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統合失調症をもつデイホスピタル長期利用者の社会的機能に対する自己決定の影響:ランダム化比較試験

木下, 栄子 キノシタ, エイコ Kinoshita, Eiko 神戸大学

2023.03.25

概要

Day hospitals were started in the late 1940s by J. Bierer and D. E. Cameron
(Goldman, 1990). “Day hospital” is a collective term for acute day hospital care,
transitional day care, day treatment programs, and day care centers for mental
disabilities (Gelder et al., 2006). A day hospital is an effective alternative to
inpatient treatment for people with severe mental disorders (Priebe et al., 2011).
In Japan, these hospitals are one method of rehabilitation for patients with
psychiatric disorders, specifically focusing on recovering day hospital users’ social
functioning (Kayama and Kobayashi, 2010). In other words, day hospitals are a
part of outpatient facilities.
After discharge, day hospitals function as a place where long-term inpatients
can spend their daytime, thus minimizing rehospitalization and supporting
community living for people with psychiatric disorders (Fukuchi et al., 2015).
Currently, 60% of Japanese day hospital users are identified as having
schizophrenia (F2 in the International Classification of Diseases and Related
Health Problems 10th Revision [ICD-10], 1991), the majority of whom are long-term
users (i.e., for over one year; Igarashi and Oki, 2018). Long-term users of day
hospitals may find it difficult to stay focused on the purpose of using these facilities,
which may result in such users not making progress regarding community
participation, such as finding employment and transitioning to community
services (Ministry of Health, Labour and Welfare, 2009).
An increase in the number of such users may denote that patients with more
severe conditions cannot use day hospitals as a medical resource. Thus, long-term
users should focus on the “improvement of social function,” the original purpose of
day hospital use, and participate in the day hospital programs that fit their
individual purpose.
Day hospitals can help patients recover their social functioning. To support
independent functioning, social-skills training is one approach for improving the
social functioning of people with schizophrenia (Ueno, 2015). In this setting,
psychoeducation can be provided to patients and their family members regarding
accurate knowledge and information on the recovery process (Ueno, 2015).
However, although there are programs designed to help people with mental
disorders recover their social functioning, their effects have not been sufficiently
examined (Ministry of Health, Labour and Welfare, 2013). In particular, evidence
of the effects of treatment in day hospitals has not been determined for long-term
users (Ministry of Health, Labour and Welfare, 2009). ...

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参考文献

Cheng, L., Sit, J.W.H., Choi, K.C., Chair, S.Y., Li, X., Wu, Y., Long, J., Tao, M.,

2018. Effectiveness of a patient-centred, empowerment-based intervention

programme among patients with poorly controlled type 2 diabetes: A randomised

11

controlled trial. Int. J. Nurs. Stud. 79 43–51.

https://doi.org/10.1016/j.ijnurstu.2017.10.021.

Chiba, R., 2008. Development of a Japanese version of the recovery assessment

scale for people with mental illness and a study on factors related to recovery.

2008 Home Health Care, Yuumi Memorial Foundation Home Health Care (public

subscription) Completion report, 1–57. (in Japanese)

Fukuchi, T., et al. 2015. Chapter 8 Psychiatric care:Section 3 Treatment ・ Others,

in: Seishin Hoken Iryou Fukushi Hakusho Henshu Iinkai (Eds.), White Paper on

Mental Health and Medical Welfare 2016 Cooperation between Psychiatric Care

and Mental Health Welfare. Chuo Hoki Shuppan, Tokyo, p. 171. (in Japanese)

Gelder, M., Harrison, P., Cowen, P., 2006. Shorter Oxford Textbook of Psychiatry,

fifth ed. Oxford University Press, Oxford.

Goldman, D.L., 1990. Two pioneers of today’s partial hospital and their ideas. Int.

J. Partial. Hosp. 6 181–188.

Hiruta, G., 2011. Behavioral Characteristics of Patients with Schizophrenia:The

Support and ICF. Kongou Shuppan, Tokyo. (in Japanese)

Igarashi, Y., Oki, Y., 2018. Survey report. The Journal of the Japanese Society for

Day Care Treatment 22 60–68. (in Japanese)

Ikebuchi, E., Iwasaki, S., Miyauchi, M., Oshima, I., Sugimoto, T., 1995.

Relationship between disability and psychiatric symptoms: analysis of social life

assessment scale for the mentally ill (LASMI). Clin. Psychiatry. 371041–371048.

