血液がん患者に対する作業療法に関する後方視的検討

A retrospective study of occupational therapy for hematological cancer patients

要旨：当院にて作業療法（以下，OT）を実施した血液がん患者47名の臨床的特徴と，実施したOT内容を明らかにすることを目的として，診療記録に基づき後方視的調査を行った．結果より，当院では高齢で活動性とADL能力が低下した患者に身体・認知機能および心理状態の低下を予防するとともに，自宅退院を視野に入れたADLの支援を行うことが作業療法士に求められていた．無菌室でOTを実施した患者は，一般病棟の患者と比較してOT開始時の活動性とADL能力が高かった．実施されたプログラムは，患者の全身状態に加え潜在的身体能力が影響している可能性が示された．今後は活動性が低下する前の段階から作業療法士が介入する意義があると考える．

　We conducted a retrospective study based on medical records to clarify the clinical characteristics of hematological cancer patients and the clinical aspects of occupational therapy (OT) interventions. We collected sociodemographic and medical data from 47 hematological cancer patients in our hospital, including medical information, aim of OT, OT programs, performance status, and activities of daily living (ADL) ability. We found that the OT was required to support ADL, take into consideration discharge from the hospital, as well as prevent decreases in physical, cognitive, and psychological function of older patients with diminished ADL abilities. Patients treated in aseptic rooms unexpectedly presented with, and maintained better ADL ability and performance status during the OT program compared with patients in general wards. The findings revealed that the OT programs were possibly influenced not only by patients' general conditions but also by patients' potential physical ability. We suggest that OT interventions are useful to patients in the early stages of the disease while their general condition is good.