終末期がん患者に対する作業療法において，他職種と協業する際の作業療法士のクリニカルリーズニングの検討

Clinical reasoning of occupational therapists when collaborating with other occupations regarding occupational therapy for terminal cancer patients

要旨：本研究の目的は，終末期がん患者の作業療法（OT）にて，他職種と協業する作業療法士（OTR）のクリニカルリーズニングを明らかにすることであった．方法は，当該領域のOTRを対象に半構造化面接を行った．作成した遂語録についてKH coderを用い，共起ネットワーク等の分析を行った．結果，看護師や他職種に理学療法とOTの違いを伝え，分からないことは聞く，医師にリハビリテーション場面をイメージしてもらい，OTの処方を促す，他職種とカンファレンスや病棟で直接会って，話す，ADL状況やゴールを共有する，患者の個性に応じた役割を果たす等が抽出された．上記はOTRの行動指針となり，他職種とスムーズな連携につながると考える．

This study aimed to clarify the clinical reasoning of occupational therapists (OTRs) who collaborate with other occupations to provide occupational therapy (OT) to terminal cancer patients. Semi-structured interviews with OTRs assisting terminal cancer patients were conducted. We analyzed the co-occurrence network using KH coder, and extracted the following: communicate the difference between physical therapy and OT to nurses and other occupations and inquire about anything they do not understand; get physicians to imagine rehabilitation situations and encourage them to prescribe OT; meet and speak directly with other occupations at conferences and wards; share patients' ADL situations and goals; and play roles according to the patient's individuality. We believe that the above will serve as an action guideline for OTRs and facilitate collaboration with other occupations.