わが国の精神科病床における身体的リハビリテーションの需要と実施状況に関する調査

The demand for and practice of physical rehabilitation at psychiatric inpatient care facilities in Japan

要旨：わが国の精神科病床では入院患者の高齢化の進展に伴い，身体面でのリハビリテーション（以下，身体的リハ）の需要が高まっていることが予想される．しかし，実際の需要や実施状況は不明であるため，全国の精神科病院934施設の精神科作業療法責任者を対象に調査した．その結果，作業療法士から回答の得られた436病院のうち，419病院（96.1％）が身体的リハを導入する必要があると回答し，すでに352病院（80.7％）で，作業療法士を中心に身体的リハが実施されていた．しかし，身体的リハを実施した場合の算定方法では，約半数が無償で提供されており，精神科作業療法の基準の変更や，新たな施設基準が必要と思われた．

　An increase in the demand for physical rehabilitation due to the increasing age of inpatients is predicted at psychiatric inpatient care facilities in Japan. However, since the actual conditions related to the demands for, and the practice of, physical rehabilitation are as yet unidentified, an investigation that targeted personnel in charge of occupational therapy in psychiatric wards, from nine hundred thirty-four psychiatric hospitals across the nation, has been carried out. The results of this investigation indicated that out of four hundred thirty-six hospitals who responded to the investigation, four hundred nineteen hospitals (96.1%) stated that introducing physical rehabilitation to their care strategy was indispensable. Also, three hundred fifty-two hospitals (80.7%) have already put physical rehabilitation into practice, with occupational therapists primarily in charge. Moreover, about half of these physical rehabilitation strategies are provided free of charge. This investigation revealed that revising the standards of occupational therapy in psychiatric wards and putting new institutional standards in place are both highly desired by professionals.