地域在住の精神障害者に対する集団作業療法プログラムの開発と有効性—実施群と対照群の比較

The development and efficacy of a community-based occupational group therapy program for people with mental disabilities

要旨：地域在住の精神障害者が，望む生活を営むための方略を学ぶことが目的である集団作業療法プログラムを開発し，その有効性を検証した．実施群18名と対照群23名の変化を，作業に関する自己評価改訂第2版とSF-36を用いて比較検討した．前者では，遂行領域の作業有能性，同一性，満足度の一部が実施群で有意に向上し，身体を使う活動に満足し，問題の把握と解決をより重要と感じるようになった．また，環境領域の作業同一性の一部が有意に低下し，価値の変化が示唆された．後者では，ストレスが関係すると思われる身体の痛みのQOLが実施群で有意に向上した．以上より，本プログラムはリカバリーの過程を支援するものであると考えられる．

　We developed and validated the efficacy of an occupational group therapy program. The aim of the program was to assist people in the community with mental disabilities learn collectively about strategies to improve their desired lifestyle. Eighteen members of a community with mental disabilities made up the enforcement group, and were compared with 23 people who made up a control group. Subjects assessed themselves with a pre-test and post-test using the occupational self-assessment version 2.1 (OSAII) and SF-36.

　The results indicate that compared to the control group, the enforcement group significantly improved on some changes in the Occupational Competence Scale, the Occupational Identity Scale and the Occupational Satisfaction Scale of the performance area in OSAII. Therefore, the enforcement group was more satisfied with physical activities and felt more able to grasp and solve problems. On the other hand, the enforcement group significantly decreased on some changes in the Occupational Identity Scale of the environmental area in OSAII. This suggests a change in the value of the environment for the enforcement group. In SF-36, the enforcement group significantly improved on the QOL of Bodily Pain, which seemed stress-related.

　The above results imply that this community-based program supports a recovery process of people with mental disabilities.