回復期リハビリテーション病棟入院中のクライエントと作業療法士の治療関係はどのような経験から成り立つのか——解釈学的現象学の方法を用いて

An interpretive phenomenology of the therapeutic relationship between rehabilitation inpatients and their occupational therapists

要旨：作業療法士（以下，OTR）とクライエント（以下，CL）が，治療関係構築時の経験をどう意味づけているかを理解するために解釈学的現象学による質的研究を行った．回復期病棟入院中のCLとOTR 3組に参与観察と面接を実施した．その結果，治療関係構築の意味づけとして，CLでは6つ，OTRでは5つのテーマが明らかになった．OTRとCLの間には，関係構築のための関わり，経験の共有を通したOTRとCLの関わり，関係の帰結に向けての関わりがあると示唆された．治療関係構築についてOTRは〈思いを汲み取ろうという態度〉と意味づけており，CLは〈改善の兆候の実感〉や〈いまの自分を知ってくれている存在〉と意味づけていた．

　The aim of this study is to clarify the meanings and experiences in building therapeutic relationships of occupational therapists (OTR) and clients (CL) in a convalescent rehabilitation ward. This qualitative research used an interpretive phenomenology, in which three pairs of CL and OTR were separately interviewed following observation of an occupational therapy session. The data regarding the relationship narratives were analyzed, and thematic analysis was performed from the viewpoint of interpretive phenomenology． The analysis revealed six themes of CL and five of OTR, suggesting that there is involvement between the OTR and the client in building the relationship, between the OTR and CL through sharing of experiences, and involvement between the two towards the end of the relationship. Regarding the therapeutic relationship, OTR revealed the meaning of <Attitude to try to understand feelings>, while CL revealed the meaning of <actual signs of improvement> and <OT let me discover my current self>.