Congress of Clinical Occupational Therapy Advanced Occupation-Based Practice

Japanese Society of Clinical Occupational Therapy

1st International / 5th Japanese Congress of Clinical Occupational Therapy Advanced Occupation-based Practice

2018/07/21 sat. - 22 sun. Fukuoka, Japan

Keynote

"The Art & Science of Occupational Therapy."

Tufts University

Dr. Linda Tickle-Degnen (PhD, OT)

https://5thcot.jimdo.com/

Invita'on Advanced Occupa'on-based prac'ce

Historically, Japanese occupational therapist had “imported” occupation- based models or tools from foreign countries. However, we believe our unique and/or advanced Japanese models or tools and practice to the other countries is worth “exporting ” For Japanese occupational therapists, please do not be afraid to share your Japanese occupation- based practice. And for the foreign occupational therapists, please import the Japanese occupation-based practice has been progressed greatly owing to in the advanced health care system and the highest elderly society. Please join us and learn about our occupation-based practice. We hope to make this an opportunity to gain an inspiration and ideas of our practice through this international congress. Kounosuke Tomori PhD, OT Moreover, our next goal is to accumulate evidence for the occupation- Congress Chair based practice. For the fifth Japanese/International congress of Clinical Tokyo University of Occupational Therapy, we invite Dr. Tickle-Degnen from Tufts University, to Technology Associate professor share her knowledge on how to build the evidence of occupation-based practice. Dr. Tickle-Degnen is an expert at providing “scientific” evidence for the “artistic” aspect of occupational therapy, such as self-management, self-initiative, and client-centered therapy. Also, we plan to special symposium or workshop regarding occupation-based practice. We believe this congress will encourage all of our members to the next step of your practice and research.

「日本に点在する作業を大切にした実践者の思いを共有し，育みたい」その思いで本学会を立ち上げ，早5年が経過しました．幸いに多くの会員の賛同が得られたばかりか，生活行為向上マネジメントなど時勢の後押しもあり，当初の願いがいよいよ現実に近づいています．そこで今回は5年後に作業療法がどう有りたいのか,その目標を共有できるような学会にする予定です．そのため，初の国際学会を開催することにしました．これまで我が国では海外の作業療法を「輸入」してきましたが，近年では「輸出」も可能になってきました．臆することなく日本型の「作業に焦点を当てた実践」を発信してください．そして海外の臨床家，研究者から話を「聞く」のではなく，「交流」してください．相互交流によって，皆様の中に沢山のインスピレーションやアイデアが生まれる機会になればと思います．もう一つの目標は，「作業に焦点を当てた実践」に関するエビデンスの共創です．これまで「作業に焦点を当てた実践」が有用であることは事例レベルで共有できたので，次の目標としてエビデンスの質を高めることが必要になってきます．今回はTufts大学のTickle-Degnen L教授をお招きし，作業療法におけるエビデンスについて，特に作業療法の「Art」の部分を「Science」に置き換えるためのヒントをいただきたいと思っています．

皆様の臨床や研究のNext Stepになることを期待しています． Keynote The Art & Science of Occupa'onal Therapy

A major strength of occupational therapy is its long tradition of bringing the arts and sciences into its knowledge base and practice. Yet art is often treated as separate from science; as originating from different paradigms, core values, and requiring different practice skills. This separation puts us at risk of underestimating their points of intersection and their vital synergy for inspiring and serving clients. There are few guides as to how to align and bridge the two paradigms, in practice and in research, without minimizing the rigor or centrality of either art or science. This presentation proposes that the current model of evidence-based practice should be re-framed to create a stronger bridge between art and science. The current model adheres to the scientific Linda Tickle-Degnen paradigm, which deflects our attention from the value of the art paradigm. On PhD, OT, FAOTA the other hand, the intellectual processes and organizational structure of an Tufts University Professor, Director of Health evidence-based practice model provide an ideal platform for bridging art with Quality of Life Lab science. A conceptual model along with concrete examples stimulate an interactive dialog with the audience. We evaluate the degree to which a re- framed evidence-based practice model is likely to create a synergy between art and science that better serves client outcomes than separated art and science paradigms of practice.

作業療法の大きな強みは，アートとサイエンスを叡智と実践として紡いできた長い伝統といえる．にもかかわらず，アートはとかくサイエンスとは異なるものとして扱われる．なぜならば，アートとサイエンスは，異なるパラダイムや中核となる価値感，異なる実践スキルを必要とするからである．しかし，アートとサイエンスを分離することは，我々がクライエントを励まし尽くすために極めて重要といえるアートとサイエンスの相乗効果や共鳴性を過小評価する危険性に繋がる可能性がある．一方，アートやサイエンスの厳格や重要性を損なうことなく，どのようにこれらの2つのパラダイムを一列に並べ，繋ぎ合わせるのか，そのガイドは実践においても研究においてもほとんどみられない．このプレゼンテーションでは，実証に基づく実践（Evidence- based practice: EBP）の現行のモデルは，アートとサイエンスとの間により強固なつながりを作り出すために再構築されるべきであると提言する．現行のモデルはサイエンスのパラダイムに固執しており，我々の注意をアートのパラダイムのもつ価値からそらしてしまう．一方，知的方法であり組織的に構造化された実証に基づく実践（EBP）モデルは，アートとサイエンスの橋渡しをする理想的な土台をもたらしてくれる．そして，この概念的なモデルに対して具体的な例を用いることは，皆様との活発な討議を引き出すことになるだろう．我々は，再構築された実証に基づく実践モデルが，どの程度アートとサイエンスのパラダイムの相乗効果を生み出すか検討したい．そして，その実践モデルに基づいた介入が，アートとサイエンスを分離させた実践と比べて，より大きな訓練効果を生むか否かを検討する． ACCESS

Centennial Hall Kyushu University School of Medicine 3-1-1 Maidashi Higashi-ku Fukuoka City 812-8582 Japan

【Subway】 ◎ Fukuoka Airport - 13minutes Fukuoka-Kuko(Airport)Sta. → (Subway Kuko Line) →Nakasu-kawabata Sta. (Transfer Subway Hakozaki-Line) →Maidashi-Kyudaibyoinmae Sta. ※Exit 7 → 8minute walk

◎ Hakata Sta'on 10minutes Hakata Sta. → (Subway Kuko Line) →Nakasu-kawabata Sta.→(TransferSubway Hakozaki Line) →Maidashi-Kyudaibyoinmae Sta. ※Exit 7 →8minute walk

【Taxi】 ◎Fukuoka Airport 15minutes ◎Hakata Staôn 10~15minutes ※The travel ^me depends on traffic situaôn.

Program

Floor informa'on

Registration Main Hall

Poster Workshop2

Workshop4 Workshop3 Presenta'on

INSTRUCTIONS FOR ORAL PRESENTATION:

‣ Presentaôn ^me is 7 minutes, Q & A session is 3 minutes (Total 10 minutes). ‣ All of oral presentaôns are requested to be a PowerPoint presentaôn file, which are wrifen on a CD, a DVD, or saved in a USB-port thumb drive. Please note that your storage device as your own risk. If presentaôn slides are prepared with Macintosh, please bring your own Macintosh and RGB connector. ‣ Please prepare your PowerPoint slides in English and oral session should be presented in English. ‣ PowerPoint 2003, PowerPoint 2007 and PowerPoint 2010 are pre-installed to the secretariat PC. ‣ PowerPoint slide will be submifed at the speaker's desk on the day.

INSTRUCTIONS FOR POSTER PRESENTATION:

‣ Poster presentaôns are a free discussion style. Presenters are required to be with their poster for the en^re 1-hour block of ^me. ‣ Since there is no chairperson, par^cipants will be free to view the posters and to discuss with presenters during the allocated ^me. ‣ You will be allocated a poster board according to your “Poster No.”, poster size: A0 (A zero) portrait format (H1189mm x W841mm) (Including ^tle, name, and affiliaôn). ‣ Poster is should be prepared in English or Japanese language. Some volunteer translators will help the presenters, please ask them if necessary. ‣ Please ensure that posters are removed by the specified ^me. Aper a specified period of ^me, we will remove a poster. Recep'on

You can apply directly at the venue on 21st July (¥5,500)

With the style ‣ Hakata Sta. Chikushi Ext → 8 minute walk

Hakata Sta.

With the style Organizing Commi`ee

Committee Name

Congress char Kounosuke TOMORI

Executive Committee Kenji HIDAKA, Erika YAMADA

Secretariat Committee Hironori YOSHIDA, Tatsuya SUZUKI

Scientiﬁc Committee Hirofumi NAGAYAMA, Yu ISHIBASHI

Manegement Committee Tetsu TASHIRO

Financial Committee Kenta NOGUCHI, Kanta OHNO

Promotion Committee Hiroyuki TAKIGAWA, Sei UEZU

Venue Committee Takayuki KURODA, Yusaku YOSHIDA

Translation Kayoko Takahashi, Hiromi NAKAMURA, Takako MATSUBARA Symposium Our Occupa'on-based prac'ce

Chinese Taipei Hung-Hsuin Ko (MS, OT) Taipei Nangang Seniors Service Center The applica'on of assis've technology device on OT interven'on of demen'a reminiscence therapy As Taiwan government increasingly pay afenôn to long-term care, “Taiwan Demenâ Policy: A Framework for Prevenôn and Care” was developed in 2014. It will become a guideline on integra^ve planning and policy implementaôn from the government. Therefore, therapists have increasingly interested in working in facility, community and home care. Occupaônal therapist has an important role in the care team of demenâ. This lecture will introduce how occupaônal therapist use assis^ve technology device in reminiscence therapy ac^vity to help the client with demenâ maintain and delay degeneraôn.

Singapore Shuet Fong CHENG (OT) Abili'es Beyond Limita'ons and Expecta'ons Ltd Occupa'onal Therapy and Return-to-Work Work is a major contributor to the occupaônal well-being of adults in Singapore. Adults with acquired disability, open require support and services to return to work, due to personal challenges and job demands. Availability of community services for Return-To-Work (RTW) clients in Singapore are few, compared to services for other rehabilitaôn cons^tuents like the older adults and children, but developing rapidly. Abiliês Beyond Limitaôns and Expectaôns (ABLE), Singapore, is a social service organizaôn, with a mission “to enable the physically challenged to live with dignity and to have a produc^ve, meaningful and independent life”. Occupaônal therapists (OT) are members of a mul^-disciplinary team that serves clients with mainly physical impairments, to return to work. The team comprise the case manager, employment support specialist, occupaônal therapist, physiotherapist and training coordinator. Re-employment may be with an exis^ng employer or, for a new job placement. OTs can contribute to various aspects of the client’s RTW journey, including being the Return-to-Work coordinator, to iden^fy appropriate service requirements based-on a RTW framework. RTW intervenôns are priori^zed to enable client’s early return-to-work with an exis^ng employer, or if for job placement, to improve client’s employability. Occupaôn-focused intervenôns, open simulated work ac^viês, are used to enable pre-vocaônal readiness, work condiôning or work hardening. OTs are also involved in job exploraôn, development of commu^ng-for-work opôns, specific work place modificaôns or work re-design, and, reducing other barriers for RTW, like client’s personal coping strategy for organizaônal demands. The understanding of the importance of occupaônal well-being and, the person- environment-occupaôn interacôn for work, posiôns an OT well to serve the RTW client. Occupaôn-focused intervenôns allow OTs to help clients respond to their unique job demands, and, to enable clients to harness their abiliês beyond expectaôns and limitaôns.

