リハビリテーションに関する達成動機尺度に基づいた自己評定法と面接法を併用した人工股関節全置換術後の患者に対する介入

Approach for a patient after total hip arthroplasty surgery using self-assessment and interview based on Scale for Achievement Motive in Rehabilitation

要旨：作業療法では，対象者の生活行為がやり遂げられるように，意欲を引き出す支援が重要となる．今回，人工股関節全置換術後患者に対して，自己評定法に加えて半構造的面接法を併用することで，対象者の目標に対する意欲や生活行為への参加を高められた介入手順について報告する．リハビリテーションに関する達成動機尺度の得点から達成動機の状態を把握し，面接法により事例の作業参加につながる目標，行動計画，周囲のサポートについて合意形成した．その内容を視覚的に意識づけし適宜修正することで，事例の達成動機の向上や積極的な行動変容が窺えた．達成動機の観点から面接法を併用することで，サポート内容を明確化することが期待できる．

　In occupational therapy, it is important to support motivation so that clients can complete their daily life performance. We report on an intervention procedure that improved the client's motivation toward goals and participation in daily life performance. The intervention utilized a semi-structured interview and a self-rating scale to improve the motivation of a female patient after total hip arthroplasty. Using the Scale for Achievement Motive in Rehabilitation total and subscale scores, and the interview method, we assessed the patient's achievement motive and agreed with her about the goals, action plans, and support from people around her, which led to her occupational participation. As a result, her achievement motive and behavior improved by making her visually aware of the content of the interview and modifying it appropriately. Thus, from the viewpoint of achievement motive, combining the interview method with the Scale for Achievement Motive in Rehabilitation can clarify the support content to the patient.