[in Japanese]

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The purpose of this study is to clarify the factors that influence the outcome of patients with dementia and suspected dementia (MMSE score of 23 or less) admitted to the recovery phase rehabilitation ward. Basic attributes, cognitive function-related items, and FIM-related items were extracted from medical records and reports, and the outcomes after discharge were divided into two groups, “home group” and “facility group”, and analyzed. There were 130 items in the “home group” and 58 in the “facility group”, and stepwise multiple logistic regression analysis was performed using the items with statistically significant difference between the two groups as explanatory variables. As a result, mobility and memory impairment were extracted as important factors. As an occupational therapist, it is necessary to evaluate the cognitive symptoms of the subjects and prepare a support environment with the team and family.

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The purpose of this study is to create a trial version of “Assessment Form for the Interaction of Daily Life Performance” (prototype) and to examine its logical and face validity. First, a prototype that focused on the causality of daily life performance was created. Second, ten experienced occupational therapists considered the contents of the prototype using the Nominal Group Technique and Delphi Method that were based on problem-solving/divergent-convergent facilitation. Finally, eighty healthy people used the revised version. As a result, the main subjects, methods, evaluation viewpoints, and the interpretation of results were revised until a consensus was reached. Furthermore, the trial version was completed. This assessment form could be used for occupational therapy because it deepens the qualitative evaluation of living conditions and ways of thinking, analyzes daily life with a bird’s-eye view using an interaction matrix, and promotes collaboration.

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The purpose of this study is to clarify process of transformation of cognition of life after discharge of stroke patients during admission to a convalescent rehabilitation ward. The experiences of three stroke patients in a convalescent rehabilitation ward were interviewed from the time of onset of stroke and their cognition of life after discharge, and their interview data were analyzed using the Trajectory Equifinality Approach. Although the three patients experienced a gap between their desired life and the current situation, they regained confidence in rehabilitation and building a new life due to being provided with advice and facilitated programs by the Occupational therapists that matched the feeling of recovery. Therefore, it is necessary to share the goal of maintaining the social role of stroke patients from the early stages of hospitalization in convalescent rehabilitation.

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The purpose of this study was to examine the characteristics of occupational therapy based on the Model of Human Occupation (MOHO) performed in Japan. The method includes analyzing the case reports quantitatively using MOHO published in Japan, and grasping the characteristics of MOHO practice from the text data. As a result, the most commonly used therapeutic strategy in practice was “identify”. Practice with MOHO is formed from seven categories. Within these categories, the emphasis was on clarifying the relationship between the client and the occupation. The practitioner built the client’s support based on the occupation revealed by MOHO.

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In our study, we sought to obtain in-depth information to support the use of occupational therapy in school settings. We conducted a qualitative study using interviews in order to clarify the origins of poor adjustment experiences of junior high school students enrolled in regular classes. All subjects reported a common understanding based on a theoretical framework related to the characteristics of sensory information processing. Researchers obtained descriptions based on this perspective from interviews, such as “The classroom environment is uncomfortable for junior high school students with sensory sensitivity;” “Easy response to sensory stimuli can be a factor that hinders learning;” and “Ease of sensory stimuli hinders school adaptation and learning.”

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The aim of this research was to clarify belief conflict in upper extremity training for stroke patients in convalescent rehabilitation. We used the Structure-Constructive Qualitative Research Method for qualitative research designs, and Steps for Coding and Theorization for qualitative data analysis. The participants were six occupational therapists. As a result, we identified three themes:process of generating beliefs related to treatment strategies, structure of belief conflict by upper extremity training, and key to the clarification of belief conflict. Findings from this study suggest that in order to elucidate belief conflicts, it is necessary to understand the reasons and EBP on which beliefs about intervention strategies are constructed, and adapt communication to the situation and purpose.

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We used the Cognitive Orientation to daily Occupational Performance (CO-OP) approach to intervene in a stroke patient with impaired cognitive function. This purpose was for the client to acquire cooking and problem-solving skills. As a result, this intervention helped the client acquire skills and achieve her goals. In addition, the client could transfer the skills to other occupations, indicating that the CO-OP approach may be useful for goal attainment, skill acquisition, generalization, and transfer in stroke patients with cognitive impairments. In cases of impaired attention, memory, and executive function, it is important to intervene using techniques such as chaining and task accommodation as enabling principles with the characteristics of the disability in mind.

