特別養護老人ホームにおける高齢女性に対する作業機能障害の種類に焦点を当てた評価および介入—園芸活動を用いた実践

Assessment and interventions focusing on the classification of occupational dysfunction in special elderly nursing home practice using horticultural activities: A case study

要旨：特別養護老人ホームに入所中で，生活全般において消極的な女性に対し，園芸活動を用い，作業機能障害の種類に焦点を当てた評価および介入を行った．観察を中心にした評価は，作業機能障害の4種類（作業不均衡，作業剥奪，作業疎外および作業周縁化）に対する必要な介入を明確にできた．その結果，症例は，笑顔が増え，外出するようになり，夜間の睡眠が十分とれるようになるなど，作業機能障害の改善に至り，健康な施設生活を送れるようになった．意味のある作業を同定しがたいクライエントに対して，作業機能障害の種類に焦点を当てた評価および介入は，有効であったと考える．

　We performed an assessment and administered interventions using horticultural activities which focused on the classification of occupational dysfunction in a client who exhibited general reluctance in a special elderly nursing home. Observation-based evaluation enabled us to clarify the necessary interventions for the four types of occupational dysfunctions: occupational imbalance, occupational deprivation, occupational alienation, and occupational marginalization. The client started to enjoy horticultural activities, talked with a smile, had more opportunities to go out, and got enough sleep at night. Her occupational dysfunction improved, and she was able to spend a healthy life in the facility. Therefore, the assessment and interventions which focused on the classification of occupational dysfunctions were effective in a client who could not identify a meaningful occupation.