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要旨:回復期病棟において,脳卒中後に抑うつ的状態となった事例に対し,入院時から作業選択意思決定支援ソフト(以下,ADOC)による具体的な目標設定を試みたが,悲観的な事例に対し,目標設定に難渋した.しかし,作業機能障害の種類と評価(以下,CAOD)を使用した結果,事例の心理面の理解につながり,事例の心情を配慮しながらADOCを併用することで目標の共有が可能となった.また,その後の支援によって,作業機能障害の改善およびADOCにおける作業満足度の向上が見られた.本事例を通して,ADOCとCAOD併用による包括的アプローチの有用性が示唆された.
In this study, occupational therapists attempted to set specific goals using ADOC from the time of admission to a client who had become depressed after a stroke in a convalescent rehabilitation ward. The pessimistic client had difficulty setting goals. However, the use of CAOD led to an understanding of the psychology of the client, and shared goals became possible by combining ADOC with consideration of the client's emotional state. The subsequent support alleviated the occupational dysfunction and improved the occupational satisfaction in the ADOC. This case study suggests the usefulness of a comprehensive approach using both ADOC and CAOD.
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