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We examined the effects of kinesthetic illusion of a segmental body part induced by visual stimulation (KINVIS) therapy on upper-limb ataxia caused by a thalamic injury. The patient had ataxia of the left upper-limb due to thalamic infarction. KINVIS therapy was administered for 20 minutes, followed by occupational therapy for 40 minutes. The intervention lasted for 10 days. As a result, the reduction of ataxia was observed before and after the intervention period, and upper-limb function continued even after 10 days. In addition, there was an improvement in both the ability to manipulate objects and in daily life functions caused by ataxia. These results suggest that KINVIS may be an effective treatment for upper-extremity ataxia and deserves further investigation.

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The objective of this study was to examine the effect of an intervention focusing on occupational dysfunction in the recovery of an inpatient with schizophrenia (the client). The assessment was based on the degree of occupational dysfunction, the recovery process, the client’s narratives and behaviors, and the number of occurrences of early warning signs. The interventions included sharing the causes of the occupational dysfunction through interviews, adjusting the environment in which the desired occupations were performed, and collaborating to make a coping plan for the client’s symptoms. As a result, the early warning signs and occupational dysfunction improved, and there were positive changes in the client’s narratives and behaviors and recovery process. Thus, this intervention focusing on occupational dysfunction contributed to understanding the client’s subjective experiences and collaborating with the client and could be one specific strategy in recovery-oriented occupational therapy.

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A patient with mild hemiplegia of the upper-left limb was treated with continuous neuromuscular electrical stimulation (RFE under cNMES) alone for four weeks after admission and with a transfer package for a subsequent two weeks. After four weeks of monotherapy, improvement was observed in the following areas:upper limb function, ability to manipulate objects, and quality of movement of the affected upper limb. However, subjective improvement in the Amount of Use (AOU) during daily activities was only 0.07 points. Following two weeks of combined treatment using the transfer package, the AOU showed an improvement of 1.43 points, indicating enhanced frequency of upper limb use. The results suggest that the combination of RFE under cNMES with a transfer package for upper limb paralysis may have a positive effect on upper limb function, the ability to manipulate objects, the frequency of upper limb use, and quality of movement.

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We had the opportunity to undertake rehabilitation for a patient with schizophrenia who received inpatient treatment under the Medical Treatment and Supervision Act following repeated psychiatric hospitalizations for violent behavior associated with psychiatric symptoms. This report discusses the instrumental activities of daily living (IADL) training used in our hospital together with a description of the case details. Following pharmacotherapy, the patient underwent IADL training, which involved daily training outside of program hours and participation in a group simulating day-care. This resulted in improvement in the patient’s social functioning. Creating an environment in a hospital ward in which daily IADL training is feasible could not only encourage patients to be active in their training, but also be an effective means for examining and sharing an image of life after discharge.

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We experienced a case in which postural control dysfunction such as dizziness and light-headedness remained after pontine bleeding, which could significantly limit life after discharge. The postural control dysfunction in this case was believed to be central vestibular dysfunction. Previous studies have pointed out the effectiveness of vestibular rehabilitation introduced into peripheral vestibular dysfunction for central vestibular dysfunction, and the current study attempted to introduce it. The client recovered her attitude control function through intensive vestibular rehabilitation, and was able to acquire meaningful occupation, including riding the train and biking.

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Supporting the resumption of driving requires a comprehensive assessment of the client’s driving ability. In this study, we conducted the occupational intervention through the traffic psychology approach in the case of a man in his seventies who had been deemed unable to resume driving due to generalized attention deficits and dangerous driving behavior at three previous driving evaluations. We observed delays in SiDS timing tests and reaction times in the initial in-hospital evaluation, as well as delays in braking before stopping temporarily, entering a curve, and inadequate monitoring of his own driving during the in-course evaluation. We conducted repeated training in braking based on a traffic psychology approach and actual driving on public roads by a driving instructor. We observed an improvement in braking, driving performance, and metacognition of his own driving, which eventually lead to a resumption of driving.

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It is important to identify the gaps between what people want and need to do and what they actually do in occupational therapy. This study aims to develop and verify the feasibility of the Japanese version of the Occupational Gaps Questionnaire (OGQ-J). The OGQ-J was translated according to standardized procedure. As a result, the linguistic validity of the OGQ-J, which consists of 30 activity items that can be used in Japanese culture, was confirmed while maintaining the content consistency with the original version. In the future, the reliability and validity of the OGQ-J should be verified by including the elderly and people with reduced physical and mental functions in the target population.

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