介護老人保健施設での在宅復帰支援に生活行為向上マネジメントを用いた早期介入

Early intervention using the management tool for daily life performance in the return home support of a geriatric health services facility

要旨：介護老人保健施設（以下，老健）の入所者に対して，入所前から生活行為向上マネジメント（以下，MTDLP）を用いて介入し，在宅復帰支援の有用性を検討した．実践の結果，研究期間中に対象者21名のうち15名が自宅に退所した．ADLは移乗，歩行，階段昇降，更衣，トイレ動作が改善し，生活行為の合意目標に対する自己評価の実行度と満足度はともに向上した．合意目標に含まれた介入要素を国際生活機能分類（ICF）で分析すると，介入要素は，心身機能・身体構造9％，活動と参加70％，環境因子21％の割合で，活動と参加に最も多く含まれていた．MTDLPによる目標設定は，対象者の活動と参加に焦点を当て，老健での在宅復帰支援に有用と考える．

　This study examined the effectiveness of the early intervention of return home support using the management tool for daily life performance (MTDLP) for people entering geriatric health services facilities. As part of this study, 15 of 21 subjects left the facility to return to their homes. Ability of ADL such as transferring oneself, walking, climbing stairs, dressing and toileting were improved, along with the self-evaluation of degree of practice and satisfaction of the subjects in their agreement goals. When intervention goals using ICF were analyzed, the following ratios emerged: body functions and body structures 9%, activities and participation 70%, and environmental factors 21%. The goal setting by MTDLP focuses on activities and participation of the client and indicates that it is useful for return home support in geriatric health service facilities.