臨床実習での学生の指導方法について 実習の学生と指導者の振り返りからの一考察

実習の際には、実習地を訪問し、課題の進捗状況を指導者と学生から聞き取り、問題が生じていれば、その原因と解決方法を共に考え対処し、実習の課題到達を目指している。今回精神領域の評価実習の訪問時、学生は「指導者に迷惑をかけたくない」「実習の場でどのように行動したら良いかわからない」との訴え、課題の進捗状況の確認に時間を要した。「実習ではできない事を見つけそれを練習する事が大切」と事前に学びの姿勢を伝えていが、学生は指導者にどう思われているかを優先していた。　この原因を知りたく、実習生と指導者それぞれに実習の振り返りを実施した。振り返りは、実習生には困った事と受けた援助、指導者には実習生が困っていた事と実施した援助にカード化した。学生と指導者それぞれのグループでKJ法を用い概念化し、結果を共有した。　学生が困った事については、学生自身よりも指導者の方が具体的に把握し、学生は自身が困った事を言語化できていなかったことが示された。この言語化できていないことが自身の実習課題の達成よりも指導者からの評価に視点がむいた原因と考えられたThe present study involved students undergoing practical training and their supervisors, and focused on supervisors’ approaches to help students complete assignments. Students who have had problems and their supervisors at a training site are supposed to report the status of progress made in assignments and discuss the causes and solutions together. Reports submitted by students who had undergone training in psychiatry included: “They did not want to cause trouble for supervisors” and “They did not know what to do at the training site”, and it took time to confirm the status of progress. Although students had been informed of a recommended learning attitude: “In practical training, it is important to identify what you cannot do and practice it for improvement” in advance, they were more occupied with their supervisors’ evaluations.Both students and supervisors were asked to reflect on the training sessions to examine the causes; the students reflected on problems they experienced and support they received, and the supervisors reflected on those problems and the support they provided. The results of the reflections were described on cards. The descriptions obtained from the student and supervisor groups were conceptualized using the KJ method, so that they could share the results.The supervisors had understood problems experienced by the students more comprehensively than the students themselves. The students had difficulty verbalizing their problems, which is considered to be the reason for their attaching greater importance to evaluation by supervisors rather than the completion of assignments

精神科デイケア利用者の自己効力感に関する研究 : 自己効力感の構造化の試み

本研究は、精神科デイケア利用者の自己効力感の因子構造および特性を明らかにすることを目的とする. 精神科デイケアの利用者260名を対象に自己効力感尺度を用いて自己効力感の横断的調査を行った. 探索的因子分析を行ったところ、精神科デイケア利用者の自己効力感は「日常生活」「社会生活」「対人交流」「気分転換」「症状自己管理」という5つの因子によって構成され、「対人交流」因子の下位尺度得点が最も低いことが明らかになった.The purpose of this study was to clarify a day treatment user\u27s factor structure and the characteristic of self-efficacy. The self-efficacy measure was used for 260 users of day treatment, and investigation of self-efficacy across boundaries was conducted. When explanatory factor analysis was conducted, the day treatment user\u27s self-efficacy was constituted by the five factors "everyday life","social life","personal exchange",a "change of pace", and "condition self-control", and it became clear that the low rank measure score of a "personal exchange" factor is the lowest

リハビリテーション医療系大学1年生の状態不安状況について : 入学から前期定期試験1週前までの縦断的研究

2014 年の文科省の調査では，高校から大学への“円滑な移行”ができていないことを理由に退学した者の割合は，18.9％に上った．現在，入学後のまもない時期が適応への重要な移行の時期であるとされている．本研究では，大学への円滑な移行，適応という観点から，リハビリテーション医療系大学１年生の『不安』に焦点をあてた．本研究の目的は，大学入学直後から定期試験1 週間前までの４期における，『不安』点数の変化の特徴を縦断的に捉えることである．結果，性別により状態不安点数の変化に大きな差異が見られた．男性は，入学１ヵ月目に状態不安点数が最も低くなり，定期試験１週前に最も高くなる特徴があった．一方女性は，3期まで状態不安は上がり続け，試験1週前で，最も低くなる特徴が見られた．これらは，性別による大学生活に求める志向の違いが反映されていると推察された．現段階ではデータからの推察が中心となっており，今後各期に行った不安対象についてのアンケート内容の整理，分析を補完的に行うことが必要と考えられた．The survey by Ministry of Education, Culture, Sports, Science and Technology of 2014, the ratio of student who quitted school for reasons of "the smooth transition" from the high school to the university not being done was 18.9%. It is reported that it begins after a university admission at the time when it is important to the　adaptation to the university. In this study, we focused on "the anxiety" of the first grader of the rehabilitation medical care university from the viewpoint of smooth transition and adaptation to the university. A purpose of this study is to clarify the characteristic of the change of "the anxiety" mark between the fourth until one week before the regular examination for running from the university admission. As a result, a difference was considerably seen in the change of the state-anxiety mark between genders. Men, state anxiety mark for admission 1 months is the lowest, also it was the highest in a regular test 1 week before. On the other hand women, state anxiety continues to rise up to three terms, was the lowest in a week before the test. These differences may reflect the difference in orientation to seek the adaptation of university life by gender. At this stage, since it is inferred from the data, it is necessary to organize and analyze the questionnaire contents of anxiety interest

