ギランバレー症候群発症後に予後不良所見を認めた事例の心理・健康状態に「作業に基づく実践」が及ぼす影響—意味のある作業，心理・健康状態，身体機能に着目して

Effects of “occupations-based practice” on psychological and physical health of a patient with poor prognosis after Guillain-Barré syndrome: Focusing on meaningful work, health, and physical function

要旨：ギランバレー症候群（以下，GBS）を発症した70代男性を担当した．入院時の事例は，GBSの機能障害により日常生活は全介助を必要とし，不安や鬱など精神症状も認められた．そこで，本人にとって「意味のある作業」を話し合い，多職種で統一した支援を行ったところ，作業遂行能力や満足度の指標は臨床上意味のある最小変化量を超える結果が得られ，心理・健康状態の改善も図ることができた．また，患者が医療者の共感を評価する指標も，先行研究以上の結果を得ることができた．これらの結果より，「意味のある作業」に基づく実践は，予後不良所見を認めたGBS患者の心理・健康状態や多職種連携促進の一助となる可能性が考えられた．

　We treated a man in his 70s who developed Guillain-Barré syndrome (GBS). At the time of admission, the patient required full assistance in daily living due to the functional impairment of GBS. Psychological symptoms such as anxiety and depression were also observed. We discussed "meaningful occupations" for the patient, and facilitated unified support by other professionals, which resulted in changes in work performance and satisfaction indices that exceeded the minimal important change and improved the patient's psychological and physical health status. The patient's evaluation of the empathy of the health care provider also exceeded those of previous studies. These results suggest that practices based on “meaningful occupations” may help to improve the psychological and physical health status of GBS patients with poor prognosis and promote collaboration among other professions.