就労体験プログラムにおける統合失調症患者の障害特徴と支援

Disabilities observed in a "simulated employment program" for patients with schizophrenia:Proposals for support

要旨：実際の企業で就労の体験をしてみるという「就労体験プログラム」において，対象患者のプログラムに作業療法士が付き添い，統合失調症患者の仕事場面における特徴や問題点を記述した．その内容を2段階にカテゴリー化し，考察を深め，就労支援における新たな視点の持ち方を提案した．その結果，支援は3つの視点，①要素的機能の障害として捉えられる問題点，②自分の行為をチェックする機能が含まれる問題点，③患者と社会との関係を考慮に入れることにおける問題点に分けられた．従来の支援では，②や③の視点が取り上げられることは少ないが，要素機能に対する支援と共に，これら2つの視点は極めて重要な視点であることが示唆された．

　The purpose of this study was to reveal the characteristics and problems of patients with schizophrenia in working situations through a simulated employment program, and elicit ways to support them. During the program, each patient was accompanied by an occupational therapist, who recorded their situation in detail. Episodes of observation were categorized, firstly, by common characteristics of the patients, and secondly, by way of support.

　Based on the results, we suggest that some of the following points be considered in providing support for patients. First, it is necessary to consider disorders simply as functional elements. Second, in addition to these disorders, we need to consider patients as the Subject of these functions. Third, the relationship between society and the Subjects should also be considered as a different dimension. In support commonly carried out now, the second and the third viewpoints are often neglected. However, we would like to affirm the necessity of these points of view, in addition to conventional support.