わが国における統合失調症患者を対象とした精神科作業療法に関する研究の動向 : 1997年～2006年の論文より

近年,わが国の精神医療保健福祉制度は激変し,統合失調症患者を取り巻く環境が大きく変化した.精神障害作業療法においても,病院での急性期における作業療法,長期入院患者の退院促進だけでなく,地域での生活支援が求められている.本研究は,統合失調症に対する作業療法の今後の動向についての示唆を得ることを目的として,それらに関する過去10年間の専門誌,関連雑誌の研究論文を取り上げ,分類・表示し概観した.その結果,論文数は増加傾向にあり研究手法は一事例研究が最多であった.作業療法は,病状安定や陰性症状改善,対人技能向上に焦点を当て実施していた.治療手段は,個々に応じた作業種目を選択し,回復状態によって適宜変更されていた.回復状態に関わらず,治療者との関係性確立が重要であり,適切な治療構造を考える必要がある.今後は実施した介入方法を明確に示し,効果の実証的データを積み重ねていく必要性が示唆された.The welfare system for mental health in Japan has recently and rapidly been changed and the situations of schizophrenic patients have also dramatically been changed. Community support for people with mental disorders is required as well as occupational therapy during acute hospitalization and promoted discharge of long-term inpatients. The aim of this study was to investigate the future trend of occupational therapy for schizophrenic patients. Studies that were published in academic journals and related ones for the past ten years (from 1997 to 2006) were reviewed and classified. Most of studies were case reports and the number of articles has been increased. Occupational therapy was given for stable disease condition, improvement in negative symptom and interpersonal communication skills. In therapy, different occupations were selected individually and replaced as required according to improved conditions. It is the most important to establish the relationship with a therapist and appropriate therapy system is required in all convalescent patients. Further studies are needed to accumulate evidential data on effects of occupational therapy with clear classification of invasions

若年認知症支援の会「愛都(アート)の会」の活動から作業療法士の役割を考える

若年認知症は老年期の認知症とは異なった特徴を持つが,社会的認知は低く利用可能なサービスが少ないのと同時に,患者は現状のサービス適応が困難である.そのため家族の介護負担は大きく,患者を取り巻く問題は複雑になる.このような中で,我々は,若年認知症支援の会「愛都の会」を発足させ,月に1回の頻度で,ミニ講演会と家族の交流会を開催し,並行してデイサービスを実施して,若年認知症患者の社会参加活動の支援を行っている.サポーターとしてボランティアで参加している作業療法士は,主にデイサービスでの援助を行っている.疾患や病期によって症状や行動が異なる若年認知症患者に対して,個々の状態を評価し,個別に適した活動や対応を選択するためにも,作業療法士が関わる意義は大きい.Early-onset dementia has characteristics that are different to those of late-onset dementia; for such patients, there are few services available at present to help adaptation. Therefore, the care burden falling on the patients family is big, and the problems surrounding the patient become complicated. We started a series of once a month meetings where we help early-onset dementia patients and families by holding a mini-lecture and interactions of families and in parallel carry out a day service that helps the social participation of early-onset dementia patients. Occupational therapists participate by a volunteer and do support by providing day service. The significance that an occupational therapist participates is great, and we evaluate the individual states of early-onset dementia patients finding that symptom and actions are different according to the disorder and stage of the disease, and we choose activities that are suitable for individuals

リハビリテーション医療系大学生における学業および大学生活適応尺度の作成

現在、高等学校卒業者のおよそ50%が大学へ進学している一方、休学・中退者の数は増え続けており、社会問題化している。文科省は休学・退学の要因として、高校と大学教育のギャップが生む『学業不振』を挙げている。必ずしも学業に重きをおかない、多様な価値観を持った学生のグローバル化が背景にある中、リハビリテーション医療系大学生は、一方で明確に学業をクリアすることを求められるという特徴がある。本研究の目的は、リハビリテーション医療系大学生を対象にした、学業および大学生活適応尺度を作成することである。作業療法学教員2名によって精選された35項目に対して、学生122名に反応を求めた。探索的因子分析の結果、感情・心理因子(6項目)、積極性因子(6項目)、適合感因子(4項目)、他者性因子(3項目)、自己対処因子(3項目)の5因子構造が得られた。信頼性に関しては,Cronbach α係数は高値を示し、因子間相関ではすべての因子間に有意な正の相関が見られ、一定の内的整合性、信頼性は保たれていた。Recently about 50 percent of the new graduates from high school enroll to university. However, the number of temporary absent or drop out students from university continue to grow up, and it becomes a social issue now. Ministry of Education, Culture, Sports, Science and Technology states that one of the factor of long term absence and dropping out from the university is poor academic performance that occurs from educational gap between high school and university . While the students with various senses of values are increasing, it\u27s important to give fixed academic performance for the student who try to be a rehabilitation related occupation. The purpose of this study is to develop the scale of relationship between academic performance and adaptation skill in university life for the OT students of Shijonawate—gakuen University.122 OT students were involved to answer the 35 questions which were selected by 2 OT teachers of the university. As a result of searching factor analysis, 5 factors which are consisted by feeling and psychological factor(6 items),initiative factor (6 items),feeling of conformity factor(4 items), other related factor(3 items) and self-cooping factors(3 items).The reliability by the Cronbach of coefficient shows high score and meaningful equilateral correlation among the factors also shows significantly high

The invariance of asymptotic laws of stochastic systems under discretization

The stochastic trapezoidal rule provides the only discretization scheme from the family of implicit Euler methods (see [11]) which possesses the same asymptotic (stationary) law as underlying linear continuous time stochastic systems with white or coloured noise. This identity is shown for systems with multiplicative (para- metric) and additive noise using fixed point principles and the theory of positive operators. The key result is useful for adequate implementation of stochastic algorithms applied to numerical solution of autonomous stochastic differential equations. In particular it has practical importance when accurate long time integration is required such as in the process of estimation of Lyapunov exponents or stationary measures for oscillators in Mechanical Engineering