わが国における終末期作業療法の関わりとその効果の文献による研究

Occupational therapy intervention and its effectiveness for terminal patients in Japan:The literatures review from 1996 to 2005

要旨：近年緩和ケアにおけるリハビリテーションに対する期待は高まっているものの，その有効性を示す研究が十分ではないことが指摘されている．本研究は，終末期作業療法の本質を明らかにする目的で，過去10年間の学会誌，関連雑誌の事例報告をレビューし分析を行った．その結果，作業療法は悪性腫瘍，進行性神経疾患などの患者を対象として生活の中での作業遂行に注目し，作業適応，人間行為のエコロジー，生体力学的，運動学習，自己の治療的利用という5つのカテゴリに分類されるアプローチを組み合わせて介入し，意志のレベルにおいて最もその有効性を感じていることが明らかになった．

　Despite the growing interest in roles of rehabilitation for clients with terminal illness, little studies have been reported, which were focused on the effectiveness of rehabilitation. The purpose of this study was to investigate intervention methods and their effectiveness on occupational therapy for dying patients. We reviewed case reports and literatures from 1996 to 2005, and we revealed the status of occupational therapists working in palliative care. Occupational therapists were working with clients with life-threatening illness such as advanced cancer, intractable neurological disorders, and so on. They focused on occupational performance in life, using various programs, which can be categorized into 5 approaches: Occupational Adaptation, The Ecology of Human Performance, Biomechanics of Human Movement, Learning, and Therapeutic Use of Self. And they found the most effectiveness of occupational therapy in the volitional affairs.