重症心身障害児の自立活動のコンサルテーションにおける医療機関に所属する作業療法士の専門性に対する学校教諭との認識の共有に向けた方略—混合研究法の説明的順次デザインによる検討

Strategies for sharing perceptions with schoolteachers about the professionalism of occupational therapists affiliated with medical institutions in the consultation of independent activities for children with severe motor and intellectual disabilities: A mixed-methods study utilizing an explanatory sequential design

要旨：医療機関に所属する作業療法士が，重症心身障害児の自立活動に対してコンサルテーションを実施する場合の，作業療法士の専門性を学校教諭と共有するための方略について，混合研究法の説明的順次デザインで検討した．まず，作業療法士と学校教諭に同一の質問項目による調査を実施した．結果，「身体の動き」で共通認識が，「自立活動6区分を包括する支援」で認識の相違が認められた（研究1）．研究1の結果から質問項目を設定し，熟練の作業療法士を対象に半構造化インタビューを実施し，SCATによる分析を行った．結果，学校の文化や制度の視点を考慮した，学校教諭との認識の相違に留意した協働のプロセスが示唆された（研究2）．

　A mixed-methods study utilizing an explanatory sequential design was implemented to investigate strategies for communicating perceptions of professionalism among occupational therapists working in medical institutions when providing consultation on independent activities for children with severe motor and intellectual disabilities. First, a survey was administered to both occupational therapists and schoolteachers, which revealed a shared understanding of 'physical movement', yet a discrepancy in awareness of 'support encompassing the six categories of independent activity' (Study 1). In light of the findings from Study 1, semi-structured interviews were conducted with experienced occupational therapists and analyzed utilizing the SCAT method. The results of this study clearly elucidated the factors contributing to the differences in perceptions and the collaborative process based on the school's cultural and institutional perspectives, and proposed strategies for effectively communicating perceptions with schoolteachers (Study 2).