回復期の脳卒中上肢機能訓練における信念対立の質的解明

Qualitative research of belief conflict in upper extremity training for stroke in convalescent rehabilitation

要旨：本研究の目的は，回復期の脳卒中上肢機能訓練における信念対立の構造を明らかにすることである．構造構成的質的研究を採用し，データ分析にはSteps for Coding and Theorizationを用いた．研究対象者は6名の作業療法士であった．結果は〈治療方針に関わる信念の生成プロセス〉〈上肢機能訓練に関わる信念対立の構造〉〈信念対立解明の手がかり〉の3個のテーマが存在した．信念対立の解明には，自身や他者の治療方針を決定付ける信念の成立根拠を自覚することや，EBPを正確に理解すること，建設的なコミュニケーションをとるなかで対象者の状況に応じた目的を明確化することなどが重要であると考えられた．

　The aim of this research was to clarify belief conflict in upper extremity training for stroke patients in convalescent rehabilitation. We used the Structure-Constructive Qualitative Research Method for qualitative research designs, and Steps for Coding and Theorization for qualitative data analysis. The participants were six occupational therapists. As a result, we identified three themes: process of generating beliefs related to treatment strategies, structure of belief conflict by upper extremity training, and key to the clarification of belief conflict. Findings from this study suggest that in order to elucidate belief conflicts, it is necessary to understand the reasons and EBP on which beliefs about intervention strategies are constructed, and adapt communication to the situation and purpose.