Malaysia Ahmad Zamir Che Daud (PhD, OT) University Teknologi MARA (UiTM) Occupa'on Based Interven'on from a Malaysian Perspec've Occupaôn Based Intervenôn (OBI) is perceived differently by occupaônal therapists around the globe. Some believe that OBI is a therapeu^c process where occupaônal therapist and the client co-create the meaning of therapy. Another perspec^ve is OBI includes all forms of occupaônal therapy intervenôns such as preparatory and purposeful methods as long as the outcome of intervenôn is occupaônal performance. Malaysian occupaônal therapists perceive OBI according to concept of occupaôn as a means and an end. Occupaôn as a means refer to occupaôn and purposeful ac^viês as a healing agent or treatment medium, while occupaôn as an end refer to occupaôn as an ul^mate outcome of occupaônal therapy intervenôn. Thus, OBI is an intervenôn on occupaônal performance that matches the client’s goal, is iden^fied as meaningful and is done within the client’s context, where the occupaônal therapist can also use the client’s occupaôn and purposeful ac^viês as a treatment medium or healing agent. Malaysian occupaônal therapists believe that there are other elements to support OBI such as; (1) client-centred approach; (2) top-down evaluaôn and intervenôn; (3) gradable and modifiable to suit the client’s abiliês and limitaôns; and (4) context where the intervenôn is provided. Although Malaysian occupaônal therapists believe that OBI benefit their client, it is challenging for them to adopt OBI as the field is dominated by the reducônist approach of the Medical Model. Therefore, many occupaônal therapists tend to neglect the core

tenet of occupaônal therapy (occupaôn) when trea^ng their clients. This situaôn is associated with many factors such as the clients, context of prac^ce, skills of occupaônal therapists and therapeu^c power of occupaôns. As a result, Malaysian occupaônal therapists struggle with their iden^ty. This presentaôn will discuss how Malaysian occupaônal therapists perceive OBI and the challenges they face when pusng OBI into prac^ce. Potenâl soluôns to the problems will also be discussed in order to strengthen the iden^ty of occupaônal therapy and to encourage more occupaônal therapists to adopt OBI in prac^ce.

Korea Ju-hee Jeong (OT) Soon Chun Hyang University Bucheon Hospital Occupa'on-based prac'ce in Hospital based se^ngs The root of Korean OT is actually restora^ve approach with reducônism. Because in Korea, OT has been started as a type of emergency aids from US/Canada aper the Korean War, and the prac^ce trend of the ^me in the donor countries was restora^ve approach. So it appears most of the clinical prac^ce of Korean occupaônal therapy has been carried out in a hospital sesng and we has not had ^me to reflect on our percepôns and knowledge about our profession. There have been many changes in Korea in recent years. We began to reflect on the iden^ty of occupaônal therapy internally and externally on such issues as the limitaôns of the naônal health insurance, limitaôns on the number of days spent in the fund, and calls for objec^ve evidence on the effec^veness of the intervenôn. Although the ^me of our internal reflecôn has begun, there have been many barriers to afemp^ng to occupaôn-based prac^ce that is consistent with the philosophy of occupaônal therapy. So, I'd like to introduce my occupaôn based prac^ce strategy that is inspired by the challenge of overcoming these barriers and turning clients into occupaônal beings. Occupaôn based prac^ce strategy in hospital based sesng. 1. Create a cri^cal pathway to facilitate occupaôn-based prac^ce even for novice therapist 2. Create guidelines to gain occupaônal informaôn 3. Make an Ac^vity selecôn list about occupaôn area to facilitate selecôn of occupaôns and ac^viês as a therapeu^c modality 4. Use various art and crap as a therapeu^c tool 5. Review and Apply the new evidence of occupaôn based prac^ce 6. Communicate with the clinical team member using the terminology of measurable indicators of occupaôns and ac^viês 7. Document occupaôn and ac^viês based intervenôns

Since I have strategically changed my clinical prac^ce, clients have performed ac^viês and occupaôns during the course of occupaônal therapy and their perspec^ve has been shiped from the view of impairment to the view of wanted, expected, and needed occupaôns. And we hear feedback from many clients who said that the successes of occupaônal performance aper disability give them confidence to lead their lives. In conclusion, among the many approaches, I believe that an occupaôn based prac^ce is our unique profession, the best way to iden^fy of being an occupaônal therapist, ensuring the therapeu^c value of occupaôn. and it makes them get closer to be the actor of their lives by redesigning the life of

Australia Mali Levav (MSc, OT) Mul'ple Sclerosis Limited Occupa'on-based prac'ce in Australia: Job reten'on of people with chronic condi'ons Employment provides financial security and is associated with improved health, well-being and quality of life. Vocaônal and avocaônal barriers faced by people with disability lead to high rates of unemployment and create addiônal difficulês. Governments commifed to improving employment outcomes for people with disability have been inves^ng in employment support services, in recogniôn that premature re^rement, or even reduced workforce par^cipaôn, takes a significant economic toll on society. People with chronic condiôns or acquired disability typically face a complex array of physical, cogni^ve and/or psychological challenges as well as social issues that may undermine their ability to work. Specialised mul^disciplinary allied health teams are well placed to understand the intricacies of health- related symptoms and their impact on work performance. The Australian MS Employment Support Service (ESS) was created to cater for the vocaônal needs of people with Mul^ple Sclerosis. Most ESS clients seek support for job retenôn. Par^cipaôn is voluntary and ongoing support is provided on a needs and benefits basis. The majority of Employment Support Consultants working in the program are Occupaônal Therapists. The service delivery can be demonstrated using the Person-Environment- Occupaôn-Performance (PEOP) model as a framework alongside principles of the Soluôn-Focused approach. MS ESS offers individually tailored advice and support focused on client’s individual circumstances, strengths and resources. The holis^c and comprehensive assessment aims to iden^fy the factors which enable or hinder work par^cipaôn and performance and includes analysis of the workers, their occupaôns and life roles as well as their work and home environments. Following a collabora^ve goal sesng, the consultant designs a client-centred intervenôn which may include educaôn about symptom management to maximise work performance and self-efficacy; remedial ac^vity such as exercises to improve physical or cogni^ve abiliês; compensatory strategies such as assis^ve technology or changes to work duês/rou^nes/environment. The consultant liaises with clients, carers, employers, service providers, and suppliers of work-related equipment. The par^cipants typically report that the combinaôn of prac^cal advice and emoônal support helps them to befer cope with difficulês at work, increases their confidence in self-management and improves their well-being. MS ESS is successful and unique because it has evolved around its par^cipants’ individual vocaônal needs and it is led by allied health professionals. Given the significant effects of unemployment, health professionals need to advocate for people with disability and explore how the delivery model of this government- funded employment program can potenâlly be replicated elsewhere.

Japan Tatsunori SAWADA (PhD, OT) Tokyo University of Technology Occupa'on Based Prac'ce in Japan Occupaôn-based prac^ce (OBP) in Japan is the evaluaôn and intervenôn that uses a client’s occupaôn. OBP is considered to be one of the typical occupaônal therapy approaches. Many occupaônal therapy researchers have advocated the importance of OBP since 1960s. Unfortunately, in the last few decades, the primary aim of occupaônal therapy in Japan has been to improve body and cogni^ve dysfuncôn. However, OBP has gradually expanded in Japan each year. There is an idea of OBP that does not include funcônal exercises at all but is open unrealis^c in a clinical sesng. Funcônal exercises are more effec^ve if they lead to the client’s meaningful occupaôn. The primary occupaônal therapy outcome should enable clients to perform and engage in their occupaôn. Although there are various limitaôns of OBP, it is necessary for OT to realize those managements for client’s occupaôn. In this symposium, I would like to introduce advanced Japanese OBP.

WorkShop

1) Pare'c arm in stroke pa'ents Takashi Takebayashi (Kibi Interna'onal University, Japan) Therapeu^c approaches involve the occupaônal based treatment for the hemipare^c upper-extremity in stroke paênts. Pai-Chuan Huang (Na'onal Cheng Kung University,Taiwan) Robot-assisted training and hybrid treatment in stroke rehabilitaôn in Taiwan.

2) Demen'a Kyoungmin Lee (Far East University, Korea) The role of occupaôn-based prac^ce for Mild Cogni^ve Impairment and demenâ. Hiroyuki Tanaka (Osaka Prefecture University, Japan): Development of ADL evaluaôn and intervenôn strategy for severe demenâ.

3) School-based OT Seokyeon Ji (Sensory Integra'on towards Social and Occupa'onal being, Korea): The collaboraôn between school teachers and occupaônal therapists in the classroom since last 10 years. Sayaka Yamaguchi (NPO habilis, Japan): INNOVATION! for children, occupaônal therapy, and community. Ling-Yi Lin (Na'onal Cheng Kung University, Taiwan): The role of occupaônal therapists in special educaônal professional teams for improving the adap^ve funcôning of elementary school children with au^sm spectrum disorder in Taiwan. Oral session Oral Session Main hall Oral session 1 July. 21, 2018 13301430 Seokyen Ji (SISO: Korea) O-1 The Effectiveness of a Parent-training Program for Preschool Children with Au- Lin Ling-Yi tism Spectrum Disorder Departments of Occupational Therapy, College of Medi- cine, National Cheng Kung University, Tainan, Taiwan O-2 Collaborative goal setting toward to client centered practice for a child with Yuto Imai communication difficulties: A case report using ADOC-S. Hiratani Clinic for Develop- ADOC-S mental Disorders of Children O-3 Withdraw

O-4 Supporting elderly people to live by their own values: A discussion from the Nobuhiro NARA viewpoint of social participation and health-related quality of life Kagoshima University, : School of Health Sciences QOL

Oral session 2 July. 21, 2018 14401540 Kazuhiko MISAKI (Saiseikai Otaru Hospital: Japan) O-5 Work-related carpal tunnel syndrome among computer users: Perspectives from Loh Ping Yeap ergonomics, Person-Environment-Occupation model, and biomechanical frame of Department of Human Sci- reference ence, Faculty of Design, Kyushu University O-6 The interrelationship between domestic roles of stroke patients before onset and Masatoshi Tahara families' QOL after stroke Saiseikai Higashikanagawa QOL Rehabilitation Hospital O-7 A successful trial of Motor Activity Log evaluation to improve the damage of left Akira Iwase arm suffered from brachial plexus injury Yokohama City Minato Red Motor Activity Log Cross Hospital Rehabilitation Center O-8 Assistive Interview Tools Promote Shared Rehabilitation Goal Setting: A Case Hiroki Iga Report of ACE and Reasoning Sheet Use 1) IMS group IMS Itabashi Rehabilitation Hospital

Oral session 3 July. 22, 2018 9301030 Tatsuya SUZUKI (Seirei Christopher University: Japan) O-9 Withdraw

