回復期リハビリテーション病棟での生活行為向上マネジメント活用の利点と作業療法士の役割—復職に至った軽度記憶障害を呈した頭蓋咽頭腫術後の1症例

Benefits of Management Tool for Daily Life Performance (MTDLP) in the convalescence rehabilitation ward and role of occupational therapists: A case of a post craniopharyngioma patient with mild memory impairment that resulted in reinstatement

要旨：頭蓋咽頭腫術後に生活行為向上マネジメント（MTDLP）を活用し復職に至った1例において，回復期リハビリテーション（リハビリ）病棟でのMTDLP活用の利点と作業療法士（OTR）の役割を検討した．MTDLPの使用により徹底した環境設定のもと適切なプログラムを立て，多職種の役割を具体化でき，意味のある作業の選択により症例の積極的な訓練参加が可能となった．結果，QOLは向上し生活期のリハビリを経て復職を果たした．日々変化する機能をよく観察し，適切な合意目標を立て，介入することが重要と考える．また，回復期のOTRとして十分な介入を行いきれない場合，症例の最終目標とその予後予測を，生活期のリハビリに繋ぐ重要な役割を担っていると考えられた．

　The purpose of this study was to examine the dual benefits of Management Tool for Daily Life Performance (MTDLP) and the role of OT for a case where MTDLP was used for craniopharyngioma after reinstatement. Through the use of MTDLP, an appropriate OT program was established, the roles of various occupations were specified, and choosing the meaningful occupation enabled the patient to joint active training. As a result, the quality of life improved, and the patient successfully returned to work after daily life rehabilitation. We think that it is important to carefully observe the functions that change daily, establish appropriate goals through consensus, and conduct OT intervention. In addition, even if the OT cannot fully intervene during the recovery period of the client, the OT still has an important role to play through daily rehabilitation and leading the client to the final goal.