国際生活機能分類を活用した重症心身障害者に対する介入の検討 −2事例報告− Interventions for People with Severe Motor and Intellectual Disabilities using the International Classification of Functioning, Disability and Health: A Report of Two Cases.

当重症心身障害者入所施設では、国際生活機能分類（International Classification of Functioning, Disability and Health；以下、ICF）の視点から、入所している重症心身障害者の生活機能向上をめざすリハビリテーションを実践している。今回われわれは、2事例に行ったICFに基づくリハビリテーション介入の有用性について、ICFの各構成要素の相互作用に着目して後方視的に検証した。検証にはICFの構成要素間の相互作用の図1）をもとに作成したICFシートを用いた。その結果、2事例ともに構成要素間の相互作用による生活機能の向上が認められ、ICFに基づくリハビリテーションの有用性が確認できた。また、チームアプローチを視野に入れたシートの活用方法を検討し、相互作用の視覚化が職種間の共通理解を得る一手法となる可能性を確認した。さらに、ICFシートがリハビリテーション介入の方向を事前に示す上で有用であるとの示唆も得た。

We have been offering a rehabilitation (rehab) program at our facility, which is intended to improve functioning of our residents who have severe motor and intellectual disabilities from the perspective of the International Classification of Functioning, Disability and Health (ICF). In this study, we retrospectively assessed efficacy of rehab interventions, which we had performed in 2 cases on the basis of ICF, focusing on interactions among components of ICF. For the assessments, we used an ICF sheet which we created from a diagram presenting interactions among these components1). As a consequence, it was revealed that functioning had been improved in these 2 cases with interactions among the components and that efficacy of rehab based on ICF had been confirmed. We also discussed how to use the sheet, which had been designed for a team approach, and found out that visualization of the interactions might possibly be one of the ways for people in different professions to achieve common understandings. It was also suggested that the ICF sheet was useful to present directions of rehab interventions in advance.