作業選択決定にPaper版ADOCを使用し意味のある作業提供を行った一例

Shared decision-making and offered meaningful occupation using Aid for Decision-making in Occupation Choice (ADOC) of paper edition: A case study

要旨：咽頭癌による構音障害と脳出血後の麻痺によりコミュニケーション能力が低下した症例に対し，症例にとって意味のある作業を把握するため，Paper版ADOCと重要度・満足度・遂行度に関するNumerical Rating Scaleを，初期，中期，後期，退院時の4期別に評価した．炊事と友人との交流が重要な作業として示され，症例にとって意味のある作業に焦点を当てることが可能となり，症例の主体性が向上し意欲的な作業活動につながった．今回の評価・介入方法は，症例にとって意味のある作業に焦点を当て主体的な作業活動を促す一助になった．また，経時的に評価を行うことで症例の現状を把握でき，症例と作業療法士の目標共有を促せたと考える．

　The case describes language expression disability due to the dysarthria and motion paralysis caused by throat cancer and cerebral hemorrhage. We used the ADOC Paper edition for shared goal setting with the patient, and evaluated the subjective changes in Importance, Satisfaction and Performance level by Numerical Rating Scale (NRS). The evaluation was carried out in four phases (Early, middle, late, and at discharge). “Cooking” and “Exchanging with friends” were shown as meaningful activities regarding passive communication. It has become possible to focus the meaningful occupations associated with identity. Subsequently, the patient voluntarily participated more actively to get cooking ability and exchange information with friends. In addition, evaluation over time indicated process of changing importance, and became possible the intervention to understand the present condition of the case.