著者

松尾 彰久 清水 一 山崎 郁雄 山下 由美 久野 真矢

出版者

広島大学保健学出版会

雑誌

広島大学保健学ジャーナル (ISSN:13477323)

巻号頁・発行日

vol.3, no.2, pp.10-19, 2004-03

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「新聞の記事の中で出現する障害者とインターネットのかかわりは,作業療法における作業の概念でとらえるとどのような特性があるのか」という研究疑問を設定し,障害者のインターネット利用状況に関する枠組み作りを試みた.今回の研究では,全国紙の新聞1紙を対象とし,データとして検出した記事の類似した内容をまとめ,KJ法の考え方を用いて,共通した概念を抽出する方法で行った.この手順は,KJ法を基に開発されたコンピュータープログラムであるISOP-KJ法を補助的に使用した.その分析の結果,6つの大きなカテゴリーを抽出した.インターネットの活用は,作業療法でいう,作業療法として追及していく「作業」を強力に実現していく手段であり,目的にもなり得るという仮説を形成できた.インターネットを利用しての「自己維持活動」,「仕事」,「遊び」,「社会参加」は,「コンピュータによって形成される身体的な接触のない状態で情報伝達が生じる環境」の結果生じる作業といえるので,「バーチャル作業(virtual occupation)」と定義できると考えた. ""The internet can be very helpful if it is fully made use of by the disabled person."This statementmay be true, but the questions arise in what ways, in what fields and to what extent it can be useful.Inorder to obtain answers to those questions, we undertook research through a technique similar to the KJ-method, by collecting related articles from a certain nationally-circulated newspaper as data. Finally, thisdata verified that the internet makes it possible for the disabled to take part in social activities more easilyand willingly and to improve their activities in daily life, both their productive activities and their leisureactivities. We believe that we can define the activities produced by utilizing the internet as a virtualoccupation.

著者

茶圓 智子 横尾 京子 中込 さと子

出版者

広島大学保健学出版会

雑誌

広島大学保健学ジャーナル (ISSN:13477323)

巻号頁・発行日

vol.6, no.2, pp.102-110, 2007-09

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本研究は, 予防接種における2歳から3歳の年少幼児の行動を類型化し, 行動の持つ意味を親や医療者の関わりの視点から考察し, 予防接種への対処を助けるために必要とされる看護ケアについて検討することを目的とした. 対象は日本脳炎の予防接種を受けた健康な2歳から3歳の年少幼児とした. データ収集は平成14年7月26日から同年9月12日までの1.5か月に行い, M小児科医院外来で行った. データ収集方法は, ビデオカメラを用いて, 第1回および第2回の日本脳炎予防接種の来院時点から帰院までの幼児の一連の行動と親, 兄弟, 医療者の行動を含めて撮影・録画した. データ分析は, 画像は事例別に全行動を言語で記述し, 予防接種に対する反応に関連する行動を抽出し, 幼児の予防接種に対する反応の出現時期(嫌がる時期, 泣き始める時期, 痛いと言う時期, 泣き止んだ時期), および, 幼児と医療者・親・兄弟との関わりを抽出し, 予防接種を受ける対象の行動の類型化を行った.その結果, 予防接種における年少幼児の行動は, 嫌がり・泣き始め・泣き止みの時期, 痛いという表現, 第1回・第2回の行動の相違点から, 3つに類型化した. タイプⅠの行動は, 第1回・第2回とも注射針刺入までに嫌がり泣き始め, タイプⅡの行動は, 第1回・第2回とも注射終了後に痛いと言って泣き始め, タイプⅢは, 第2回においてのみ注射針刺入時に痛いと言い液注入時に泣き始めるという行動であった. 年少幼児でも, 他者と注射の方法や意義について理解できること, 嫌がり・泣きがあってもがんばろうとしていたこと, 痛みに耐えようとしても耐えられないと泣いてしまうこと, 注射を見ることで不安が増強すること, 反応の内容や強さは個人差があることが考えられた.年少幼児の予防接種におけるケアとしては, 1)がんばるという心構えを支えること, 2)痛み体験を受け止め, がんばったことをほめる, 3)痛みを緩和すること, 4)注射部位の固定・注射の準備の仕方, 5)個別なアセスメントを行うことが示唆された.The purpose of this research is to find patterns in the behavior of infants during immunization injections and to ascertain the care needed when dealing with infants at vaccination. The subjects were five infants (aged from 2 years 11 months to 3 years 8 months old) who received immunization injections for Japanese encephalitis. The data was collected using a video camera of a series of interactions between the subjects, parents, siblings, and the medical treatment staff from their arrival at the clinic to their departure. Semi-structured interviews with the parents were also used to obtain information about the background of the subjects.As a result of inductive and descriptive analysis, the behavior of infants during immunization injections could be classified into three types. Infants of type I showed their dislike of the injection and cried before the prick of the needle at both the first and second injections. Infants of type II complained that it was painful and began to cry after the injection was over at both the first and second injections. Infants of type III said that it was painful at the prick of the needle but cried only during the second injection.Infants could talk with others about the meaning and the method of the vaccination. They tried to bear with the discomfort even though they disliked it and wanted to cry.When they could not endure it, they cried with pain. Seeing the syringe increased their anxiety. There were also individual differences in the strength of their reaction.Based on the infants' backgrounds and their behavior according to type, points relating to the care of infants during vaccination were enumerated as follows: 1) Child's determination to do his/her best. 2) Understand the infant's experience of pain and praise his/her endurance. 3) Consider methods of easing the pain. 4) Devise a method choosing the injection spot and for preparing the materials of the injection. 5) Individual assessment and correspondence.