O-10 A case study: renewed self-confidence with outdoor walking exercises to a shopping Takatsugu AKAIKE center by home-visit rehabilitation Fuji Orthopedic Hospi- tal O-11 Pilot study on novice occupational therapists' experience of using narrative reason- Sho MARUYAMA ing for elderly clients in Japan Shonan-Keiiku Hospital O-12 Regional Characteristics in Activities/Participation and Social Capital among Elderly Shinpei Ikeda -Comparison of Regions between Different Rate on Requirement Certification of School of Health Sciences, Long-Term Care- Tokyo University of Tech- nology 2

Oral session 4 July. 22, 2018 10401140 Supat Chupradit (Chiang Mai University: Thailand) O-13 The application of the new therapeutic program in Mental health Lee Chi Jen Buddhist Tzu Chi Medical Foundation Dalin Tzu Chi Hospital O-14 Change of attitude forward recovery of inpatients with alcohol dependence using Tetsutaro Kosago narrative slope National Hospital Organi- zation Kurihama Medical and Addiction Center O-15 A time-course analysis of changes in activity profiles of outpatients with schizo- Takayuki Kawaguchi phrenia in occupational therapy Kitasato University School of Allied Health Sciences O-16 Investigation of the influence that positive participation has on the result of occupa- Hiromi Mori tional therapy Higashikawaguchi Hos- Using for Aid for Decision making in Occupation Choice (ADOC) pital ADOC Oral presentation (English) No. O-1 July. 21, 2018 13e3014e30 Child and Adolescents The Effectiveness of a Parent-training Program for Preschool Children with Autism Spectrum Disorder

Ling-Yi Lin1), Meng-Hsin Ho1) 1) Departments of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan,

Key words: autism spectrum disorder, parent-training program, adaptive functioning

Introduction: Effective interventions are required to improve the social interaction skills and adaptive behaviors of children with Autism spectrum disorder (ASD). Research has increasingly focused on the effectiveness of the play- and developmental, individual difference, and relationship-based (DIR) parent-training programs for children with ASD. However, well-conducted randomized controlled trials are still necessary to produce strong evidence. This study aimed to implement a dose-matched control group and comprehensive measurements to examine if the play- and DIR-based parent-training program would improve children’s adaptive functioning and parents’ parenting skills. Method: Thirty-six preschool children with ASD and their parents were included and randomly assigned them to either the parent-training program group or the traditional program group for 14-week intervention programs. Results: The Functional Emotional Assessment Scale (FEAS) scores significantly increased in the parent-training program. The parent-training program had significant within-group differences in communication and motor composites in the Chinese version of Psychoeducational Profile-Third edition (CPEP-3), and communication, daily living skills, and total scales in the Vineland Adaptive Behavior Scales (VABS). The traditional program only showed significant differences in the communication composite in the CPEP-3 and motor skills in the VABS. Conclusion: The results suggested that the play- and DIR-based parent-training program improved children’s developmental levels, adaptive functioning, and parents’ parenting skills. Findings contributed to evidence-based practice for children with ASD and their parents by demonstrating a feasible and economical program in current clinics. Oral presentation (English) No. O-2 rDC July. 21, 2018 13e3014e30 O Child and Adolescents Collaborative goal setting toward to client centered practice opi for a child with communication difficulties: A case report 365D １w： using ADOC-S. ʼaw Yuto Imai1), Maiko Fukutani1), Hiroaki Naruse2), Konosuke Tomori3), wa Michio Hiratani1) oip/ , a 1) Hiratani Clinic for Developmental Disorders of Children, kla 2) University of Fukui Hospital, wk 3) Tokyo University of Technology lwm wdwwynーykhhflー Key words: Autism Spectrum Disorder, ADOC-S, Client centered practice va3OR UIRBTOS03B ( ( OBJECTIVE: This case report describes the use of Aid for 5NOQJ 4NGOT 5NIP =O Decision-making for Occupation Choice for schools (ADOC-S) EGIN CUTJ 8TR 0 545= EC8 to facilitate to collaborative goal-setting in 9-years-old child with ), va〇i severe communication difficulties. His parents gave informed ʼw consent with this case study. ami CASE: Rui was born in China and he moved to Japan 18 months zwnm ago. He was diagnosed with Autism Spectrum Disorder. The level nwa of Japanese speaking was degree to talk two sentences, and of 3OJLT6IOOTSRGPOSMOSIIUGOTS5NTOILT understanding was degree to select yes/no question. The score on DINTTQ365D １a Autism Questionnaire was 21 points; on Children Behavior mna Checklist teacher reported form was 40 points. His negative z behaviors (ex. Playing with toys alone at group activity time, Not kd keeping time to go home) bothered the surroundings. The il？ occupational therapist conducted the interview using ADOC-S to axi identify and share meaningful occupations with him. Rui chose xw “Interaction with friends”. Then, the occupational therapist and xa staffs re-planed and provided the group activities to promote ix interaction with friends, and Rui tried to communicate with ʼxwa friends. Finally, the 10 point of subjective performance score of mnw) “Interaction with friends” is improved from 3 to 7. - →a CONCLUSION: This report suggests ADOC-S probably op365D １w involves the child with communication difficulties in goal setting, i： and it may promote collaborative approach with child and staffs. va Oral presentation (English) No. O-3 July. 21, 2018 13e3014e30 withdraw

Community Service Health Informatics in Occupational Therapy Services for Children in the Community

Kewalin Panyo1), Suchitporn Lerslip1), Supawadee Putthinoi1) 1) Chiang Mai University

Key words: Health Informatics, Occupational Therapy Services, Community

Health Informatics is the integration of healthcare information and technology as a health information management tool for occupational therapy services, including screening, stimulating, promoting, and following the development of children. However, occupational therapists have an unclear health informatics system. Therefore, this research explored the community health system through the use of health informatics in order to provide effective occupational therapy services for newborn to 6-year-old children. The research and development method was used in this study and consisted of 2 steps such as documentary analysis and focus group discussion with eight experienced occupational therapists in pediatrics at the community level. The results from content analysis indicated that occupational therapy services in the community recently used health informatics for screening and monitoring the development of children. However, this did not link to occupational therapy services for children at risk or those with disabilities. Thus, occupational therapists need systematic health informatics for evaluation, intervention, follow-up and referral. In addition, the system still needs to comply with Ministry of Public Health policy. In conclusion, health informatics is a useful system that can link public health policies to practical guidelines of occupational therapy services for children in the community. However, this research was studied in specific areas of Chiang Mai, Thailand and cannot be generalized for other regions. Further research should expand to other areas and study of the holistic aspect of community health services. Oral presentation (English) No. O-4 July. 21, 2018 13e3014e30 Community Service Supporting elderly people to live by their own values: A discussion from the viewpoint of social participation and health-related quality of life ．w w Nobuhiro NARA1), Mitsushi Sekimoto2), Naoki Kusumoto3), axw Hiroyuki Ohgi4), Takahiro Tani2) yw 1) Kagoshima University, School of Health Sciences B=kD8), la 2) “KANAERU” Link, 3) Taito Hospital z。ii１w 4) Tokyo Rehab Service + 36= iwD8), a Key words: Social participation, Health related QOL, Elderly z 5 wa We investigated the situation of activities and participation of elderly people who used community rehabilitation services and i36= S2), d found that several cases satisfied the condition despite the low ʼ S2(dw S2( participation. To provide better support, it is necessary to 36= S2)( aD8), understand such circumstances accurately. Therefore, we kA8 attempted to cluster elderly people based on their activity kC7l v A8 36= participation and assessed their health-related quality of life using ．C7 dw the Short Form Health Survey (SF-36). A cluster analysis was ．a performed based on 15 items assessing the instrumental activities of daily living (IADL) of elderly people (n=114) who used w C7 ． visiting and home rehabilitation services. Additionally, inter-group wv comparisons of the SF-36 subscale scores were conducted. These wwa procedures were approved by the Ethics Committee of the Tokyo University of Technology and there are no conflicts of interest to declare. The cluster analysis yielded the following four groups: good IADL group(n=36), good with preparing a meal/clearing up after a meal group(n=24), good with going for outings/shopping group(n=24), and worst IADL group(n=32). The physical function (PF) and emotional role functioning (RF) subscales of the SF-36 showed significant main effects of IADL. Further, multiple comparisons revealed that the worst IADL group exhibited significantly low scores on PF, while the good with outings/shopping group exhibited significantly low scores on the RF. This finding showed that the performance of social activities was a source of stress for elderly people; however, stress levels were low in those who were reluctant to engage in such activities. This finding provides useful knowledge on the support needs of elderly people. Oral presentation (English) No. O-5 July. 21, 2018 14e4015e40 Others Work-related carpal tunnel syndrome among computer users: Perspectives from ergonomics, Person-Environment-Occupation model, and biomechanical frame of reference

Ping Yeap Loh1), Satoshi Muraki1) 1) Department of Human Science, Faculty of Design, Kyushu University

Key words: work-related musculoskeletal disorder, carpal tunnel syndrome

Introduction: Carpal tunnel syndrome (CTS) among office worker lead to high impact on the individual quality of life as well as the socio-economic burden. However, pathophysiological relationship between computer users and CTS remains questionable. Our previous studies investigated the acute changes of median nerve at several biomechanical factors and computer typing. Subsequently, integration of the research results into practice by Person-Environment-Occupation model, and biomechanical frame of reference could provide a more comprehensive approach towards prevention of work-related CTS. Objectives: To formulate conceptual ideas for workplace ergonomics assessment and intervention in relation to prevention of work-related CTS by understanding the changes of median nerve shape. Method: This study was approved by the Ethics Committee of the Faculty of Design, Kyushu University (Approval number 141). Informed and written consent was obtained from the participants. The measurements of the median nerve morphological characteristics before and after typing were examined by ultrasound imaging. The obtained results were analyzed and integrate from various perspectives ergonomics, Person-Environment-Occupation model, and biomechanical frame of reference. Practice Implications: Continuous keyboarding typing lead to an acute enlargement of the median nerve shape. In addition, the design of keyboard affects the changes of the median nerve after typing. Conclusion: Biomechanical stress from repetitive active wrist and finger movement during typing has an impact on the median nerve shape. Oral presentation (English) No. O-6 v July. 21, 2018 14e4015e40 y Physical Dysfunction The interrelationship between domestic roles of stroke op patients before onset and families' QOL after stroke ʼvb yycb Masatoshi Tahara1), Arata Kawakami1), Kayoko Takahashi2), ）wwzb Michinari Fukuda2) wb yycb 1) Saiseikai Higashikanagawa Rehabilitation Hospital byb 2) School of Alien Health Sciences, Kitasato University yvcb zʼ Key words: caregiver, stroke, QOL bbz bc oIntroductionp opxb Stroke patients require long-term hospitalization to rebuild their ：cb lives in Japan, which may affect not only patients but also their bbbk8l family. Domestic roles are essential to life supporting each other, ci and hospitalization could eliminate the role which could increase c the burden on the family. This cross-sectional study focuses on b 83 １wcbz QOL, life satisfaction of stroke patients and spouses. B= bD8. z oMethodsp k9D7Dl１wcD8. Participants were stroke patients and their spouses in B=kA5Dlb B=k5Dlc Kanagawaken hospital who return home. Demographic data was ybb 83 b corrected from medical record: age, sex, diagnosis, functional kDAl independent measurement (FIM). Both patients and spouses １wcw assessed with self-reported questionnaire at discharge. Patients' １wc domestic roles before onset were assessed with Frenchay （ʼb Activities Index (FAI). QOL of both patients and spouses was wc measured by SF-8 (PCS and MCS), General Self-Efficacy Scale op , e ) b ) c (GSES). Life of the spouses were assessed with FAI and ,+r(- b 8 Self-completed Occupational Performance Index (SOPI). The )(r- b ,(.r(/ v correlation between patients and spouses was evaluated using the c 83 b Spearman’s rank correlation coefficient (P<0.05). A5D DA 9D7D oResultsp k2+ 2,)b2+bU1+l 16 participants (13 male patients) were recruited. Average age of c patients was 65.1±12.7, and FIM score was 113.2±14.7. The opw） average age of spouses was 62.8±12.9. The significant negative yb correlation was shown between patient’s FAI and spouse’s PCS, ．wcb spouse’s SOPI, and spouse’s GSESkr=-0.51, r=-0.63, r=-0.51, w）b respectively). B= vyc oDiscussionp These results suggest that the loss of the patient's domestic roles may increase the burden on the spouses and decrease their QOL. Thus, reacquiring patients' domestic roles may reduce the burden on the spouses and improve their QOL. Oral presentation (English) No. O-7 Lt July. 21, 2018 14e4015e40 --2 O Physical Dysfunction A successful trial of Motor Activity Log evaluation to improve opg the damage of left arm suffered from brachial plexus injury １・１ʼ TT3IOO=TM 3= １ Akira Iwase1), Takashi Matsumoto1) a】wa 1) Yokohama City Minato Red Cross Hospital Rehabilitation Center op+ a

