精神障害者に対する入院早期からの作業療法介入の現状と課題—日本における事例報告および介入研究のスコーピングレビュー

Current status and issues of early occupational therapy intervention for persons with mental disorders: A scoping review of case reports and interventional studies in Japan

要旨：日本における入院精神障害者に対する早期作業療法の既存の研究結果を要約し，今後の研究や実践の示唆を得るためにスコーピングレビューを実施した．データベース検索とハンドサーチにて早期作業療法に関する事例研究，介入研究計14論文を抽出し分析した．早期作業療法では精神症状，作業遂行，認知機能の評価の利用が多く，認知心理機能，健康管理能力，日常生活活動，社会生活適応能力の改善を目的に介入が実施されていた．主な成果として精神症状や認知機能，機能的自立度および動機付けの改善が示された．一方で，集団プログラムの目的が不明確な報告が多いこと，作業に関する成果報告が乏しいことも明らかとなり，今後の課題と考えられた．

　This study conducted a scoping review to identify the content and outcomes of occupational therapy interventions for people with mental disorders from the early stages of their hospitalization in Japan. Ten case reports and four interventional studies were identified by both database and hand search. Early occupational therapy for people with mental disorders often began in the second or third week of hospitalization and lasted from two to three months, and most of the assessments were related to psychiatric symptoms, occupational performance, and interpersonal interactions. Interventions aimed at improving cognitive psychological functioning, health management skills, activities of daily living, and social adjustment skills were implemented-most of them as individual interventions. The main outcomes were improvements in psychiatric symptoms, cognitive function, functional independence, and motivation, but the purpose of the group program was unclear, and there was a lack of reports on the outcomes of the occupation. Future studies should clarify the purpose of the group program and verify the effect on the occupation.