回避性パーソナリティ障害を持つ入院患者に対する作業機能障害に焦点を当てた実践の効果—単一事例実験研究

Effectiveness of a practice focused on occupational dysfunction for an inpatient with avoidant personality disorder: A single-case experimental study

要旨：社会的相互作用を極端に抑制することを特徴とする回避性パーソナリティ障害を有する事例に対して，作業機能障害の種類と評価を用いた面接に基づく作業療法介入を実施した．介入の有効性を単一事例実験研究デザインに基づき，作業療法参加回数および語りの変化，行動の変化を実施前後で調査した．その結果，作業療法参加回数は有意に増加および維持された．また日々の活動に意味を感じられる語りの変化が見られ，日中生活において主体的な行動の拡大に影響を及ぼした．これより，作業機能障害に焦点を当てた面接に基づく作業療法介入は，回避性パーソナリティ障害のあるクライエントの作業活動への参加に対し有効であることが示唆された．

　An interview-based occupational therapy intervention using the Classification and Assessment of Occupational Dysfunction (CAOD) was conducted on an inpatient with avoidant personality disorder characterized by extreme inhibition of social interactions. The effectiveness of the intervention was investigated based on a single-case experimental design, examining the following: number of times the inpatient participated in occupational therapy programs, changes in his narratives, and changes in his behavior before and after the intervention. The results showed a significant increase in the number of occupational therapy participation, changes in the narrative of meaningfulness in daily activities, and an influence on the expansion of proactive behavior in daily life. These results suggest that occupational therapy intervention based on interviews, focusing on occupational dysfunction is effective for participation in occupational activities in inpatients with avoidant personality disorder.