）d Key words: motor activity log(MAL)dpatient educationdlife cycle ww】＝a xv々a Introduction: We report a successful trial using Motor Activity / Log (MAL) for a case who faired moving damaged arm. We got k El ao p<5Da the consent of presentation from this patient. w】．a Case: 50-y.o. woman who depressed at past tried to suicide. She k C was rescued. When she became awake, she couldn’t raise her left ・amwny arm. Precise examination showed her diagnosis as left brachial １・ plexus injury. After conservative treatment, OT therapy was vaC started. She often complained "I can’t move my arm anyway". amwnmwn After ROM exercise, she could raise her arm. But she still ywaDE78eC./ complained " I want to sleep now”. Clearly, she faired damage. =+. a8e .) (- ao Graduallyher ROM ranges, muscle strengths improved, but she p C didn’t try to use her damaged arm and spend laying down. １ag Cd Methods: We challenged evaluating the Amount of Use (AOU) １a and Quality of Use (QOU) of damaged arm using MAL. Then 3= １１ we explained her the results for induce her to use damaged arm 3F BF and improve her QOL. i１ Results: First evaluation showed the states as below. STEF: R a (( 89/100, L58/100. MAL: AOU:2.57, QOU:2.28, FIM-motor:83, xx１ -cognitive :27. Final evaluation showed the states as below. aopDE78 0 C ./ t/. = +. STEFeR 98/100, L 94/100 (cut off score 93). MAL: AOU:3.26, t/ k 5 TLL /) 3=e QOU:2.71. FIM-motor: 91, -cognitive: 27. She became easy to 3F(+-t)(, BF((.t(- 8e .) consult nurses about her schedule. On 22th day, she could hold a t/ (- t)( ae bowl, comb her hair with a brush herself. wi Conclusion: MAL evaluation and explanation about the results to 〇aop3= １w the patient might be effectively for cases who fair the damages to １i confirm the recovery and improve QOL. 36= ʼ ʼ a Oral presentation (English) No. O-8 r: July. 21, 2018 14e4015e40 M Physical Dysfunction Assistive Interview Tools Promote Shared Rehabilitation op Goal Setting: A Case Report of ACE and Reasoning Sheet b。ʼwc Use bi 3RS TL 5QOS 7SGHQRSkb357l i i １ Hiroki IGA1), Kanta OHNO2), Ayumi OHNO1), Taiji ITO1) b 1) IMS group IMS Itabashi Rehabilitation Hospital c。bzʼ 2) Tokyo University of Technology School of Health Sciences Department of i１wc Occupational Therapy op3 b. bcec edcw Key words: Cerebral vascular disease,interview, wc】v wc BACKGROUND op (. b36= b We have developed assistive interview tools for revealing gaps ckbElb between clients and therapists, namely, Assessment of Client’s ：wc Enablement (ACE) and Reasoning Sheet. This case report b 3 w】wc describes experiences in occupation-based practice using these o357 px tools. 357 cbmnwx CLIENT bE +.RRb3 -RR )(RR 93A The client (CL) was an 84-year-old man with cerebral infarction. wc357 b3 g→ He worked as a tofu seller with his wife and daughter. He was bʼxc able to independently perform activities of daily living; however, oiipii１w he had mild right paralysis. Occupational therapist (OT) mnwxc suggested that he could return to work after altering some b3 activities. However, he misunderstood the advice of OT and bʼ completely gave up on returning to work. wwcb APPLICATION OF ACE ywc OT interviewed him using ACE to reveal gaps in the recognition bc of returning to work. The scores were as follows: +58 mm (OT), b −74 mm (CL), and 132 mm (GAP). His recognition of working cʼ changed because he received an explanation of the results. xc APPLICATION OF REASONING SHEET op 357 bmn We wrote down in the reasoning sheet events concerning his 93A)RRbm d n 93A/RR b occupation. We summarized and shared with him the meaning c and purpose of “working as a tofu seller.” We realized that there opb357 １w were two aspects of being a tofu seller: “as a skilled craftsman” bcbi and “as a shopkeeper.” i RESULTS b： The GAP scores of ACE at discharge were 13 mm (imparting ci１ skills of making tofu to daughter) and 9 mm (waiting on the １vc costumers). He was able to return to work with support from his family. DISCUSSION The findings of this case suggest that ACE and reasoning sheet would be useful as interview assistant tools. Oral presentation (English) No. O-9 July. 22, 2018 9e3010e30 withdraw

Geriatric Care Active Ageing Levels and Time Use Pattern of Thai Elderly in a Suburban Community

Autchariya Punyakaew1), Supawadee Puttinoi1), Suchitbhorn Lerslip1) 1) Occupational therapy department, Chiang Mai university

Key words: Active ageing, Time use pattern, Active ageing levels

The elderly population is growing rapidly worldwide, thus enhancing their independent health care, productivity and balance of occupations is most important. This research aimed to examine the active ageing levels and time use patterns in active elderly persons. The participants comprised 140 persons aged 60 years and older, who were representative of active ageing. Moreover, they studied in the Sannameng Elderly School, Sansai sub district, Chiang Mai province. They had no cognitive deficits and an MMSE score of 14, 17, 22 and more. Data, including active ageing levels, were collected in 2 steps through 1) an interview-based active ageing questionnaire, and 2) a time use pattern collected by using a time diary. The second step also included individual semi-structured interviews on occupations that the elderly had engaged in for over 24 hours. The results showed that most elderly people were at the moderately active ageing level and their time use pattern had varied activities, including the eight categories: basic activities of daily living, instrumental activities of daily living, rest and sleep, education, work, leisure and social participation. Furthermore, the participants spent most of their time resting and sleeping. This study suggested how to use management time as well as maintain and promote active ageing, good quality of life and health, and participation and security for elderly people in the community. Oral presentation (English) No. O-10 AcA July. 22, 2018 9e3010e30 SrAAO Geriatric Care A case study: renewed self-confidence with outdoor walking exercises to a shopping center by home-visit rehabilitation op c Takatsugu AKAIKE1), Tatsuya Suzuki2), Masataka Kato1), Keigo w Fukuyama3) c】v 1) Fuji Orthopedic Hospital wc 2) Seirei Christopher University op 3) Nursing Care Insurance Center Pam - c ( c wʼcb Key words: home-visit rehabilitationccentercoutdoor walking exercises x、c3 【c ( c Introduction opi１wi We provided occupational therapy to a client who wanted to walk cimw to restaurants with friends. Her activity levels had decreased after wn (b (c a lumbar compression fracture, but increased with outdoor ．vc :6DCe(/ c36= walking exercises. She consented to publishing the results. b40/+ b:H=D30)+ c36= 830() c Case information 、c、 The client was a woman in her late 70s who regularly went out ）b walking with friends. She presented with lower back pain while iwʼ taking out the trash, and was diagnosed with a lumbar c compression fracture. In-home rehabilitation started 2 years after op、c the injury. mb Assessment ：wn Needs: “to go to restaurants by walk with friends.” Satisfaction kb(lwwbd and performance were both 2/10cHDS-R: 29, BI: 95bHb-LSA: wc 31.5, FAI: 23. Client’s afraid of back pain. Her goal was to walk o ( pd to a shopping center. b x Intervention c “The lifestyle of homebound seniors is characterized by more o ( pi negative attitudes toward daily activities than non-homebound cʼ seniors.” (Ishibashi, 2011). OT focused on conversation of →c 40 b client’s context. After 12 weeks, client didn’t went out, but :H=D30 b830) ci activity levels in home was increased. After 24 weeks. Client mwwn -b performed outdoor walking exercises to the shopping center. Final - c assessment scores: BI: 100bHb-LSA: 110band IFAI: 30. Activity opw levels increased. Satisfaction and performance increased to 7/10. bb Discussion b．w For disabled seniors struggling with isolation and depression, vk，b(lc b regaining self-confidence and enthusiasm are crucial to increasing day-to-day activity levels and recovering declining abilities and ycbv function (Tsuboi, 2000). Because we listened closely to the bb client’s concerns, her anxiety decreased. She could walk outdoors. yc Her self-confidence and enthusiasm increased, leading to wider her life. Oral presentation (English) No. O-11 LQrS July. 22, 2018 9e3010e30 L Geriatric Care Pilot study on novice occupational therapists' experience of 「e using narrative reasoning for elderly clients in Japan zwbk lv Sho MARUYAMA1), Yohei JINBO 2), Yuki SAITO 3), Fuminari wcxib KANEKO1), Keiichiro SINDO1), Kazuto AKABOSHI1) xyxzb 1) Shonan-Keiiku Hospital i１ 2) Chigasaki Rehabilitation College 3) Sendai Seiyo Gakuin College vycb i１ Key words: professional reasoning, novice occupational therapists, qualitative yvc research e １wc： Purpose: cb - Professional reasoning focusing on the client's narrative is + bw important in OT for the elderly. The purpose of this study was to cv + ）b describe the experience of novice occupational therapists using ()( k(((, lb ( ) b narrative reasoning for elderly clients in Japan. + k +)+ lbi々 Methods: b cib - A qualitative method was used in this study. We used purposive ididiki sampling. The five participants in this study had an average age of ,- lcibiv DU 23.2 years; 2 were male and 3 were female; and clinical LT5TJOSMGSJENTOGOTSkD53El１c experience averaged at 1.5 years. We collected data using focus bw group interviews. We utilized the Steps for Coding and Theology cb (SCAT), which is a qualitative data analysis method. We c explained the study to the participants and their managers v〇wc obtained their consent. e Resultse b(/ ib. ib ik36l - As a result, we generated 129 codes, 18 categories, 4 main biixc categories (A-D), and described it as a story line as follows. (A) b3 They used narrative reasoning in OT situations and processes. i１wcb Their use of narrative reasoning was supported by (B) learning i１b4 experiences of narrative reasoning in educational courses and zʼywc clinical practice. Further, their use of narrative reasoning was i１b5 influenced by (C) OT practical environment and needed −wcb6 correspondence. Moreover, (D) they experienced difficulties and i１y felt confident in using narrative reasoning and reflected them in bwc learning experiences. e Discussione bzw - The present study indicated that novice occupational therapists bi１ experienced the difficulty of interacting with clients and １zb environments when using narrative reasoning. Therefore, it is ii１ important for novice occupational therapists to use narrative vc reasoning together with pragmatic and interactive reasoning. Oral presentation (English) No. O-12 rii July. 22, 2018 9e3010e30 Geriatric Care DL Regional Characteristics in Activities/Participation and Social Capital among Elderly o「pbzw： -Comparison of Regions between Different Rate on wcb（ Requirement Certification of Long-Term Care- 3 ：．wwc 3 Shinpei Ikeda1), Kenichi Yamane 2), Takeshi Suzuki2), Miki Satoh2), b。bbid Yuichi Nojiri2), Hiroshi Haga3) wyc 1) School of Health Sciences, Tokyo University of Technology gc 2) Senior Citizen’s Welfare Division, Ayase City, Kanagawa Prefecture b：w 4 3) Graduate School of Gerontology, J. F. Oberlin University b3 vc op3 + b4 +- Key words: activities, participatin, social capital c ,+ ： ʼwwvcbi Introduction: The rate of Requirement Certification of Long-Term bddc Care Insurance for Older Adults (RLO) has risen within elderly (- , (. - / vc population in Japan. In spite of this fact, the rate of RLO of one opk region (A) in Ayase City, Kanagawa has been kept lower for the --lcb past years. The city government had been interested in bwb characteristics of A and we thus conducted the population survey. c The purpose of this study was to examine the characteristics of op3 -++r+/ 4 elderly in A from the comparison of other region (B) which has -)r,) vc3 been kept higher rate of RLO. bbvc Method: 1,511 in A and 1,547 in B that community dwelling wb elderly participated in this study respectively. They were all aged cb3 65 and older, and they were not in RLO. We collected data on b 96D+ ：x demographic status, physical, and psycho-social factors. ．wvc36= Results: Elderly in A ware significantly older, higher education c 4 than those in B. There were no significant difference between the wb3 cd number of diseases and IADL independence in both regions. wb3 However, Self-rated health was significantly better among those ibbbb in A. On the other hand, elderly in B had a significantly poorer of cyb3 b life-space mobility than those in A. In activities and participation zwʼxwc=DD, ： related to leisure and/or routine, elderly in A had significantly dbivc higher rates of implementation including sports, traditional culture, op：．wb intelligence, and tourism. They also tended to trust in living bzwg people around their home, and they had a mind of helping each wvycy other. Social networks on family and friends among elderly in A bwb were larger than those in B. d。idi Conclusion: The city’s government have to support its citizens to xidvc participate in various activities in their living area. Occupational therapists have roles of creating places with citizens and facilitating their social capital through activities and participation. Oral presentation (English) No. O-13 July. 22, 2018 10e4011e40 Mental Health The application of the new therapeutic program in Mental health

