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Japanese Occupational Therapy Research Volume 38, Issue 2 （April 2019）

作業療法 38巻2号（2019年4月発行）

Japanese English

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◆研究論文

「生活目標設定手法」を用いた多職種協働による介護予防ケアマネジメントの効果に関する研究 Effects of preventative care management by a multidisciplinary team on a program for frail community-dwelling elderly: Introducing the Life Goal Setting Technique to support life goals through activities and participation 由利禄巳 ^1,2 , 高畑進一 ³ , 岡万理 ⁴ , 藤井有里 ¹ , 辻陽子 ¹ Yoshimi Yuri ^1,2 , Shinichi Takabatake ³ , Mari Oka ⁴ , Yuri Fujii ¹ , Yoko Tsuji ¹ ¹関西福祉科学大学保健医療学部リハビリテーション学科 ²前所属；大阪府立大学大学院総合リハビリテーション学研究科博士後期課程 ³大阪府立大学大学院総合リハビリテーション学研究科 ⁴和泉市役所 ¹Department of Rehabilitation Sciences, Faculty of Allied Health Sciences, Kansai University of Welfare Sciences ²Former affiliation;Doctoral Course, Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University ³Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University ⁴Izumi Government Office キーワード：介護予防 , 目標 , マネジメント , 他職種連携 , 主観的健康感 , Preventive care , Goal , Management , Multidisciplinary team , Self-rated health Keyword: 介護予防 , 目標 , マネジメント , 他職種連携 , 主観的健康感 , Preventive care , Goal , Management , Multidisciplinary team , Self-rated health pp.129-139

発行日 2019年4月15日 Published Date 2019/4/15

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要旨：我々は，活動や参加レベルの向上を支援する「生活目標設定手法（Life Goal Setting Technique：LGST）」を導入し，関係多職種が連携する介護予防ケアマネジメントを考案した．これを通所型介護予防教室参加者に実施し，クラスター非ランダム化比較試験を用い，介護予防と主観的健康感の向上に及ぼす効果を12週間の教室開始時，終了時と教室後3ヵ月時，6ヵ月時に調査した．結果，介護予防効果の指標とした基本チェックリストの該当基準による予防事業対象者から非該当者に変化した割合は，介入群は約60％で，対照群の約40％に比べ有意に高く，主観的健康感も高かった．介護予防効果は教室後3ヵ月間持続することも明らかとなった．

　Objective: We sought to determine the effects of the Comprehensive Life Goal Setting Technique method of Preventive Care Management (C-LGST-PCM), which supports achievement of life goals regarding Activity and Participation Level (APL) using a multidisciplinary team for preventive care outcomes in a preventive care program for frail community-dwelling elderly. Methods: This was a cluster-nonrandomized controlled trial. Participants were frail older people living in Izumi, Osaka, Japan, all of whom attended weekly 120-min preventive care exercise classes over 3 months. We compared the C-LGST group, which introduced the C-LGST-PCM, and a control group. We introduced the C-LGST-PCM from the assessment stage at a community center and assessed outcomes by comparing baselines and follow up at 3, 6, and 9 months. The primary outcome measure was preventive care outcomes according to the Kihon Checklist for assessment of frailty, which was analyzed by chi-square test. Results: No significant differences were found between the two groups for any variables. Improvement as per the Kihon Checklist for the C-LGST group was approximately 60% from baseline to the 9-month follow up;the control group improved by approximately 40%. The difference between groups was significant both at 3 and 6 months (p=0.039), but not at the 9-month follow up. Conclusion:This study shows that C-LGST-PCM, which supports achievement of life goals for APL by a multidisciplinary team, benefited preventive care outcomes in a preventive care program for frail community-dwelling elderly. Furthermore, the effect of preventive care was maintained after 6 months.