(in Japanese)

Ishitani, N., 1997. Psychiatric Occupational Therapy, revision, Seiwa shyoten,

Tokyo. (in Japanese)

Kawanori, Y., Kambara, M., 2010. The improvement of the mental and life

symptoms and Duration of Untreated Psychosis in schizophrenia patients at day

care centers. Research Bulletin of the Faculty of Education, Chiba University. 58

305–309. (in Japanese)

Kayama, A., Kobayashi, M., 2010. Basic practical theory of occupational therapy,

in: Tomioka, N., Kobayashi, M. (Eds.), Occupational Therapy, 5th volume Mental

Disorder, third revised ed. Kyodo Isho Shuppansya, Tokyo, pp. 87–129. (in

Japanese)

Kobayashi, M., 2010. Theories, models and techniques related to psychiatric

occupational therapy, in: Tomioka, N., Kobayashi, M. (Eds.), Occupational

12

Therapy Complete, 5th volume Mental Disorder, third revised ed. Kyodo Isho

Shuppansya, Tokyo, pp. 287–324. (in Japanese)

Koda, M., 2009. Practice of employment support by disabilities:Mental disorders,

in: Hiraga, A., Iwase, Y. (Eds.), Occupational Therapy, 12th volume Work-related

Activities, third revised ed. Kyodo Isho Shuppansya, Tokyo, pp. 77–95. (in

Japanese)

Kuwaharada, M., Yamashita, Y., Takekawa, Y., 2013. Empowerment and discharge

support skills for patients with strong anxiety about death. J. Jp. Soc. Resp. Care

Rehab. 23 318–322. (in Japanese)

Ministry of Health, Labour and Welfare, 2003. The Global Assessment of

Functioning. https://www.mhlw.go.jp/shingi/2003/11/dl/s1111-2a.pdf (accessed 19

June 2016).

Ministry of Health, Labour and Welfare, 2009. About psychiatric daycare.

https://www.mhlw.go.jp/shingi/2009/06/dl/s0604-7b.pdf (accessed 26 February

2020).

Ministry of Health, Labour and Welfare, 2013. Individual matters 2 about

psychiatric care. https://www.mhlw.go.jp/file/05-Shingikai-12404000Hokenkyoku-Iryouka/0000031076.pdf (accessed 26 February 2020).

Priebe, S., McCabe, R., Schützwohl, M., Kiejna, A., Nawka, P., Raboch, J.,

Reininghaus, U., Wang, D., Kallert, T.W. 2011. Patient characteristics predicting

better treatment outcomes in day hospitals compared with inpatient wards.

Psychiatr. Serv. 62 278-84.

Someya, T., Anzai, N., Ikebuchi, E., Ozawa, M., Harada, S., Ueda, S., Kano, Y.,

Nakagome, K., Iwanami, A., Kumagai, N., Miyauchi, M., 1986. Negative

symptoms and the course of social adjustment in schizophrenia. Seishin Igaku.

28(11) 1229–1236. (in Japanese)

Song, H.Y., Nam, K.A., 2015. Effectiveness of a stroke risk self-management

intervention for adults with prehypertension. Asian Nurs. Res. 9 328–335.

https://doi.org/10.1016/j.anr.2015.10.002.

Takano, Y., Kato, M., Tsukahara, T., Kasahara, T., Suzuki, T., Hara, T., 1995. The

improvement of psychiatric symptoms of schizophrenic patients during day

care treatment. Seishin Igaku. 37(4) 369–376. (in Japanese)

Tajima, A., Kato, T., Yuasa, S., Eguma, Y., 1967. Approach to people with

schizophrenia in social life. Psychiatria et Neurologia Japonica 69 323–351. (in

13

Japanese)

Tsushima, E., 2011. Statistical methods used in research in the field of

rehabilitation. Journal of the Society of Biomechanics. 35(1) 67–75. (in Japanese)

Ueda, S., Tsurumi, K., 2003. Essence from Dialogue: Suggestion from Patient’s

view, Intrinsic Rehabilitation. Fujiwara Shoten, Tokyo. (in Japanese)

Ueno, T., 2015. Treatment and rehabilitation of mental disorders:Social therapy

and rehabilitation, in: Ueno, T. (Ed.), Standard Physical Therapy and

Occupational Therapy Specialization: Psychiatry, fourth ed. Igakushoin, Tokyo, pp.

245–251. (in Japanese)

Yokoyama, H., 2005.Considering the way of recovery of self-determination for

people with mental disabilities. Kouteki Fujyo Kenkyu 38 34–36. (in Japanese)

Figure Legends

Figure 1. Areas of daily life activities

The two figures show the first and second pages of the “Areas of daily life

activities.” When the participants wrote down the areas that fitted their goal on

the goal sheet, they chose one from seven of the listed areas on Page 1. When it

was difficult for them to think of any daily goals, they wrote down their goals in

reference to the set examples of the seven areas provided to them. Page 2 shows

examples of concrete goals for the area of health management. These were

developed based on input from authors and day hospital professionals.

Figure 2. CONSORT diagram

Consolidated Standards of Reporting Trials for this study. Of the 66 eligible

participants, 57 were included in the study sample. Subsequently, 29 were

randomly allocated to the intervention group and 28 to the control group. Three

months later, 24 patients in the intervention group and 25 in the control group

had participated for the full study period, and their data were included for

analysis.