Chi Jen Lee1) u) Department of psychiatric, Buddhist Tzu Chi Medical Foundation Dalin Tzu Chi Hospital

Key words: KAWA, MOHO, Expressive arts therapy

The KAWA model provides therapists with a new perspective: what roles should they play when patients ask for help? In this research, the author suggests a new multi-model program for mental health to direct a therapist, who should start an interview with the KAWA model, evaluate the clients’ ability with the MOHO model, and intervene with other psychiatric theories like the expressive arts therapy. After all, he/she has to assist the client in the humanistic way. When the therapist approaches the client with the KAWA model, he can handle the client’s life story thoroughly to identify clearly the core problems in the life story with MOHO model. As a result, the therapist can assist the clients in finding their solution to the problem encountered by using an appropriate psychiatric theory. Oral presentation (English) No. O-14 vrrQ July. 22, 2018 10e4011e40 orgOr Mental Health Change of attitude forward recovery of inpatients with e alcohol dependence using narrative slope i々zwbg b Tetsutaro Kosago1), Takeru Mizuno2) wczwb) 3CA 1) National Hospital Organization Kurihama Medical and Addiction Center, zwb 2) Showa University Karasuyama Hospital, wcy →kbEl Key words: Alcohol use disorder, Psychiatric Occupational Therapy, narrative wcb b3CA xwb Purpose: Reducing the number of patients who drop-out from an ʼxw ARP has been a challenge at our center. The authors examined the b 3CA zʼ E factors that increase completion of an ARP as well as the roles OT c may play in order to facilitate treatment completion. e Methods: Individuals who were expected to complete our 3CA i々b) 3-month adult ARP were recruited for the study. Those with yxb〜 dementia and intellectual disabilities were excluded. Participants bk were asked to fill out narrative slope forms reflecting their attitude lc toward recovery during their hospitalizations. In this study, the →i１b points where positive or negative slopes started were defined as c１b Turning Points (TP). Flat lines were defined as stability. wcbi Participants were then asked to explain their narrative slopes; in mnmnkESOSM particular, the factors associated with TP were analyzed. ATOSb EAl：cm Results: Out of 52 qualified patients, 23 participants (average age nybEA 47.3±7.3) completed the study. Based on existing studies using c narrative slope methods, we categorized participants’ e free-writings on their slopes. The TP for positive slopes and their +( xb() k-)r-) l maintenance were associated with “interactions with others,” and icb “participation in OT activities.” The TP for negative slopes were ibEA z frequently reported during either weeks 4-7 with “poor opopwxi adjustment” or weeks 8-12 with “anxiety about discharge.” b ( opbo Conclusion: Current findings were consistent with previously pwxic reported findings. Improvement and its maintenance of patients’ e attitude toward recovery were associated with “interactions with zʼi others,” and “participation in OT activities.” Negative attitude bvc were associated with “poor adjustment” and “anxiety about EA bm discharge.” Hence, OT interventions targeting these factors at nmnybb( these identified weeks are likely to improve treatment completion mnbmny rates. wcb3CA ʼb E b １wwc Oral presentation (English) No. O-15 L July. 22, 2018 10e4011e40 Mental Health A time-course analysis of changes in activity profiles of op outpatients with schizophrenia in occupational therapy k Elzʼ →：） Takayuki Kawaguchi1), Aki Watanabe1), Etsuko Asano2), Yoko ：vc Shirakihara2), Toru Sawayama3), Michinari Fukuda1) b E zʼ 1) Kitasato University School of Allied Health Sciences →：vc 2) Kitasato University East Hospital op 3) Kitasato University School of Medicine . c 3IOO ATLOQDIGQTLAGOSONAINOGOI6OTJ3AD Key words: activity profile, schizophrenia, longitudinal study １wczʼ ：bb( b b( b Introduction: ) bE , c Identification of the time course of changes in activity profiles of ：kC(lcU1+ outpatients with schizophrenia in occupational therapy (OT) is vczʼ important for determination of support contents and endpoints wc according to recovery. The purpose of this study was to estimate a op regression curve based on the time course of changes in activity 3AD →b profiles of outpatients with schizophrenia in OT. e QS L 2 ) ) kC( s Methods: -()bU s )(lc We enrolled 48 patients from our hospital. We used the Activity op Profile Scale for Patients with Psychiatric Disorders (APS) to b E zʼ assess the activity profiles. To estimate the regression curve of the → time course of activity profiles, the assessment was carried out on wcbE zʼ 3AD 6 occasions: initial assessment; 2 weeks, 1 month, 2 months, and １w 3 months after the initial assessment; and at the end of OT. The １vc degree of fit of the regression curve was statistically analyzed by the coefficient of determination (R2). A p value < 0.05 was considered statistically significant. This study was approved by the ethical committee of our institution. Results: The regression curve with mean APS score as the dependent variable was most suitable for the sigmoid function: ln f (x) = 3.1 + (-0.3 / x) (R2 = 0.723, p = 0.032). Discussion: This result suggests that the time course of changes in an individual’s activity profile among outpatients with schizophrenia in OT regressed to a sigmoid function. This is useful as basic information for constructing a model to predict recovery of activity profiles using APS scores of outpatients with schizophrenia in OT. Oral presentation (English) No. O-16 D July. 22, 2018 10e4011e40 eO Physical Dysfunction Investigation of the influence that positive participation has op on the result of occupational therapy ：xyb Using for Aid for Decision making in Occupation Choice wkb()lc (ADOC) bvb ʼwk3R

P-2 A case in which maternal and child's occupation performance improved with a mother– Naoki Yoshida child double system combined with occupation science FUNABASHI FUTAWA HOSPITAL P-3 The clinical application of image analysis technology for quantitative assessment and Shuhei Takahata effect measurement of pediatric occupational therapy: A pilot study Hakuho College

P-4 Setting Goals For Connecting To An Empowerment Of The Team In School Occupation Ichie Higa Yuimawaru P-5 Quantitative Analysis of Spatiotemporal Facial Landmark Dynamics for Pediatric Hiromichi Hagihara Occupational Therapy: A preliminary Study Kyoto University P-6 The Effects of CO-OP for Improving School-based Tasks Performance in Children with Kangmi Choi Cerebral Palsy: A Single-Subject Research Design Dept. of Occupational Therapy, Graduate School, Yonsei University P-7 The Effect of Teacher's Understanding about Student's Functional Level in Collaboration Kangmi Choi Dept. of Occupational Therapy, Graduate School, Yonsei University P-8 Spreading local transportation through “BEE CARE’S automobile driving support plan” Tasuku Nagashima ~From an occupational science point of view~ BEE CARE visit nursing rehabilitation station

P-9 Efforts toward establishment of total life support center Shingo Inoue –Needs survey of working environment of victims using text mining analysis– Medical Corporation KNI P-10 Risk factors for falls in terms of attention during gait in elderly residents living in the Tadatoshi Inoue community Graduate School, International University of Health and Welfare, Tokyo, Japan

P-11 Therapists’ difficulties in enabling occupation in visiting occupational therapy Nana Hashimoto Keyaki Total Clinic P-12 The Form of Role Required for Occupational Therapist Satomi Munakata - Report on Regional Rehabilitation Project - General foundation Ota comprehensive Hospital affiliated Ota Nishinouchi Hospital P-13 Change to a positive life by flower gardening: A case study Masaki Matsumoto Ikigainomachi day-service misato P-14 Basic Opinion for Clients with Dementia Occupational Therapy Intervention from Kazuhiko Nagae Maslow’s Hierarchy of Needs Toyama Prefecture Rehabilitation Hospital · Child Support Center P-15 A case where the expansion of occupation was seen by having intervened in both the client Hiromu Osada and the primary caregiver Day service Tsumugi P-16 “I want to help my wife who is in end of life”: A case report. Akari Ito Day service Tsumugi

