作業療法実践における通所授産施設で働く重度障害者への2次障害対策の構成—シーティングバギーに媒介された参加者の相互作用過程を通して

Constructing the steps to prevent secondary impairments for adult severely disabled people who are working in sheltered work institutions in occupational therapy practice: Through the process of interaction with participants mediated by Seating buggy

要旨：この論文は，作業療法士の実践がどのように作業所で働く重度の成人障害者への2次障害対策を構成したかを示す．作業中の姿勢運動の評価と，彼らと彼らの母親に半構成的インタビューを行った後に，ユニークな機構をもつシーティングバギーを導入した．シーティングバギーは西村重男氏が1997年に考案したものである．シーティングバギーを導入した利用者において姿勢のアライメントがよくなった．テキストは，約2年間に及ぶ日常の作業療法実践におけるシーティングバギーに媒介された参加者の相互作用の過程を示した．この研究における実践の一つの成果は，シーティングバギーの導入が2次障害対策を新たな段階へ発展させたことである．

　This article presents how an occupational therapist constructs the steps to prevent secondary impairments for adult severely disabled people who are working in sheltered work institutions. After evaluating their body postures and movements in their natural settings, and having in-depth interviews about their secondary impairments with them and with their mothers, I introduced Seating buggy with unique mechanisms into the institution on improve their working postures and movements. Seating buggy was developed by S. Nishimura in 1997. All of the clients who used Seating buggy recovered their alignment of body posture. Illustrations show the process of interaction with participants mediated by Seating buggy in my everyday occupational therapy practice over a period of two years. One outcome of this research component was that Seating buggy took a new turn in the steps forward preventing secondary impairment of the adult severely handicapped.