重症熱傷後に両下腿切断となり不安感が強く抑うつ傾向であった高齢患者に対し，交換日記を用いた作業療法が良好な転帰につながった事例

Successful occupational therapy using an exchange diary in a highly anxious and depressed elderly patient with severe burns and double lower leg amputation: A case study

要旨：今回，重症熱傷後に両下腿切断となり，不安・抑うつやPTSDの危険性が高まっている高齢患者を経験した．さらに，コロナ禍による面会制限によって，家族の不安感も増強していた．そのため，本事例と家族双方への精神的支援の目的として交換日記を開始した．その結果，本人の不安・抑うつの改善やPTSDの危険性は低下し，また家族の不安感の軽減にもつながっていた．その後は，リハビリに対して前向きに取り組むことが可能となり，良好な経過を辿り，最終的に自宅退院に至った．交換日記は，熱傷後の精神・心理的状態における精神的支援や，コロナ禍による面会制限がある中での情報共有の手段の一つとして有用な可能性が示唆された．

　In this study, we experienced an elderly patient who suffered amputation of both lower legs after severe burns and was at increased risk for anxiety, depression, and PTSD. In addition, the family's anxiety was also heightened due to visitation restrictions caused by coronary disease. Therefore, we started an exchange diary to provide emotional support to both the patient and his family. As a result, the patient's anxiety and depression were relieved, the risk of PTSD decreased, and the family's anxiety was reduced. The patient was able to positively engage in rehabilitation, made good progress, and was ultimately discharged home. We suggest that the exchange diary may be useful as a means of providing emotional support for post-burn psychiatric symptoms and for sharing information when visitation is restricted due to secondary conditions such as coronary disease.