Poster session 2 Discussion Time Odd number: July. 21, 2018 13301430 Even number: July. 21, 2018 14401540 P-17 Rehabilitation of community dwelling elderly male with history of stroke Naoki Takashi : Gaps between the Needs of Patient, Family and Rehabilitation service providers Kyoto University, School “” of Public Health, Department of Global Health and Socio-epidemiology P-18 the possibility of cognitive improvement in severe dementia Hiroyuki Tanaka Osaka Prefecture University P-19 Early dementia occupational therapy in psychiatric hospital Kyoko Amano Hikarinooka Hospital P-20 Occupational therapy for patient who desired to initiate supporting professional baseball Daisuke Ban again: Sugino Neurosurgery Use of a MOHO with a MTDLP Hospital -MOHOMTDLP - P-21 Small group occupational therapy in day care: Two cases showing different emotional Haruna Ogawa changes by activities based on life history Nishiyamato rehabilitation hospital 2 P-22 Utility of the reasoning sheet as an assistive interview tool for realizing meaningful Haruna Fujimoto occupation IMS group Clover no sato P-23 Improvement of Occupational Dysfunction Satoshi Takahashi Case report Focusing on Occupational Form and Advocation Teshigawara Internal Medicine Clinic P-24 Pool Activity Level helps patient with dementia regain participation in occupations in Misato Osakabe subacute rehabilitation hospital IMS group IMS Itabashi Rehabilitation Hospital P-25 Challenge to Invite His Eyes to the Reality and to the Future Satomi Sato Sen-Enn General Hospital, Medical Corporation Houjukai P-26 Comparison of occupational dysfunction, recovery and difficulty in daily life in inpatients Aki Watanabe and community-dwelling clients with mental disorders Kitasato University P-27 The improvement of occupational dysfunction and social functioning through NEAR Taichi Matsuoka NEAR Fukui Memorial Hospital P-28 Psychiatric hospitalization occupational therapy for acquisition of adaptive behaviors in a Hiroaki Sakuma woman with Down syndrome who became unresponsive to intervention Sankei Hospital P-29 Outcomes of Transitional Working Skills Program: A Pilot Study in a context of Coffee MUTTIKA Shop at Somdet Chaopraya Institute of Psychiatry CHANAMONTREE ONGART CHIANGKAG P-30 Research on actual employment support in psychiatric medical institutions Takayuki Hagawa ~ Comparison between psychiatric hospital and psychiatric clinic in A prefecture ~ Koriyama Institute of Health Sciences A P-31 Building Process of OBP focused Rehabilitation Team Nozomu Shiraki Medical Corporation Naranomori Izum-chuo Minami Ohisama Visiting Nursing Station P-32 The use of the pamphlet for clients’ understanding and acceptance of occupation-based Shigenori Narushima interventions Tsukuba Memorial Hospital P-33 Importance of occupational resumption in the family’s cooperation Riho Hosokawa Support based on the angle of occupational dysfunction of the family Medical corporation Syouyoukai Takikawa Neurosurgical Hospital P-34 A case in which the importance of family is reminded through the process of reinstatement Yuno Kasuga Toyama Prefectural Rehabilitation Hospital and Support Center for Children with Disabilities

Poster session 3 Discussion Time Odd number: July. 22, 2018 9301030 Even number: July. 22, 2018 10401140 P-35 A terminally ill cancer patients with adjustment disorder who relieved pain and improved Miyu Imizu QOL owing to the meaningful occupation. International University of QOL Health and Welfare Mita Hospital P-36 Visiting school-based occupational therapy in Japan Chiho Nakama Child support center Yuimawaru P-37 Practice of occupational therapy for people with severe aphasia in the convalescence Rie Ito stroke- Interview evaluation using Paper version ADOC- Itami Kousei Neurosurgical Hospital ―Paper ADOC Nishinomiya Kyoritsu Rehabilitation Hospital P-38 Comparison of the Perceptions of Occupational Therapists and Clients regarding Goals Yuki Saito and the Goal Setting Process Sendai Seiyo Gakuin Collage P-39 Occupational therapist 's way of working in Support for transition to employment - Atsushi Hagihara focusing on support for higher brain dysfunction - CROSS JOB Abeno P-40 Meaning of bathing of clients after discharge of recovery rehabilitation unit. Minako Shirai Saiseikai Otaru Hospital P-41 A case in which i intervened for the goal to reduce the mental burden of caregivers Ayaka Yamamoto Higasi Osaka hospital

P-42 An aphasic patient with improved volitional expression and enhanced occupation Ei Sugimoto motivation Okhotsk kai hospital P-43 A client got back a motivated life through sharing the time to brew coffee Tetsuya Kumata with an occupational therapist Kobe rehabilitation hospital P-44 About cases that promoted understanding of the present situation through practical Yuki Aoyagi cooking training Kitahara Rehabilitation ~Aiming to acquire role in household~ Hospital P-45 A case who felt a sense of loss taking photos was improved. Naoki Kuwajima Seikeikai Secomedic Hospital P-46 A case in which the use frequency and efficiency of paralyzed upper limb in ADL Tsutomu Kodama improved by applying Transfer package Merry Hospital Transfer package P-47 A report of occupation based practice from early hospitalization in rehabilitation Sachihiko Nakayama Heisei Hospital COPM AMPS P-48 Turning point between changing hospital and discharge Koyuki Yoshimura in acute phase brain disease Teine Keijinkai Hospital What should the occupational therapist provide?

OT P-49 Is group activity necessary for occupational therapy in Rehabilitation specialized ward? Megumi Sato From the result of questionnaire of occupational therapists. Shintotsuka Hospital P-50 Goal setting by ADOC-H made possible a change in consciousness to rehabilitation of Yuri Hirano upper limb paralysis: a case report SHNTOTSUKA hospital ADOC-H P-51 Case of the inclusion Body Myositis that led to the introduction of the self-help tools by Natsuki Inoue shared volition Saiseikai Higashikanagawa Rehabilitation Hospital P-52 Practice of occupational therapy based on value for distal radial bone fracture case wishing Ryota Kimura to return to work Isogo Central Hospital P-53 Examination of Occupational therapy for patients with acute stroke through a factor Jun Nakayama analysis study KANSAI UNIVERSITY OT OF WELFARE SCIENCES

Poster session 4 Discussion Time Odd number: July. 22, 2018 9301030 Even number: July. 22, 2018 10401140 P-54 The process by which a woman with extremely pessimistic thinking regained her sense of Naoaki Sakata self Shin-Kaminokawa Hospital P-55 Support for role reacquisition Takeyoshi Nakano ~ Cases supporting AMPS and ADOC along the Oumi recovery occupational therapy Oumi Onsen Hospital pass~ AMPS,ADOC P-56 A case of implementing COPM and AMPS before and after surgery for brain tumor in Michika Hirota addition to functional evaluation Department of COPM AMPS rehabilitation,Tokai university hospital P-57 The impact of NEURO-15 on performance skills in the chronic phase of stroke Shingo Yamane NEURO-15 Hiroshima University P-58 Effects of task-oriented practice aiming at re-acquisition of toileting ability and reflection Mika Takanami in a convalescent stroke patient Saiseikai Otaru hospital - Verification using single case design - P-59 Benefits of combined evaluation of the assessment of motor and process skills with blood Takuya Hirose oxygen saturation measures in patients with respiratory disease: a case study Department of AMPS ｢ rehabilitation, Tokai university hospital P-60 The case that occupation-based practice in acute phase was effective for achieving goals. Yuji Tashiro southern TOHOKU General Hospital P-61 A case study of resuming a braille translation through intervention with occupational based Mana Fujita practice Saiseikai Higashikanagawa Rehabilitation Hospital P-62 Allen Cognitive Level Screen-5: A Client Reacquires Her Family Role Ryosuke Watanabe Allen -5 IMS group IMS Itabashi Rehabilitation Hospital

P-63 A case of promoted self-recognition through occupation spreading to life Emi Inoue Visiting Nursing Station A WAZAKEA P-64 Severe ataxia symptoms caused by Miller Fisher syndrome Kaihou Tomori Shin-Kaminokawa Hospital

P-65 Process of achieving control on occupational balance: A single case interview Takashi Koyama ̶̶1 Ichihara Hospital P-66 Devices of Reasoning sheet to Understand the Value of the Client Chinatsu Horiki From "for myself" to "for my family" IMS group IMS Itabashi CL Rehabilitation Hospital P-67 "I want to start a kitchen garden." Jun Yagai The case of a new occupation realized through MTDLP Ichihara Hospital MTDLP P-68 I want to be myself Saki Nagamine Support those facing obstacles in various types of jobs. Oohamadaiichi hospital P-69 Reacquiring the role as a father through the experiences helping his daughter: a case study Katsuhide Masaki Saiseikai Higashikanagawa Rehabilitation Hospital P-70 A Case Report on Improving IADL Independence through Place-making Takuya Ojimo IADL Nishi-Hiroshima Rehabilitation Hospital Poster sessionNo. P-1 MSscON July. 21, 2018 13301430 ce Child and Adolescents A case of elementary school students who used CAOD and found important occupation in school life ” Shoya Kato1), Tomoe Takeda2) 1) Furano Kyokai Hospital ” 2) Child development support business · Day service, such as after school Doremi Key words: CAOD,Autistic spectrum disorder,Elementary school student . + ± Classification and Assessment of Occupational Dysfunction ±+ (CAOD) is a tool developed by Mutsumi Teraoka (2015). CAOD . consists of 16 items of questionnaires and answers in 7 stages of 1 ±' (not applicable) to 7 (applicable). The higher the score, the worse the Occupational Dysfunction, the cut off is said to be 52 points. ± This time, we used an interview using CAOD for Mr. A, a fifth grade elementary school student of our outpatient occupational ,(+1 -(+ therapy prescription at our hospital. On occupational therapy 2(+ +-(-+ 0)(+ intervention day, under the mother's room, the therapist conducted ±”3- a CAOD from the therapist to the mother and mother in question ”±± form. As a result, the presence or absence of work function impairment ± was clarified, and the task considered as important by Mr. A was ± clarified, so the progress is summarized and reported below. ±± - ±. 1(+1 1(+ -(+ +0(-+ .0(+ ±” 3,”± ” +). Poster sessionNo. P-2 eO July. 21, 2018 14401540 Child and Adolescents A case in which maternal and child's occupation performance improved with a mother–child double system combined with occupation science Naoki Yoshida 1) 1)FUNABASHI FUTAWA HOSPITAL ⑤TTdRcZ⑥ Key words: mother–child double system.occupation science.development [OBJECTIVES] Parental problems may influence child development. I used a mother–child double system based on the model of human , , occupation for a mother who is not good at communicating with others. I report occupation performance improvement of the , mother and child. This report gained consent from them, by the

Kangmi Choi1), Minkyung Hong1), Ah-Ram Kim1), Jung-Ran Kim2) 1) Dept. of Occupational Therapy, Graduate School, Yonsei University 2) Dept. of Occupational Therapy, College of Health Science, Yonsei University

