医療観察法の対象者に対する家事および調理技能の獲得に向けた作業療法介入

Occupational therapy interventions for the acquisition of housework and cooking skills for subjects of the Medical Treatment and Supervision Act Law

医療観察法の対象者の中には，精神疾患以外に知的障害や認知機能障害の併存が認められ，家事や調理の基本的技能の低さから生活が安定せず病状悪化につながる事例も多い．本事例にも知的障害と認知機能障害が認められ，健康や生活に無関心で不健康な生活を続けていた．作業療法や外泊訓練を通して，健康管理と家事や調理の技能獲得に向け，本事例が遂行できた内容に対して肯定的なフィードバックを用いて効率的な見本の提示や助言を行った結果，健康管理や生活技能の改善が図れた．医療観察法下における本事例への健康管理や生活技能への介入は，社会生活への価値を高めると共に再他害行為防止に作用し，社会復帰につながると考える．

　Among the subjects of the Medical Treatment and Supervision Act Law (MTSA), there are cases in which intellectual disability and cognitive dysfunction coexist with mental illness. Furthermore, poor basic skills in housework and cooking lead to unstable living and worsening of the patients' condition. The present case had both intellectual disability and cognitive dysfunction, and was indifferent to health and life, which contributed to an unhealthy lifestyle. Through occupational therapy and overnight training, the authors used positive feedback on what the patient was able to accomplish and provided effective examples and advice to help the acquisition of skills in health care, housework, and cooking. As a result, improvement in health management and daily living skills was achieved. The health management and life skills intervention for this case under the MTSA resulted in an increase in the value of social life. This intervention prevented the recurrence of harmful behavior and influenced the future reintegration into society.