , Tetsuo Nagao ³ ¹医療法人稲仁会三原台病院 ²医療法人再整会口石病院 ³長崎大学大学院医歯薬学総合研究科 ¹Medical Corporation Toujinkai, Miharadai Hospital ²Medical Corporation Saiseikai, Kuchiishi Hospital ³Nagasaki University, Graduate School of Biomedical Sciences キーワード：認知症 , 集団活動 , （精神・心理機能） , Dementia , Group work , Mental and cognitive function Keyword: 認知症 , 集団活動 , （精神・心理機能） , Dementia , Group work , Mental and cognitive function pp.20-28

発行日 2011年2月15日 Published Date 2011/2/15

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要旨：回復期リハビリテーション病棟での集団活動の報告は少ないが，認知症者に対しては集団活動が広く用いられている．しかし，集団活動の構造については記されているが，作業工程の進め方については検討されていない．そこで，我々は回復期リハビリテーション病棟において認知症者20名を対象に，作業工程の進め方が異なる2つの集団を設定して介入研究を行った．その結果，集団活動実施により，精神・心理機能の維持・改善へ影響を及ぼすことが示唆され，2つの作業工程の進め方にそれぞれの影響を認めたが，影響に差は認められなかった．その要因は，認知症の臨床像の違い等による影響が考えられ，今後の検討課題としたい．

　We often conduct group therapy for the elderly with dementia in a clinical setting. Within this setting, varying occupational therapy processes have different effects on the improvement of mental function, including psychological stress, satisfaction, and self-efficacy. However, no investigations in this area have been reported regarding occupational therapy.

　Since OT research in this area is non-existent, the purpose of this study was to investigate the effectiveness of group work on the mental and cognitive function of the elderly with dementia, and elucidate any differences in the two groups through differing OT processes.

　Twenty elderly people with dementia participated in this three-month study and all subjects gave their informed consent to participate. The subjects were divided into two groups: the individual group, consisting of 11 subjects who all worked individually, and the allotment group, consisting of 9 subjects who worked together. All subjects were evaluated before and after this program using HDS-R, NM scale, GDS-15, GSES and QOL-D.

　The HDS-R and GDS-15 score significantly improved in the allotment group only. However, no significant difference was found between the two groups.

　These findings suggest that the group work in this study had a positive effect on both the cognitive function and the QOL without regard to the specifics of the therapy process.

　In conclusion, occupational therapists should address both the mental and cognitive functions when treating the elderly with dementia. These results support the validity of group work for improving the mental function of the elderly with dementia.