2022 年 18 巻 1 号 p. 127-131
Introduction: Few reports describe the occupational therapy practice of reinforcing the daily life behaviors hoped for by clients with schizophrenia in community mental health services. We outline a therapeutic process to enable bathing hoped for by a client with schizophrenia through the combined use of the Canadian Occupational Performance Measure (COPM) and a checklist as a cognitive aid.
Methods: The study was divided into a baseline phase and intervention phase based on the single-system design. The interventions were focused on occupation based on the COPM and positive feedback by using the checklist. Assisted bathing, advice, suggestions and prompting of voluntary activities were conducted in the baseline phase.
Results: The frequency of bathing per week increased significantly in the intervention phase compared to baseline phase by binomial test (p = 0.03). Although bathing performance score and satisfaction score in the COPM assessment decreased from 10 and 9 (20th week) to 6 and 4 (34th week), respectively, the assessment was influenced by the client's further positive inquiries into ways of bathing.
Conclusion: Bathing hoped for by a client with schizophrenia was enhanced, and further positive inquiries into activities of daily life in a personal context were initiated. The findings suggest that in community-dwelling clients with schizophrenia, a client-centered approach combining COPM and a checklist as a behavioral reinforcement-based cognitive aid is sufficiently appropriate for promoting client participation in activities.
