高齢透析患者に対する作業療法の役割

Effects of Occupational Therapy in Elderly Hemodialysis Patients

要旨：高齢透析患者のADL改善とQOL向上を目的として，継続的に作業療法を行った．導入期のベッドサイドから，患者とスタッフ・家族間の対人交流を援助し，維持期には透析体操で体力の向上と患者相互の交流をはかった．さらに多様な行事を通じて地域との交流を行った．以上により，ADL自立への意欲は向上し体力が維持され，長期入院患者が減少する効果を得た．この効果は，単に体力の向上によるというよりも，交流の場が拡がる中で自立への意欲が向上したためと考えられた．

　To improve the ADL and QOL of elderly hemodialysis patients, we produced an original rehabilitation program using many activities of occupational therapy in 1991.

　The rehabilitation has 3 steps related to the patients' condition. 1. At acute stage of hemodialysis therapy, we start the bed side exercise rehabilitation and proceed the communication between patients and staff, as well as between patients and their families. 2. At the chronic stage, we start an original gymnastics exercise with a small group of patients. The patients can communicate with other patients and staff. 3. Furthermore, we promote a party where the patients are cooking, enjoying a music concert and bazar in the community for communicating with each other.

　As the result of this type of occupational therapy, hemodialysis patients improved ADL and maintained health related physical fitness. The number of patients with lengthy hospital stays was decreased.