呼吸困難が軽減したことにより家庭内役割の再獲得が可能となった膠原病関連間質性肺炎の一症例

Relief of dyspnea caused by Collagen Vascular Disease-Associated Interstitial Pneumonia through adjusting household behavior: A case study

要旨：膠原病関連間質性肺炎（Collagen Vascular Disease-Associated Interstitial Pneumonia；以下，CVD-IP）と診断された60歳代の男性患者に対し，呼吸困難が生じていた家事動作への作業療法介入を行った．本症例の呼吸困難は，拘束性換気障害による換気効率の低下と拡散障害による低酸素血症が影響していた．呼吸困難を軽減するために，作業様式の変更，仕事量の調整，環境調整，本症例に適した呼吸方法の指導を行った．作業療法介入後は呼吸困難が軽減し，満足度の高い生活への行動変容が可能となった．CVD-IPの病態把握，呼吸分析，作業遂行分析が，本症例の呼吸困難を軽減することに有効であった．

　A male patient in his 60s suffered from Collagen Vascular Disease-Associated Interstitial Pneumonia（CVD-IP）resulting in dyspnea. The patient experienced inefficient ventilation resulting in respiratory difficulty. Occupational therapy (OT) intervention was performed on the patient's household behavior. To alleviate the dyspnea, OT intervention included modifying his working style, adjusting the workload, conducting environmental studies, and coaching in the breathing methods appropriate for this case. As a result, dyspnea was reduced, and behavior improved to a significant degree. Understanding the pathophysiology of CVD-IP, as well as both respiratory and work performance analyses were effective in reducing dyspnea.