精神科長期入院患者の身体機能と「身体性プログラム」の意義について

Personal-body focused programs for long-term hospitalized chronic psychiatric patients

要旨：「入院患者の身体機能は低下している」が，「身体感覚に焦点をあてた作業療法は生活の狭小化した長期入院患者に新たな関心を引き起こす好機となる」という仮説を立て，統合失調症を中心とする入院患者145名を対象に身体性プログラム(身体機能測定・ストレッチ体操・手足のツボ押し)を実施した．その結果，患者の7割以上に肥満傾向がみられ，標準値と比較した握力・背筋力・立位体前屈・肺活量・視力の低下傾向が認められた．呈示した症例は，長期入院患者が身体に意識を向け，新たな活動に興味・関心を拡げていく過程，心身の柔らかさを取り戻していく過程を示しており，身体感覚に焦点をあてた本プログラムの治療的意義が確認された．

　The purpose of this paper is to develop the characteristics of the general physical status of chronic psychiatric in-patients, and to discuss the therapeutic significance and effectiveness of the personalbody focused programs with brief case illustrations. The program consists of two main parts, one being a physical check up and fitness test and the other being stretching and acupressure work. Points to be kept in mind during the implementation of the program include focus on communication between patients and therapists; i. e. to feedback the obtained data with a norm of the same age group along with simple health advice and/or to provide physical feedback by touching and holding the proper body parts in stretching and acupressure work.

　The following are significant results of the personal-body focused programs for long-term hospitalized psychiatric patients :

　1. Patients who had been hospitalized for a long time showed a high rate of body fats and tended to have decreased muscle strength and vital capacity.

　2. The program basically provided non-threatening therapeutic structures based on non-verbal communications to support patients' awareness and concerns for their own body, which resulted in promoting the relaxation of a rigid mind-body restraint and increasing more positive feelings of self-awareness.

　3. The program combines usefulness with practicality by requiring no special facilities.