脳腫瘍のクライアントと作業療法士の治療的関係に関する文献研究

A literature review of the therapeutic relationship in occupational therapy for clients with brain tumors

要旨：脳腫瘍のクライアントと作業療法士の治療的関係を文献により検討した．国内文献を検索し，原著論文6編と会議録8編を対象文献とした．人間作業モデルの概念をもとに，治療的関係のエピソードを，クライアントが作業療法に取り組む中で考え，感じたことを表明する作業従事と，それを促すために作業療法士が行う治療戦略から検討した．その結果，クライアントと作業療法士は，能力低下に関する認識と感情を明らかにするとともに，ニーズである作業に従事する手続きを計画し，その継続を支援する治療的関係をとっていたことがわかった．今後，本研究で得られた治療的関係の作業療法実践への妥当性を検討する必要がある．

　The purpose of this study was to examine the therapeutic relationship between the clients with brain tumors and occupational therapists. Japanese articles on occupational therapy for the brain tumors were searched, and six original articles and eight proceedings were selected. The episodes regarding therapeutic relationships were extracted and classified according to the components of occupational engagement and therapeutic strategies which had been conceptualized in the Model of Human Occupation. As a result, it was revealed that the occupational therapists supported the clients with brain tumors to be able to recognize their own abilities, be aware of limitations, and express their feelings. Moreover, the therapeutic strategy of occupational therapists made an intervention plan for clients to engage in the occupations in supportive conditions. It is suggested that the therapeutic relationship according to the stage of cancer treatment produces good conditions of occupational participation of clients with brain tumors.