人工膝関節置換術後患者における患者教育を取り入れた作業療法実践が疼痛と心理的要因および活動量に与える影響

Effect of occupational therapy patient education on pain, psychological factors and activity levels in patients recovering from total knee arthroplasty

要旨：人工膝関節置換術（以下，TKA）後患者の疼痛に対する心理的要因は慢性疼痛，生活の不活動を招く恐れがある．本研究は，患者教育を用いた作業療法（以下，OT）実践が疼痛と心理的要因および活動量に与える影響を検討することを目的とした．TKA後患者を対象とし，対照群28名と教育群36名に分類した．測定指標には疼痛（安静時痛，歩行時痛）と破局的思考（下位項目；反芻，無力感，拡大視），不安と抑うつ，自己効力感，活動量を測定し，分散分析にて解析した．その結果，教育群において歩行時痛，反芻，不安，抑うつに交互作用を認めた．本結果より，TKA後患者に対する患者教育を用いたOT実践の有用性が示唆された．

　Total knee arthroplasty (TKA)-induced pain has been known to affect psychological factors, chronic pain and activity levels. This study investigated the efficacy of patient education by occupational therapists on TKA patients' chronic pain, psychological factors and activity levels. TKA patients were classified into two groups: the educational group (36 subjects) and a control group (28 subjects). The following outcome indices were investigated: pain levels, including both walking and stationary pain, catastrophizing, including rumination, helplessness and magnification, psychological factors including anxiety and depression, and activity levels. Analysis through ANOVA found a connection among walking pain, rumination, anxiety and depression in the education group. The results demonstrate the effectiveness of patient education during occupational therapy on patients suffering from TKA.