脳卒中後アパシーを呈する症例の意欲や行動障害に「意味のある作業」の提供が及ぼす影響—症例報告：小集団活動の介入可能性に関する一考察

Effects of “meaningful occupations” on motivation and behavioral disorders in patients with post-stroke apathy: A case study on the Intervention Potential of Small Group Activities

要旨：脳卒中後アパシー（Post-Stroke Apathy：PSA）を中心に複数の精神症状を認めた70代女性を担当した．症例は，情動感情処理障害や認知処理障害が顕著だったが，興味関心チェックリストより，〈カラオケ〉や〈親族とのおしゃべり〉に関心を抱いていることが伺えた．そこで，他者交流を介した自己効力感の向上や，自他への興味関心を引き出すことを目的に小集団活動を試みたところ，導入中は一部症状の改善が認められた．また，本人にとって「意味のある作業」を取り込めれば，集団から得られる作用を高められる可能性も示唆された．ただし，1症例による検討のため，今後は症例数を増やし科学的に証明することが必要である．

　The case is a female patient in her 70s who had multiple psychiatric symptoms, including predominantly post-stroke apathy. Emotional-affective processing disorder and cognitive processing disorder were prominent in the patient, but the results of the interest checklist indicate that she was interested in <Karaoke> and <Talking with relatives>. Therefore, we attempted small group activities aimed at improving self-efficacy through interaction with others and eliciting interest in oneself and others. As a result, some symptoms were improved during the introduction, suggesting that if the subject took part in “meaningful occupations”, the effect obtained from the group could be enhanced. However, since this study was based on a single case, it is necessary to increase the number of cases and scientifically prove future results.