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自殺未遂による身体障害を合併した精神障害患者に対する作業療法の経験

山田, Yamada, ヤマダ and 9 others

Kobe University Repository Kernel (Kobe University)1 Jan 1993Open access

NobleIDark:/48914/w1/20260526/1B02C369DOI10.24546/80070251

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Abstract

Occupational therapy for two psychiatric patients who attempted suicide was described and discussed in terms of therapeutic significance. Case I : The schizophrenic patient was a 21-year-old single male who consulted a psychiatrist for the first time because of symptoms including bizarre actions. His father had been admitted to this hospital for some time. When the patient first saw his father again and found that he had changed quite a lot, he was terribly shocked at the sight. Fearing that he might become like his father, he attempted to commit suicide by cutting his wrist a few days later. He was referred to an occupational therapist for treatment, when the author started the treatment of the physical impairment caused by cutting his wrist. The wrist joint could move voluntarily only very little because of pain. The patient was very depressed. The author strove to remedy his situation. His greatest concern was the recovery of movement in his wrist joint. The author indicated that he should do practice cutting paper and tiles with scissors and shears. The author also persuaded him into practicing tip and lateral pinch movements. He practiced hard and the recovery was satisfactory. As a result, he began to communicate with the author and others comfortably, and he recently got a part-time job. Case II: The involutionsparanoid patient, a 58-year-old mother of three children, had her calcaneal fractured when she attempted suicide by leaping from a high place. She was markedly hyperactive and agitated on her admission to the hospital. It was extremely difficult to follow any thought on the part of the patient because of her lack of responsiveness and frequent changing of the subject. She was referred to an occupational therapist for treatment. Treating her fracture, the author waited until she recovered her composure and carefully listened to her inexplicable anxiety. The author took her a walk three times a week for better communication with the patient. As her fracture recovered, she regained peace of mind and came to adjust herself to her family life again. From these two cases, we conclude that it is advisable to give treatment to patients in the early stage of their physical impairment.

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