多彩な高次脳機能障害を呈した事例に対する介入—生物医学的側面，現象学的側面からの考察

Intervention for a client with variegated higher brain dysfunctions after stroke: Consideration of biomedical and phenomenologic aspects

要旨：本報告の目的は，難渋する高次脳機能障害をもつ事例に対して行った介入のリーズニング過程を構造化し，介入方法の一助とすることである．事例は，左中大脳動脈梗塞後，多彩な高次脳機能障害を呈し，入浴や更衣，家事といった生活障害があった．介入では，本人，家族に面接を行い，Mattinglyの指摘する叙述的リーズニングの視点から捉え，本人，家族の価値を重要視した．また，介入方法を考察する際には，同じくMattinglyの科学的リーズニングの側面から捉えた．結果，事例は更衣，入浴，家事の一部を獲得した．

　This study suggests an intervention method constructed through a reasoning process for clients with higher brain dysfunctions. The client had stroke-related variegated higher brain dysfunctions, which were manifested in his inability to get dressed, bathe, and do housework independently. Firstly, the client and his spouse were interviewed using narrative reasoning about their needs as indicated by Mattingly. Secondly, intervention methods were considered using scientific reasoning regarding getting dressed, bathing, and doing housework. Finally, the client became able to dress, bathe, and complete some parts of housework.