生活行為向上マネジメントを用いて重度訪問介護の利用による外出支援を実現した長期療養患者の事例

Supporting going out through long-term home-visit care using the Management Tool for Daily Life Performance: A case study

要旨：長期療養目的で入院している脊髄損傷患者を担当した．事例は外出を希望していたが，外出を行うにあたり移動や吸引の介助が必要であり，定期的な外出が困難な状況であった．また障害が治らなければ日常生活動作や自身のやりたいことはできないという信念を持っており，自身で行える動作も介助者に依存していた．今回，生活行為向上マネジメントを用いて，重度訪問介護の利用による外出支援を実施した．その結果，定期的な外出が可能となった．また自己効力感が向上し，自身のことは自身で行うという行動変容につながった．

　This case study describes a patient who requires long-term care due to spinal cord injury. The patient's desire to go out was limited due to his reliance on assistance in both endotracheal suction and moving. In addition, he believed that he could not participate in neither daily living activities nor hobbies unless his disability was cured, so he depended on the caregiver for motions that could be performed by himself. We did going-out support for persons with severe disabilities using Management Tool for Daily Life Performance. As a result, he became able to go out regularly by public transportation. Furthermore, both his self-efficacy and independence increased.