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Japanese Occupational Therapy Research Volume 28, Issue 4 （August 2009）

作業療法 28巻4号（2009年8月発行）

Japanese English

◆研究論文

在宅生活をおくる神経難病患者の社会参加と関連する要因—Craig Handicap Assessment and Reporting Technique for Japanese version（CHART-J）を用いて Factors related to participation of patients with chronic neurological diseases in the community : Utilizing the Japanese version of the Craig Handicap Assessment and Reporting Technique (CHART-J) 加藤由里 ¹ , 外里冨佐江 ² , 李範爽 ² , 王治文 ³ , 白倉賢二 ¹ Yuri Kato ¹ , Fusae Tozato ² , Lee Bumsuk ² , Chin-Wen Wang ³ , Kenji Shirakura ¹ ¹群馬大学医学部附属病院リハビリテーション部 ²群馬大学医学部保健学科作業療法学専攻 ³東北文化学園大学医療福祉学部 ¹Department of Rehabilitation, Gunma University Hospital ²Department of Occupational Therapy, School of Health Science, Faculty of Medicine, Gunma University ³Department of Rehabilitation, Faculty of Medical Science and Welfare, Tohoku Bunka Gakuen University キーワード：社会参加 , (神経難病) , 在宅 , (CHART-J) , Participation , Chronic neurorogical disease , Community , CHART-J Keyword: 社会参加 , (神経難病) , 在宅 , (CHART-J) , Participation , Chronic neurorogical disease , Community , CHART-J pp.410-419

発行日 2009年8月15日 Published Date 2009/8/15

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要旨：在宅神経難病患者の社会参加を定量的に把握し関連する要因を検討した．43名を対象に，ADLはBI，IADLはFAI，社会参加はCHART-Jを尺度とした.結果はBI88.0±16.4点，FAI16.6±9.5点．CHART-J総得点316.5±91.6点(PI89.8±21.2点，Mo65.7±26.5点，Oc38.6±38.7点，SI62.3±34.0点，ESS56.0±34.0点)であった．対象者はPIが高くOcは低く他疾患を対象とした先行研究と同様の結果となった．一方でSIは他の疾患と比較して低い得点を示し，地域社会活動への参加が低く，OTにおける重要な視点が示唆された．

　The purpose of this study was to clarify social participation of patients with chronic neurological diseases in the community using the Japanese version of the Craig Handicap Assessment and Reporting Technique. Participants were twenty-three men and twenty women (age 63.1 ± 11.4 yrs) with neuromuscular disease (five with spinocerebellar degeneration, 21 with Parkinson's disease, five with amyotrophic lateral sclerosis, and two others). The main Outcome Measures were medical condition, motor function, performance in basic activities of daily living (the Barthel Index ; BI), instrumental activities of daily living (the Franchey Activity Index; FAI) and level of participation (the revised Japanese version of Craig Handicap Assessment and Reporting Technique I CHART-J). The BI score was 88.0± 16.4 points, and the FAI score was 16.6±9.5 points. The CHART-J subscores were as follows: Physical independence (PI) was 89.8 ±21.2 points, Mobility (Mo) was 65.7 + 26.5 points, Occupation (Oc) was 38.6±38.7 points, Social integration (SI) was 62.3 ±34.0 points and Economic Self-Sufficiency (ESS) was 56.0±34.0 points. Compared with previous studies on stroke survivors and spinal cord injuries in the community, there were similar trends in both studies: the mean PI score was high and the mean Oc score was low, although our patients scored lower in the SI sub score. Therefore, participants in our study had limited exchange of personnel between societies. This study suggests that approaches to participation, particularly patients' relationship with relatives and community, employment, housework and hobbies, are important to occupational therapy for neuromuscular disease patients.