ある記憶障害者の障害認識獲得過程—メモリーノートの使用と共に

The effectiveness of a memory notebook on self-awareness in a patient with memory disorder

要旨：前交通動脈瘤術後に記憶障害を呈したある男性が，自らの障害を認識していく過程を明らかにすることと，障害認識の獲得と共に代償手段の使用の変化を明らかにすることを目的に，男性の語りを継続的に記録，質的に分析し，メモリーノートの使用行動を観察した．結果，男性が戸惑いながら徐々に障害に気付いていく過程を7つのカテゴリーで表現することができた．また自らノートを参照することで自分自身を確認しながら積極的に代償手段として使用していく様子が明らかになった．一方，障害認識の獲得過程には防衛機制や不安も生じており，心理的負担を考慮した長期的な関わりが必要であることが示唆された．

　The purpose of this study was to clarify the process through which a man with memory disorder had gained self-awareness of his condition through the use of a memory notebook as a compensatory tool. The patient's comments about the disorder were recorded continuously and analyzed qualitatively. We also observed and recorded how he used the notebook to compare with his comments. As a result, we could illuminate a process through which he had gained self-awareness by seven categories. Futhermore, the patient exhibited a positive attitude towards using the notebook. However, it was also clear that the subject experienced anxiety through the process. The results indicate that therapists must intervene, taking into consideration the client's anxiety and consider appropriate long-term treatment.