地域支援事業における作業療法初期評価に関する現状調査

Effectiveness of occupational therapy evaluations within a System for Prevention of Deterioration of Health Status

要旨：地域支援事業で作業療法士が初期評価に用いる評価ッールの現状を調査した．無記名による郵送留め置き方法を用いて，全国の895公的機関にアンケートを送付した．作業療法士が回答した41通を分析した結果，36施設(約90％)が作業療法初期評価を行い，大多数が身体機能，ADL，認知機能に焦点を当てた構成的評価を行っていた．趣味と興味，生活歴，役割を評価項目に回答する施設は多かったが，それらに対する作業療法の専門性を反映した評価ツールが回答されなかった．現在も高頻度の利用が示された身体機能，ADL，認知機能の評価に加え，興味，人生の軌跡，役割について作業療法の専門性を反映した評価ツールの使用が必要であると思われる．

　The purpose of this study was to analyze the present condition of the initial evaluation tools used by occupational therapists within a system of Prevention of Deterioration of Health Status. 41 occupational therapists responded to a questionnaire sent nationwide to 895 public facilities using the unsigned mailing detention method. The following four insights were obtained from the subjects: 1) 36 facilities (90%) implemented initial evaluations, 2) structured evaluations such as physical and precognitive functions and Activities of Daily Living (ADL) were implemented in most of the facilities, 3) hobbies or interests, personal histories and roles were reported by many facilities as initial evaluation items, although no specific tool directly reflecting occupational therapy was identified within those initial evaluation items and 4) problems emerged because of the gap between reported initial evaluation items and no reported tools for hobbies or interests, personal histories and roles. The study indicates that during the initial evaluation, occupational therapists are required to utilize the specific tools relating to patients' interests, life histories and roles which directly reflect occupational therapy, in addition to evaluating physical and precognitive functions and ADL.