左半側空間無視患者の障害に対する気づきのプロセス

The process of awareness of disabilities in clients with unilateral spatial neglect

要旨：自分の障害への気づきを持つプロセスを知るために左半側空間無視（以下，USN）患者6名にインタビューを実施した．USNによる問題を予期し代償的手段を使用した2名を「自己認識できた」，他4名を「自己認識できない」として修正版グラウンデッド・セオリー・アプローチに準拠した方法で分析した．自己認識できた患者の語りからは14概念7カテゴリーが，自己認識できない患者の語りからは17概念6カテゴリーが得られた．自己認識できた患者のプロセスは先行研究の結果と一致した．両者の違いは全般性注意障害の程度，活動経験の質，内的経験の有無が考えられ，気づきを促すには適切な課題設定と同意を得た介入が必要だと考えられた．

　The purpose of this study was to analyze the awareness process of disabilities of clients with left unilateral spatial neglect (USN). 6 clients with left USN were interviewed: 2 clients with anticipatory awareness were labeled as “clients with self-awareness”, and the other 4 clients were identified as “clients without self-awareness”. Their responses were analyzed using the modified Grounded Theory Approach (M-GTA). 7 categories were identified from the narratives of the clients with self-awareness: 〈Obvious change of inner experience〉, 〈Choosing favorite right side〉, 〈Playing the role of a patient〉, 〈Realization of matter of left USN〉, 〈Original strategy for left USN〉, 〈Strategy for left USN as a habit〉 and 〈Difficult reaction to new pattern of USN〉. 6 categories were identified from narratives of clients without self-awareness: 〈Biased attention with lack of inner experience〉, 〈Doubts about myself and interpretations the cause as something except disability〉, 〈Playing the role of a patient〉, 〈Vague awareness of left USN〉, 〈Denial of left USN〉 and 〈Vague strategy for left USN〉. The findings suggest the following differences between the clients: the level of generalized attention deficit, the quality of activity experiences and the existence of inner experience. Appropriate challenges and clients' agreements with interventions may be necessary to encourage awareness of USN.