一般病院における身体疾患を合併した精神障害者に対する作業療法の現状と意義―身体障害領域に従事する作業療法士への質問紙調査から─

The current status and significance of occupational therapy for psychiatric patients with physical disabilities at general hospitals: A survey of occupational therapists in the field of disability

要旨：本研究の目的は，一般病院における身体障害を合併した精神障害者（以下，身体合併精神障害者）への作業療法のあり方を検討することである．調査は無記名式の質問紙法を用い，都内一般病院の身体障害領域に従事する作業療法部門責任者226名を対象に行った．その結果，回答者76名中の84％が身体合併精神障害者に対応経験があり，そのうち82％が対応に困難を感じていた．総合病院や大学病院，急性期リハビリ施設を有する病院では，精神科の有無に関わらず，身体合併精神障害者への対応を前提に個別の工夫や対処方法を体系化すると共に，多職種間の情報交換やリエゾンカンファレンスなどを通じて組織的連携を強化する必要性が示唆された．

　The purpose of this study is to reveal the current status of occupational therapy (OT) for psychiatric patients with physical disabilities at general hospitals and to seek the proper method of carrying out rehabilitation.

　We conducted a survey of 226 chief occupational therapists working in the field of disability at general hospitals in Tokyo. According to the survey results, 84% of respondents have treated this type of patient, and 82% of these respondents had difficulty in practicing OT for them. This study indicates that the treatment of the psychiatric patients with physical disabilities has become one of the most important issues for many occupational therapists.

　It is highly recommend that general hospitals, university hospitals, and hospitals with an acute rehabilitation facility systematize their tailored devices and methods in order to deal with these patients, regardless of whether or not a Department of Psychiatry exists at these institutions. In addition, it is essential that they strengthen organizational cooperation through multidisciplinary information exchange and liaison conferences.