橈骨遠位端骨折患者の患手を使用した大切な作業への取り組みにおけるカナダ作業遂行測定と自己モニタリングシートを併用した作業療法実践の効果

Effects of occupational therapy practice combining the Canadian Occupational Performance Measure and a self-monitoring sheet on engagement in meaningful occupations with the affected hand in a patient with distal radius fracture

要旨：本単一事例研究では，右橈骨遠位端骨折外来患者に対して患手を使用した大切な作業の遂行を目指し，カナダ作業遂行測定による面接および自己モニタリングシートを併用した作業療法介入を行った．介入期においてカナダ作業遂行測定の面接で特定された事例の大切な作業である調理について，週あたりの実施回数をカウントし，ベースライン期と比較することで介入の有効性を検討した．その結果，介入期における週あたりの調理回数は有意に増加し，患手を使用した調理が可能となった．カナダ作業遂行測定による面接および自己モニタリングシートを併用した作業療法実践は，患手を使用した大切な作業の実施状況の改善に有用であることが示唆された.

　This single-case experimental study of client-centered occupational therapy intervention combining the interview-based Canadian Occupational Performance Measure (COPM) and a self-monitoring sheet was conducted on an outpatient with a right distal radius fracture. The goal was to enable the patient to perform cooking (as her meaningful occupation revealed by the COPM) with her affected hand. The effect of the intervention was assessed by comparing the number of times the patient was able to cook per week during the intervention period with the baseline period. The number of times the patient cooked per week significantly increased during the intervention period, and she was able to cook with her affected hand. Thus, occupational therapy practice combining the interview-based COPM and self-monitoring sheet may be effective for patients with distal radius fracture engaging in meaningful occupations with the affected hand.