14

Table 1. Characteristics of the participants

Intervention group (n=24)

Control group(n=25)

n(%) Mean±SD

n(%) Mean±SD

Age(years)

50.83±10.06

46.16±10.12

Sex

male/female

0.11

0.68

18/6

20/5

Education

0.39

Junior high school

High school

14

17

Technical school

Technical college

Junior college

University

Work experience (%)

21(87.5)

23(92.0)

Duration of illness (months)

Total length of admissions (months)

Number of admissions

Intellectual disability (%)

p-value

0.48

242.25±143.54

225.24±130.63

0.67

26.83±30.48

29.4±55.23

0.84

3.42±2.54

2.68±2.36

0.30

2(8.3)

2(8.0)

0.68

Age at first participation of day hospital

(years)

42.92±11.58

39.32±10.74

0.27

Period of use of day hospital (months)

92.46±83.63

82.6±68.42

0.65

4.25±0.90

3.88±1.13

0.21

504.79±352.35

700.15±556.55

0.15

1.08±1.02

1.00±1.23

0.80

Frequency of day hospital use (days/week)

Medication (CPZ equiv, mg/day)

Number of housemates

Pearson's chi-square test (p < 0.05) for gender.

Fisher's exact test (p < 0.05) for education, working experience, and intellectual disability.

Non paired t-test (p < 0.05) for other items.

The items of work experience and intellectual disability show the ratio.

Medication and the number of the housemates are data at baseline.

Table 2.GAF, PANSS, and RAS scores in the intervention and control groups

Intervention group (n=24)

Control group (n= 25)

Mean±SD

Mean±SD

59.91±11.70

61.08±11.21

η2

0.12

.730

.003

F(interaction) <0.01

.990

<.001

GAF

T1

T2

F(group)

61.33±13.14

62.48±10.44

F(time)

8.82

<.005

.158

66.38±24.85

70.56±19.74

F(group)

0.44

.510

.009

F(interaction) <0.01

.950

<.001

PANSS

T1

T2

64.29±24.56

68.56±19.85

F(time)

9.48

<.004

.168

87.43±13.20

81.625±11.77

F(group)

0.76

.390

.017

F(interaction)

3.28

.077

.068

F(time)

1.75

.190

.040

RAS

T1

T2

86.74±14.41

86.08±14.99

GAF: Global Assessment of Functioning Scale. PANSS: Positive and Negative Syndrome Scale (total score).

RAS: Japanese version of the Recovery Assessment Scale.

T1: baseline, T2: post-intervention.

Analysis were conducted using a two-way repeated-measures ANOVA.

Areas of daily life activities       

Area of daily life

Content

Pa

age

Health

management

Management of medication,,

health condition, and nutrition

Წ

Daily life

performance

Performance of tasks, such as

eating, bathing, shopping, and

cleaning

Ჭ

Daily liife

management

Management of

other valuables

Ხ

Social

interaction

Study/Work

Reesource

utilization

Leisure

activity

money

and

Interaction with friends and

colleagues in the workplace

Ჯ

Continuing school,, retturning to

school or work, and

em

mployment

Ჰ

Using public

transportation

Ჱ

facilities

and

Rest, hobby, and amusement

Health

management

Ex

xample of concrete goals

ũI go to the hospital regularly..

ũI keep taking medication.

ũI wake up in the morning and

go to bed at night.

ũI manage my physical and

nutritional condition.

I eat well balanced meals.

I don’t overeat my favorite food.ͤ

I take a rest when I feel tired.

ͤ e.g., alcohol, coffee, chocolate.

Ჱ



Figure 1. Area list of daily life activities



Assessed for eligibility (n=66)

Enrollment

Excluded (n=9)

 Did not meet inclusion criteria (n=6)

 Declined to participate (n=3)

Randomized (n=57)

Allocation

Allocated to intervention group (n=29)

 Received

 Did

allocated intervention (n=28)

not receive allocated intervention

- reason: hospital admission (n=1)

Allocated to control group (n=28)

 Received treatment as usual (n=26)

 Did not receive treatment as usual

-reason: poor physical condition (n=1)

-reason: did not participate regularly (n=1)

Follow-Up

Lost to follow-up (with reason) (n=1)

Discontinued intervention; reason: long absence (n=1)

Lost to follow-up (with reason) (n=1)

Discontinued intervention; reason: admission (n=1)

Analysis

Analyzed (n=24)

 Excluded from analysis (with reason) (n=3)

- reason: admission (n=1)

- reason: excessive number of intervention (n=2)

Figure 2.

Analyzed (n=25)

 Excluded

CONSORT diagram

from analysis (with reason) (n=0)

...

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