著者

松原 麻子 車谷 洋 村上 恒二 青山 信一

出版者

広島大学保健学出版会

雑誌

広島大学保健学ジャーナル (ISSN:13477323)

巻号頁・発行日

vol.3, no.2, pp.27-34, 2004-03

被引用文献数

1

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頸髄損傷者の食事動作に関して,スプーンの使用方法を替えることにより,上肢各関節(肩・肘・前腕・手関節)の角度と運動の範囲がどのように変化するかを明らかにするために,三次元動作解析を行った.対象はC6レベルの頸髄損傷者5人で,「ヨーグルトを食べる」という課題を2種類の自助具(自助具1:母指側使用,自助具2:手掌側使用)を用い実施した.撮影された画像から時間と上肢各関節角度を求め,自助具1,自助具2使用時で比較検討した.結果,自助具1使用時には自助具2使用時と比べ,1回の食事動作におけるすくう動作が占める割合が多い傾向にあった.また,食物をすくう際に肩関節屈曲,肩関節外転の運動が多く必要とされ,一連の動作を通じて前腕が回内方向に移行し,肩関節が屈曲・外転方向に移行することが明らかとなった.以上より,前腕の回外運動が十分可能である場合には手掌側使用の自助具の導入が望ましく,また母指側使用で食事を行う場合には,食物を口へ運ぶ動作だけでなく,すくう動作においても肩関節の運動が必要になることを十分に考慮した上で,自助具の提供やセッティングを行うことが重要であることが示唆された.The purpose of the present experiment was to examine how the upper limb movements (shoulder, elbow, forearm, wrist) of patients with spinal cord injury (C6 level) were affected while using two types (type 1: pronation type, type 2: supination type) of self-helping device. Five subjects were required to eat 5 spoonfuls of yoghurt. We recorded the position of 11 light reflecting markers attached to the subjects' body with three cameras. We divided the eating action into three phases, the scoop phase, reach-to-mouth phase, and reach-to-plate phase. These kinematic landmarks were used to define the dependent variables. We calculated five joint angles (shoulder flexion, shoulder abduction, elbow flexion, forearm supination, wrist extension) with a three-dimensional video-based motion analysis system (APAS System, Ariel Dynamics), and analyzed how they changed at each phase. We compared them while using type 1 and type 2. While using type 1, the scoop phase played a larger part than other phases, and shoulder flexion, shoulder abduction and elbow flexion angles increased, not only in the reach-to-mouth phase but also in the scoop phase, and the supination angle decreased. This result suggests that patients who can supinate their forearm had better use type 2, and also that it is important to consider upper limb movements in the scoop phase when we provide patients with a self-helping device. In this study, however, we focused only on upper limb movements. We also have to analyze head, neck and trunk movements and examine the relationship among upper limb, head, neck and trunk.

著者

小柴 順子

出版者

広島大学保健学出版会

雑誌

広島大学保健学ジャーナル (ISSN:13477323)

巻号頁・発行日

vol.6, no.2, pp.95-101, 2007-09

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Hikikomori (Social withdrawal) has recently been examined as a problem facing Japanese society. Despite the issuance of guidelines by the Japanese government, the creation of parent groups and the availability of support from various government agencies and private organizations, no countermeasure policy has been established. Research on Hikikomori as a problem for the entire family and analysis of functioning in cases of Hikikomori has not been carried out.Hikikomori is seen in the same home and two or more cases are often seen. Then, it thought whether having related to the family function.This study is to find the Hikikomori family's characteristic and make available the clue of the method to it.The present study examines family functioning associated with cases of Hikikomori by assessing 16 families with social withdrawal, 15 families with autism, and 25 control families using the Family Assessment Device (FAD). The seven subcategories of the FAD [Problem Solving (PS), Communication (CM), Roles (RL), Affective Responsiveness (AR), Affective Involvement (AI), Behavior Control (BC) and General Functioning (GF)] were analyzed by a multiple comparison test. Statistical significance was established at p<0.01 or p<0.05.Results demonstrated that families with Hikikomori have higher CM, AR and GF scores than families with autism, and higher PS, CM and GF scores than control families. Furthermore, PS scores for fathers with a family member with Hikikomori scored higher than the control fathers. The PS, CM and GF scored for mothers with a family member with Hikikomori were higher than those of the control mothers, and than mothers with a family member with autism. Also, the AR scores for mothers with a family member with Hikikomori were found to be higher than those of the control mothers. No marked differences were observed between the control and autism groups in any of the scores for the families, fathers, or mothers.While measures and social support are available for autism, the lack of clarification regarding the cause and measurement of Hikikomori appears to have contributed to the observed differences in FAD scores.Mother feels that the family function is the worst in the family, because there are a lot of items with a significant difference of the FAD score.Therefore, appealing to and mother of the solution of "Hikikomori" obtained the suggestion of effective.