外来心臓リハビリテーションにおいてADOCを使用し目標設定を行った1症例

Goal setting in cardiac out-patient rehabilitation with ADOC: A case study

要旨：外来心臓リハビリテーション（以下，外来心リハ）を実施するにあたり，目標設定のために作業選択意思決定支援ソフト（以下，ADOC）を使用した．症例は50歳代の女性で，本態性高血圧による心不全を呈したと診断された．その再発予防を目的に外来心リハと薬の内服を開始した．外来心リハに際しADOCを用いた面接で目標設定を行った．目標は「心不全再発予防のための食事療法および運動療法の継続」と「スィーツビュッフェでの友人との交流」であった．目標設定後，症例は週1回の外来心リハと自宅での食事療法および運動療法を行った．結果，友人との交流は可能になった．また血圧および体重は退院時に比較し大幅な改善を認め，薬は1剤が中止となった．

　The iPad application Aid for Decision-making in Occupation Choice (ADOC) was utilized to set goals when initiating outpatient rehabilitation. The subject was a woman in her 50s who suffered from hypertension-related heart failure. Outpatient rehabilitation included medication to prevent recurrence, and goal setting through interviews with ADOC. The target goals were “Preventing heart failure through continuation of diet and exercise therapies”, and “Socializing with friends at the dessert buffet”. After the goal setting, the patient participated in home-based outpatient rehabilitation, diet therapy, and exercise therapy. As a result, it became possible to socialize with friends, blood pressure and body weight were greatly improved at discharge, and one medication was discontinued.