Key words: Task-based approach, Cerebral palsy, CO-OP

Objective: The purpose of this study was to investigate the effect of CO-OP intervention on the quality of tasks performance, occupational performance and satisfaction, and improvement of motor and process skills for children with CP by using CO-OP. This study tried to find out if the learned skills were generalized to other tasks. Methods: The subject is a children aged 7 years old who were diagnosed with CP and applied the design as ABA which is a single subject experimental research design. The baseline period consisted of 2 sessions until the data stabilized, 10 sessions during the intervention period and two sessions were conducted in the same period as the baseline period. Three tasks were selected to validate occupational performance improvement, two of which were trained by the CO-OP approach and one was not trained to assess the generalization effect. In order to examine the quality of the school-based task performance and the changes in the performance skills, PQRS, COPM, AMPS. Result: The PQRS score change was improved during the intervention period compared to baseline in both the two tasks trained by the CO-OP approach and one in the untrained task, and was maintained during the early recall period. The COPM performance and satisfaction before and after the CO-OP intervention was improved by two or more points in three tasks and showed a clinically useful improvement. In the AMPS, the treatment technique showed a significant improvement from -0.1 to 0.5. Conclusion: The CO-OP intervention proved to be an effective intervention method to improve the school-based task performance of children with cerebral palsy, and it was confirmed that generalization and transition can be achieved as untrained tasks through strategy learning of problem solving. Poster sessionNo. P-7 July. 21, 2018 13301430 Community Service The Effect of Teacher's Understanding about Student's Functional Level in Collaboration

Kangmi Choi1), Seokyeon, Ji2) 1) Dept. of Occupational Therapy, Graduate School, Yonsei University 2) SISO

