外来作業療法における認知関連行動アセスメント（Cognitive-related Behavioral Assessment; CBA）の臨床有用性—OTと患者家族間でCBAを活用した一事例

Clinical usefulness of the Cognitive-related Behavioral Assessment (CBA) in outpatient occupational therapy: A case study of the use of CBA between OT and patient's family

要旨：高次脳機能障害者に対する支援では，患者だけでなく家族教育や情報提供が重要である．本事例は注意障害を有する被殻出血を発症した60歳代女性である．家族から症状の理解が得られず作業剥奪をはじめとする作業機能障害が発生したため，認知関連行動アセスメント（Cognitive-related Behavioral Assessment; CBA）を作業療法士と家族間で活用した外来作業療法を実施した．結果，CBAを用いた評価と介入により，家族は支援的な立場となり，作業機能障害は改善した．本事例の介入経過から，患者家族が症状の理解や適切な関わり方を習得する目的において，CBAの臨床有用性が示唆された．

　Family education and information provision are important in supporting persons with higher brain dysfunction. This case is a woman in her 60s who developed capsular hemorrhage with attention disorder. Because the family did not understand the symptoms and the patient suffered from occupational dysfunctions, outpatient care was conducted utilizing Cognitive-related Behavioral Assessment (CBA) between the occupational therapist and the family. The results showed that the family became more supportive, and their occupational dysfunction improved after the assessment and intervention using the CBA, as they gained an understanding of the patient's symptoms. The intervention process in this case suggests the clinical usefulness of CBA for the purpose of helping patients' families understand the symptoms and learn how to relate to the patient appropriately.