急性期脳血管障害者におけるニーズとADLの比較

A comparison between the needs and ADL of stroke patients in the acute period

要旨：急性期脳血管障害者33例に対し，COPMとADL項目提示評価(評価者が提示したADL項目の重要度遂行度，満足度を聴取)それぞれとFIM運動項目の点数との関連性を分析した．その結果，FIMの点数とADL項目提示評価の相関は認められたが，COPMより抽出されたニーズとの相関は認められなかった．FIMの点数が高い項目は対象者が自立している項目であるため，セラピストは問題点として挙げない場合が多いが，対象者は自立している項目でも問題点として抽出する場合がある．そこには，対象者とセラピストのニーズに対する捉え方の相違があり，客観的評価によるADLの自立度だけでなくニーズや心理状況を捉える重要性が確認できた．

　We analyzed the relationship between the Canadian Occupational Performance Measure (COPM) and activities of daily living (ADL). We showed 33 stroke patients in the acute period an ADL item and listened their descriptions of the importance/performance/satisfaction level of the ADL, and compared their responses with their score on the motor item of Functional Independence Measure (FIM).

　The results show a correlation between the score of FIM and the ADL importance/performance/satisfaction level. However, we didn't find a correlation between FIM and the needs extracted from the COPM. Therapists are not likely to think the needs of patients as important because they scored high on the independent FIM item, but patients are likely to think of them as problematic. We are convinced of differences of thoughts between patients and therapists and the importance of not only ADL independence in objective evaluation, but also their needs and state of mind.