作業バランスの不均衡を起こした統合失調症男性への就労生活支援—ケア会議を通した作業バランス自己診断の活用

Working life support to a man suffering from schizophrenia induced disproportion of the occupational balance: Effectiveness of the Self-Assessment of Occupational Balance through care meetings

要旨：今回，作業バランスの不均衡，抑うつ・意欲減退から，欠勤が増えた統合失調症のA氏に対する，ケア会議での作業バランス自己診断（以下，SAOB）を通した就労生活支援を実施した．ケア会議では，作業バランスとA氏が取り組む行動目標を，A氏と多職種で話し合った．A氏は，平日と休日の作業数を意識し，楽しみ作業や休息も取り入れた生活に1ヵ月間取り組んだ．A氏の作業バランスは，平日と休日の作業数の偏りや意味なし作業がなくなり，願望作業が増加した．また，A氏は，うつ・意欲減退も改善し，就労生活を継続するための作業バランスを獲得できた．本報告では，ケア会議と，SAOBを用いた統合失調症に対する就労生活支援の有用性を検討した．

　Here we report the case of a patient with schizophrenia, who received employment support to reduce work absence due to occupational imbalance, depression, and hypobulia. This support was assessed using the Self-Assessment of Occupational Balance (SAOB) tool during care meetings. The occupations that he wrestled with were made clear. He engaged in fun and relaxing occupations for one month while being conscious of the number of occupations. The patient ceased to avoid a number of duties, and meaningless duties ceased as well. His desire to engage in meaningful occupations increased, and occupational balance for continuous employment could be obtained. We suggest that it is important for patients with schizophrenia receive support using SAOB in care meetings.