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ID 16424
file
title alternative
The effect of “Approach for Encouraging Patients' Initiative" for patients with unilateral spatial neglect
creator
Ando, Yoshihiko
Hatta, Tatsuo
Kamakura, Noriko
subject
半側空間無視
治療的介入法
シングルケースデザイン
unilateral spatial neglect
therapeutic approach
single-case design
NDC
Medical sciences
abstract
半側空間無視は右半球脳損傷による後遺症として比較的頻繁に現れ,患者の日常生活への復帰を困難にする因子として知られる.本研究はこれに対するアプローチにおいて患者の自発性という問題に焦点をあて,これを促すことが半側空間無視の改善を生むかどうかを検証することをめざしたものである.なお,本研究において“自発的解決を促す介入"とは患者が興味のある課題を行う中で,無視症状の正しい認識と代償戦略の立案・獲得を促すことを目的にデザインされたものである.2症例を対象にそれぞれA-B-A'型のシングルケースデザインを用いて実験を行った.独立変数を“自発的解決を促す介入"の有無,従属変数を半側空間無視による見落とし数を標的とした半側空間無視量とし,A,B,A'各期それぞれ10回のセッションを週3~4回の頻度で実施した.さらに汎化の程度を調べる目的で,行動性無視検査を実験開始時と各期の終了時に計4回実施した.その結果,半側空間無視量は2症例ともB期において改善を示し,行動性無視検査の成績も1症例においてB期終了後に改善を示した.また,B期で得られた代償法のA'期における使用や自発的な無視に関するコメントの出現が認められた.すなわち,“自発的解決を促す介入"は半側空間無視に対する病識の芽生えと代償法の獲得ならびに拡張的使用を促すものと判断された.
abstract
Unilateral Spatial Neglect (USN) is common after right hemisphere brain damage and has beenfound to be an important predictor of functional ability after injury. In this study, the focus was on patients'own initiative to see if this initiative helps improve their USN. In this study, “Approach for EncouragingPatients'Initiative"is designed to encourage patients to acknowledge their neglect symptoms, and to planand acquire some compensations while doing their favorite tasks. The experiment was carried out on 2 cases using a single case design (A-B-A'). The independentvariable is considered to be “Approach for Encouraging Patients'Initiative", and the dependent variable tobe USN quantity. A series of 10 sessions for each of the A-B-A'stages were held at the frequency of 3-4times a week. The Behavioral Inattention Test (BIT) was administered at the beginning and at the end ofthe experiment, 4 times in total, in order to examine the degree of the generalization. As a result, both ofthe 2 cases on USN quantity showed an improvement at the B stage, and the BIT experiment alsoindicated an improvement at the end of the B stage. It allowed the compensatory methods acquired at theB stage to be used in the following A'stage. Voluntary comments about USN were also noted. It issuggested that “Approach for Encouraging Patients'Initiative"can prompt the patients'awareness ofUSN, plus the acquisition and expansion of its compensation methods.
journal title
Journal of health sciences, Hiroshima University
volume
Volume 3
issue
Issue 1
start page
13
end page
20
date of issued
2003-11-28
publisher
広島大学保健学出版会
issn
1347-7323
ncid
SelfDOI
language
jpn
nii type
Departmental Bulletin Paper
HU type
Departmental Bulletin Papers
DCMI type
text
format
application/pdf
text version
publisher
department
Graduate School of Health Science
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