A Study of the Effectiveness of Occupational Therapy for the Senile Elderly

在本研究的第一部分，通过对日本秋田市老年医院和老年设施的老年残疾患者的身体能力、自我照顾技能和社会功能的前后评估来检验职业治疗干预的有效性。Parachek老年评定量表（Parachek Geriatric Rating Scale， PGS）是在美国开发的，用于评估个体患者的能力。195名老年人参与了这项研究。实验组111例老年人，平均年龄80.3岁。对照组由84名老年人组成，平均年龄为80.9岁。在第一次使用PGS后，每周进行一次以上的职业治疗（OT）干预，主要使用工艺美术活动和感觉整合（SI）治疗，如l.j.k king所描述的，添加到OT方案中。这一组被分成两个小组…更多的取决于一周内OT服务的频率。6个月后，对同一组患者进行了第二次PGS试验。将Kruskal-Wallis测试应用于三组，并对三种分类的PGS分数进行测试，以分析和测试重复测量的差异。从结果来看，OT干预对两个接受OT服务的亚组都有效，并且对改善患者的基本身体功能和日常生活技能的活动都有效。在第二项研究中，为了使用单系统设计（SSD）来研究老年职业治疗（OT）干预的有效性，需要建立不受重复测量影响的重复测量。从以往的研究来看，老年人日常生活技能的活动随着痴呆状态的加重而减少，与正常儿童日常生活技能习得的发展过程正好相反。我们决定使用日本版米勒学龄前儿童评估量表（JMAP）的子测试，该量表最初由L.Miller在美国开发，并由第一作者等人在日本翻译和重新标准化，作为本研究的重复测量方法。初步研究结果表明，JMAP的四个子测试：塔、跟随方向、图地或排序、立方体或迷宫的构建可以作为重复测量。采用这些子测试作为重复测量，对老年人应用SSD来检验职业治疗干预的有效性。最初有9位老年人参与了这项研究。然而，由于在收集到完整的数据之前，我们可以从医院和设施中收集到五个人的数据。在A期，患者没有被分配常规的OT干预，主要使用艺术和手工艺活动。然后，将l.j.k king所描述的感觉统合（SI）疗法添加到OT方案中。这一阶段称为b阶段。本研究结果如表3和图1 - 8所示。从结果来看，这些患者在常规OT处方中加入SI治疗可有效提高除Following Direction外的重复措施得分。少

In the first part of this study, the effectiveness of occupational therapy intervention was examined through pre- and post- assessments the physical capabilities, self-care skills and social functioning of the elderly disabled patients in a geriatric hospitals and elderly facilities in Akita, Japan. The Parachek Geriatric Rating Scale (PGS), which was developed in the U.S., was used to evaluate the capabilities of individual patients. One hundred and ninety five elderly participated in this study. The mean age of the patient population of experimental group which consists from one hundred and eleven elderly was 80.3 years. For the control group which consists from eighty four elderly, mean age was 80.9. After PGS was first administered, occupational therapy (OT) intervention was performed more than one times a week, primarily using arts and crafts activities and sensory integrative (SI) therapy, as described by L.J.King, was added to the OT regimen. This group was divided two subgroups … More depending to the frequency of OT services in a week. Six months later, a second PGS was given to the same patient population. The Kruskal-Wallis Test were applied to three groups, and for each of the three categorized PGS scores, in order to analyze and test the differences of repeated measures. From the results, OT intervention appeared effective for two subgroups of taking OT service as well as for improving the basic physical functioning and activities of daily living skills of patients.In the second study, in order to study the effectiveness of occupational therapy (OT) intervention for the Senile elderly using single systems design (SSD), it is necessary to establish the repeated measures which should be free from the effect of repeated measurements. From the previous researches, it was suggested that the activities of daily living skills of the elderly were decreased as states dementia became more severe, just opposite against the developmental process of acquisition of these skills in normal children. We decided to use the subtests of the Japanese Version of Miller Assessment for Preschooler (JMAP) that was originally developed by L.Miller in the United States, and translated and restandardized by the first author, et al.in Japan, as repeated measures for this study. Results of the preliminary study indicated that four subtests of JMAP : Tower, Following Direction, Figure-and-Ground or Sequencing, and Construction of the Cube or Maze were able to use as repeated measures.Using these subtests as repeated measures, SSD was applied for the elderly to test the effectiveness of the intervention of occupational therapy. Orginally, nine elderly persons participated in this study. However, due to discharge from hospitals and facilities before gathering complete data, we could gather data from five persons. During the phase A,patients were assigned no OT intervention of regular OT intervention primarily using arts and crafts activities. Then, sensory integrative (SI) therapy as described by L.J.King was added to the OT regimen. This phase was called as B.The results of this study are shown in Table 3 and Fig.1 through 8. From the results, adding SI therapy to regular OT prescription for these patients was effective to improve the scores of the repeated measures except for Following Direction. Less