クモ膜下出血後の記憶障害患者に対する間隔伸張法を中心とした作業療法

Occupational therapy based on the spaced retrieval approach for a patient with memory impairment secondary to subarachnoid hemorrhage

要旨：クモ膜下出血術後に記憶障害を呈した50歳代女性に対して，間隔伸張法(spaced retrueval法；以下，SR法)を中心にデザインした作業療法プログラムを実施した，具体的には，SR法を基本として，事例に必要な日付，担当セラピスト名，病室名，メモリーノートの利用等を，徐々に間隔を空けながら想起して覚えさせる訓練を行った．その結果，見当識や予定の把握などに改善が見られ，高次脳検査の評価点も向上して自宅退院となった．これらの結果から，SR法を中心にデザインした作業療法プログラムは，クモ膜下出血後の記憶障害に対して効果的であったと考えられた．また，本事例への関わりを通して，家族や他職種との連携の重要性を再確認した．

　In the present study, an occupational therapy program designed according to the spaced retrieval (SR) approach was implemented for a woman in her 50s who developed memory impairment following surgery for a subarachnoid hemorrhage. Specifically, the patient underwent memory training based on the SR approach in which she was asked to recall information such as relevant dates, the name of the therapist in charge, the ward name, and the use of memory notes at gradually increasing intervals. The results showed improvements in factors such as orientation and understanding of schedules, and scores on higher brain function tests also increased. The patient was discharged following these improvements. The present findings suggest that occupational therapy programs designed using the SR approach are effective for memory impairment resulting from subarachnoid hemorrhage. In addition, our interactions with the patient reaffirmed the importance of cooperating with patients' families and other professionals.