Key words: Collaboration, School based OT, Pediatric OT

The client is a 14-year-old male student at a special school who is diagnosed with an intellectual disability. Student is difficulties in using tools and participating in class. After observing Teacher's Day Memorial letter and computer typing activities, we analyzed PEO Model. In letter writing activities, the student left after less than five minutes of sitting in class, moderate inefficiency and moderate physical effort increased. In the computer typing activities, the students refused the teacher's instructional goals and looked for the videos they wanted to watch, but the physical inefficiency and hardness of the severity increased. When analyzed by PEO model, the teacher's motivation and function level were not understood and the participation of students was decreased. The goal is, first, to make a repertoire of activities by making simple works using various tools every morning. Second, the difficulty of the class is adjusted to the student. Third, provide the role of the class to students. Students can search and run photos and videos, and use their strengths to share class time material with friends. The teacher's understanding of the student's level of functioning had the effect of expanding the student's two occupational areas. Through collaboration, the teacher adjusted the difficulty of the class, changed the parish used, and created an environment in which students could participate. The student spent more time using the tool, and the time and frequency of sitting in class increased. In case, the expert on human dynamic activities in school is an occupational therapist, and we can confirm that the occupational therapist can develop further as an expert in school. Poster sessionNo. P-8 DeEOs July. 21, 2018 14401540 e Community Service e Spreading local transportation through “BEE CARE’S automobile driving support plan” ~From an occupational science point of view~ %FDA Tasuku Nagashima1), Yoshio Fujita 2) % 1) BEE CARE visit nursing rehabilitation station ' 2) Chiba prefectural university of health sciences +)0 ) ' Key words: automobile driving support,community mobility suppot,occupational %”‐Ⅵ‐% science ' % There are only very few facilities that are implementing efforts to ' support driving vehicles in the visiting rehabilitation field, in order % to broaden the clients desire to improve “the quality of life” %% during life stages and expand their width of everyday life.From ' October 2017, our office commenced “BEE CARE’S automobile ―% driving support plan “ as an approaching initiative.The features of ' this service firstly, is to be able to conduct evaluation of physical ― function checks, neuropsychological examinations, along with % interviews and other information all collected at the clients %% home.Secondly, using the combination of nursing care insurance %'③ and medical treatment at one's own expense including actual ”±%③ implementation training at the driving school together making it % possible to conduct detailed evaluation.Further more, if the result ' of the evaluation turns out negative, considering the clients %”%% meaning of the occupation to drive and also from the viewpoint of ' occupational science, we can innovate an inclusive transportation ' support by using compensation measures and local resourses.We will report the outline and our future prospects about this service +)0')3'+)03 while exchanging the contents of activities until today. '+)1'3 '+)13 %③' ”±% ' % +)/'6DI6 9aZeZX 8]]dZch BSZZch ' % '”% ”%% ' Poster sessionNo. P-9 Srl July. 21, 2018 13301430 ee Community Service Efforts toward establishment of total life support center Ⅲ C⑤⑥ –Needs survey of working environment of victims using text +)+ mining analysis– ± ' Shingo Inoue1), Hideaki Ito1), Narumi Morohoshi1), Shinpei Suzuki1) 1) Medical Corporation KNI ”⑤⑥ Key words: town development, needs survey, text mining analysis ③ We (Medical Corporation KNI) are planning to build the facility ± in afflicted district that suffered huge damage caused by a major ± earthquake. The role of this facility is to solve the problems such as the declining population, the declining birthrate, employment, ±‐' medical care and education. The aim of this study was to consider the new style of facility (future medical treatment) that optimized ⑤⑥ for the area contain the perspective of occupational therapy which the community and life through analyzing the needs of the victims. This survey was a sub study as to think about future ” medical treatment. We used the street interview format, and its data was analyzed using a text mining method. ' 1/ , As a result, it turned out that the residents demanded a useful -, + ± supermarket, and they wanted places like the cafe could interact, ⑤ .- ⑥⑤,, ⑥ and that diverse needs existed. It seems that the regional ⑤, ⑥⑤+ ⑥ characteristics of this district historically have strong community ties and influences the diversity of residents' lifestyles. In other ±± words, we believe that facilities need to function efficiently as + /.④ existence having diversity and versatility. It is to participate in ' nurturing cultural and social activities of residents. In the future, ± we will conduct ongoing investigations and plan to carry out reasoning for the needs. We will work toward realization of future medical care optimized for this area. Ⅲ ” ”± ±' Poster sessionNo. P-10 MSseNle July. 21, 2018 14401540 Community Service Risk factors for falls in terms of attention during gait in ③ 1+ elderly residents living in the community ”‐ ” Tadatoshi Inoue1), Kenji Kamijo2), Kenzo Haraguchi1), Akihiro ”” + Suzuki3), Misako Noto4), Takashi Nakamura5) 1) Graduate School, International University of Health and Welfare, Tokyo, Japan 2) Graduate School of Health and Welfare Science, Nishikyushu University, Saga, Japan, 3) Department of Mechanical Engineering, National Institute of Technology, Ichinoseki College, Ichinoseki, Japan 4) Faculty of Health and Welfare, Seinan Jo Gakuin University, Fukuoka, Japan 5) Faculty of Education, University of Teacher Education, Fukuoka, Japan Key words: attention, eye movements, falls Ⅰ③Ⅰ ③ Aim: This study aimed to examine the factors related to ”± functioning and falls, including eye movements and gait ” variability, in 82 elderly residents (21 men, 61 women, average ± age 76.1 years) living in the community in Japan. Methods: We measured eye movements and gait variability during walking, and cognitive, attentional, and life function. We compared two groups according to their fall history and used multiple logistic regression analysis to determine its relevance. Results: The fixation time and number of fixations that were estimated from eye movements during obstacle crossing, and gait variability, were significantly associated with falls. There was also a significant correlation between the fixation time and gait variability during obstacle crossing. In other words, the higher the gate variability in the elderly people, the higher the risk of falls, which was due to an increase in the fixation time and number of fixations on the visual field during the obstacle crossing that required obstacle avoidance. Conclusions: These results show that poor attention during gait is an important risk factor for falls in elderly residents living in the community. For fall prevention, it is necessary to promote exercises for attention and to maintain an elderly friendly pedestrian environment. Poster sessionNo. P-11 MSseee July. 21, 2018 13301430 Community Service Therapists’ difficulties in enabling occupation in visiting occupational therapy Nana Hashimoto1), Sawako, Saito2) 1) Keyaki Total Clinic 2) Ibaraki Prefectural University of Health Sciences Key words: home visit; qualitative research; participation ± 2 [Purpose] The purpose of this study was to understand therapists’ difficulties in enabling occupations in visiting occupational therapy services ⑤ /2-⑥ [Method] Nine semi-structured interviews with experienced occupational therapists on visiting occupational therapy services were implemented The interviews were audio-recorded transcribed and coded ± [Results] There were four phases in enabling occupations: “acceptance of rehabilitation service ” “sharing goals ” ± “struggling to achieve ” and ”becoming a part of the client’s daily occupation” The therapists faced different difficulties in each ± phase Twelve categories were extracted: “cannot obtain consent P to initiate the service ” “big hurdle in enabling the occupation the QPQ client wanted to do ” “client expecting other professionals’ PQP” services ” “cannot identify occupational goals ” “client’s QPQPQ wishes ” “cannot acquire necessary efforts from the client ” PQ±± “lack of occupational therapists’ abilities ” “lack of available resources ” “supporter's opinions ” “client’s insufficient physical PQ and mental capacities ” “cannot identify reasons why the client P does not engage ” and “cannot identify next support service” QPQ More difficulties were raised for the therapists when gaps existed PQ between the client’s expectations for occupational therapy services and the services provided by the occupational therapist PQ [Conclusions] This study will help occupational therapists who provide visiting occupational therapy services to use methods to prevent facing difficulties in enabling occupations ± Poster sessionNo. P-12 TNase July. 21, 2018 14401540 eN Community Service The Form of Role Required for Occupational Therapist - Report on Regional Rehabilitation Project - +)+. satomi munakata1), Yuki Saito 2) ± +2 1) General foundation Ota comprehensive Hospital affiliated Ota Nishinouchi Hospital 2) Sendai Seiyo Gakuin Collage DI Key words: Region Visit Role 8D ± Introduction ― The main object of this report is an introduction of the project and a case report. Currently, it is urgent to construct 'comprehensive ±69A 69A regional care'. Through participation in this project, I learned the necessary abilities for occupational therapists. + What is Regional Comprehensive Care? For the care recipients and the subjects in need of ADL support, ++ the administration is the subject, the rehabilitation staff conducts . regular visit guidance. All information is shared in many occupations. 0) 6 Case report 69A The Client is a 70 year - old woman. Diagnosis name is spinal ± canal stenosis and hypertension. ADL and housework are Ⅲ”DI independent. However, she has gonalgia and limb numbness. Her 6 ± husband is repressive to her. she was inactive and lacking 6 ① opportunities for social participation. Occupational therapists prescribed environmental adjustment to prevent falls, gymnastics to maintain physical strength, continuation of housework. And IK occupational therapist explained these necessities to her husband 6 and multi-occupation, and shared information. In addition, regular DI officials visited and decided to relieve stress by becoming a 6 partner with her. In the reevaluation, she increased the opportunity to go out and the satisfaction level improved. Conclusion As compared with the past, occupational therapists are required to ” 6 have instant effective target education and guidance skills for other occupations so that intermittent support can contribute to the client. ± Poster sessionNo. P-13 erc July. 21, 2018 13301430 Geriatric Care Change to a positive life by flower gardening: A case study %⑤3BD=D⑥%6 '%6 Masaki Matsumoto1), Kousuke Tamura1), '% 1) Ikigainomachi day-service misato ±%%' Key words: MOHOOccupation Day service 1)''+% '%'B [Case Study] 0+ '% A woman in her 80s, needed carelevel3. Her FIM score is72. Her ±%'%% whole body condition is unstable because of pressure sores. %±' Furthermore, we received an agreement from her, her family ⑤ announcement. DH6u⑥ [Occupational Self Assessment,version2 (Revised edition DH6u . following: OSA II)] ±%±' There were five problem items on her OSAII, At a % non-constitutive interview, we heard many pessimistic remarks, ' for example, “I would like to try but I can’t”. We had a chance to %% talk about what she liked to do before she was ill, she said, ' “watering was my responsibility. I always got strength from ⑤M - +) M / +) ⑥ gardening”. %'6 [Progress and Reassessment] (April 20, XXXX – June 20, XXXX) '+ %% We put her into the watering the flowers position on her first day '6 % of intervention. She watered the flowers and talked to them that ' “You look so beautiful today”. the second week, she moved %' herself watered the flowers. After she pressure sores got better. 2 + 'DH6u% months pass. OSAII is put into effect once again. “there is a %'±% satisfactory routine”, it showed that the practice level and %Ⅰ% satisfaction level improved, but on the other hand, “I have to go to % a place where I should go”, changed from good to a little ±' B 0/ difficulty. Ⅰ [Consideration] We determined that after we put she into gardening work, using ”③ this Model of Human occupation, her realized that doing the ±⑤%+))0⑥' gardening work reacquired her role as a hobbyist and reinforced %BD=D 6 personal cause attribution. At re-interview she said, “I would like %6 % to go home as well”. As a result, we determined that her ' occupation and sharing her experience stories based on the OSA 6 ' II, woke up the hope deep inside of her. DH6u 6 % ' Poster sessionNo. P-14 seNe July. 21, 2018 14401540 Geriatric Care Basic Opinion for Clients with Dementia Occupational 1) Therapy Intervention from Maslow’s Hierarchy of Needs BRbf Kazuhiko Nagae1), Yuno Kasuga1), Shizuyo Kyouzuka1) 1) Toyama Prefecture Rehabilitation Hospital · Child Support Center Ⅰ 8D ± Key words: dementia +, The client was a woman in her late 80s who had M dementia. Based on Maslow’s Hierarchy of Needs, as a result of N O intervention, the time to spend peace of mind and happiness O/ BBH: 2 increased, so we will report on some considerations. We have ± obtained consent on the announcement and there are no B -) companies in the COI relationship that should be disclosed in ± relation to the presentation. Before being hospitalized, she stayed in bed and there was no exchange with other than family members. ' X year +' Y month Z day Tearing down at home and injuries, the next day ”,' bipolar Hip Arthroplasty was performed. MMSE was 19 points. There was no exchange between her and the other person. , To stay safe and to voluntarily interact with other patients and staff. Approach 1) + ⑤⑥ Input of place, 2) Creation of opportunities for exchange with B /) , other patients and staff. ± After 1 month: She had stayed away from the bed. A smile appeared in the interaction involving staff and other patients in a caught manner.Two and a half months later: She started BRbf talking to staff and other patients. ③ Maslow says that when desperation for higher order is deprived and threatened, it tries to satisfy low desire. She also saw an action to satisfy the safety desire. Therefore, I believe that it has brought psychological stabilization by raising the satisfaction of safety desire and raising it to belonging desire stage. Poster sessionNo. P-15 TaO July. 21, 2018 13301430 O Geriatric Care A case where the expansion of occupation was seen by having intervened in both the client and the primary caregiver Hiromu Osada1), Shingo Harada1) 1) Day service Tsumugi 6 1) ⑭ -+ ” Key words: expansion of occupation /) During this time, we were in charge of Ms. A. Although she had the ability to carry out her occupational activities, she had not yet ±M taken action toward her goal, as set by herself on completion of Aid for Decision-making in Occupation Choice (ADOC). We supposed that one of the reasons she did not act was that Ms. A’s daughter, her primary caregiver, acted as an inhibitory factor in Ms. A’s occupation choice and occupational performance. We focused on the relatively easy ADOC activity of making bean 69D8 bags in our intervention with both Ms. A and her daughter. We prompted Ms. A to join our teaching staff in nursing service in ” the making of bean bags. To obtain her daughter’s consensus, we ± explained the situation to her and she agreed to cooperate with us. As a result, Ms. A began a new habit of making bean bags, and 6 she began working aggressively on the other ADOC goals. ± Moreover, she set some new goals. ± Then, we theorized that the interaction between Ms. A and her daughter was the circumstance that facilitated the making of bean ± bags, thus leading to a virtuous circle and expansion of occupation. 6 We learned that a primary caregiver (e.g., family member) may be an environmental factor impacting the occupational performance of a client; thus, it should be important to intervene with both the client and the caregiver. 69D8 6 6 6 ± Poster sessionNo. P-16 DUseEeN July. 21, 2018 14401540 cer Geriatric Care “I want to help my wife who is in end of life”: A case report. % Akari Ito1), Shingo Harada1) 6 ' 1) Day service Tsumugi, % ' Key words: CEQ,occupational alienation /) 'ⅢⅢ'++ A client is 60-years old man with stroke using day care and home - '% nursing service. He had enabled his customary occupation 'M %Ⅲ (cleaning by mop and walking), however he looked unsatisfied. 'M, Based on Comprehensive Environmental Questionnaire for the %%'% Elderly (CEQ), we found that client had become as Occupational '%- % alienation. Because his wife is in end of life with renal cancer and %% client wanted to help her, but client felt that he couldn't do ' anything for his wife due to his low physical and sense of %”' capability. We re-sought the occupation that is useful for his wife, and massaging the edema leg could be performed by client, and it ③ 8:F made wife happy. Then client started to practice new housework ' (washing of dishes), because the wife couldn't housework % partially. The client’s occupational alienation had been gradually ' 6 ± resolved. This case study suggested that occupational therapy should evaluate and provide the occupation based on interaction '%6 ±% among person-occupation-environment. ' %' % 6 '% %' '% 6 ±' 8:F±' '% ' % 6 % %% '%6 % %'% % ±' Poster sessionNo. P-17 eeA July. 21, 2018 13301430 MSsse Geriatric Care s Rehabilitation of community dwelling elderly male with history of stroke ⑤⑥ : Gaps between the Needs of Patient, Family and Rehabilitation service providers ± ± Naoki Takashi1), Patou Masika Musumari1), Teeranee Techasrivichien1), S. Pilar Sugimoto1), Masako Ono-Kihara2), Masahiro Kihara2) 1) Kyoto University, School of Public Health, Department of Global Health and Socio-epidemiology ③ 2) Kyoto University, School of Medicine Key words: Stroke, elderly, patient-provider communication ③ + → Background: ③⑤ It is critical to provide rehabilitation services that are sensitive ⑥ to the needs of patients. Previous studies found gaps between the needs of stroke patients and the rehabilitation service providers; however, no study to date, has explored the needs, perceptions and expectations related to rehabilitation within the triumvirate of 2 ⑤ 2 ) patient-family-and rehabilitation care provider in Japan. 2 . ⑥± Objective: &&& To explore the needs, attitude, and experiences regarding , rehabilitation services from the patients, families and providers’ perspectives, in order to detect potential gaps, and reasons of these gaps. Methods: ± This is a qualitative study. We used purposive sampling to recruit male stoke patients along with a family member (caregiver) and rehabilitation service provider (care-manager, Ⅰ rehabilitation therapist) to constitute a “set”. All interviews were audio recorded, transcribed, and coded. Data were analyzed using ± thematic analysis with each "set" as the unit of analysis. Results: 9 sets were analyzed. We have identified gaps in needs, ± perceptions and expectations between 1) “patient and caregivers”, 2) “patient and providers”, and 3) “caregivers and providers”. The gaps were mostly due to lack or ineffective communication. Patients felt uncomfortable to express their feelings due to emotional barriers likewise; caregivers felt it was difficult to understand patient’s emotion. The goal of the rehabilitation was not clearly explained to patients and caregivers. Conclusion: These gaps led to patient's perceived unmet needs as well as caregiver's, and negatively impacted the process of rehabilitation care. Addressing these causes of gaps is essential for a successful rehabilitation care for patients. Poster sessionNo. P-18 MSse July. 21, 2018 14401540 Geriatric Care % The possibility of cognitive improvement in severe dementia ”'% %”‐± 8XZcZeVcVbc Hiroyuki Tanaka1), Yuma Nagata2), Daiki Ishimaru2), Takashi WaHVeVaV9V]VcZR8IH9 Nishikawa2) ” %8IH9 BZZ]R 1) Osaka Prefecture University 9VcVTcRSV8YRXVB98- Ⅰ - 2) Imai Hospital '% - ‐%” Key words: severe dementia, cognitive function ' Ⅰ 38ZZTR9V]VcZRGRcZX, [Introduction] / %8IH9 + We developed the Cognitive Test for Severe Dementia (CTSD) -) 8IH9 B98 and assessed the change in CTSD scores between baseline and 1 - ' 31- year later in patients with severe dementia. We found four patients +31+ who had improved cognitive function above the minimal ,32/ 6iYVZ]Vab detectable change (4 points) of the CTSD. 9ZbVRbV%-310 Here, we report on the possibility of cognitive improvement in '% severe dementia by examining the common clinical features 1//'.l.+)'-3./&,0/' among these cases. 8IH9 % &- %%/% [Participant presentation] 0%-%- ±'%BZZ&BVcRHcRcV:gR]ZRcZ Participants: We extracted four participants with Clinical ' Dementia Rating (CDR) 3. Case 1 was an 84-year-old woman ' with vascular dementia (VaD) by thalamic hemorrhage. Case 2 - - was an 82-year-old man with VaD by cardiogenic embolism. % Case 3 was a 96-year-old woman with mixed dementia %+% (Alzheimer's disease with cerebrovascular disease). Finally, case 4 ,% was an 87-year-old woman with VaD by cerebral infarction. - - % We conducted baseline assessment at 866.5 ± 520.4 days after %' hospitalization. For the CTSD change in each case, the scores ‐%± were improved by 6, 7, 4, and 4 points for cases 1-4, respectively, while Mini-Mental State Examination (MMSE) scores were not changed. %”' [Result: common clinical features] % 8IH9 The common clinical features among the four cases are as ±' follows: 1) diagnosed as VaD caused by cerebrovascular disease, 2) continued prescription for vascular treatment, 3) increased frequency of getting out of bed and improved daytime activity level, and 4) improved feeding ability, except for case 4. [Discussion and conclusion] These results suggest that non-pharmacological rehabilitation in combination with pharmacological treatment to vascular treatment improves cognitive function even in severe dementia. Poster sessionNo. P-19 MSsNe July. 21, 2018 13301430 Geriatric Care Early dementia occupational therapy in psychiatric hospital Kyoko Amano1), Miho Kishigami1) 1) Hikarinooka Hospital Key words: Dementia, BPSD, early occupational 6 0) A lady in her 70s with Alzheimer-type dementia (described as + M&, ‘Mrs. A’ in the following).Conversation with her has not been able M& to establish gradually since 11 years ago. M&, =9H&G ) Due to the frequent sleep disturbance and wandering. M Occupational therapy was started from acute-phase isolation on the hospitalization day. 89G , ⑤ The expression is stiff. Mrs. A had kept complaining “quickly, 7EH9⑥979,,(.+ 69A quickly” one-sidedly, providing a strong sense of urgency. We estimated the timing at which Mrs. A can spend time gently by cooperating with a nurse. t As a result, we found that Mr. A can spend time gently at meals. In addition, we could obtain some more information from her family. DIG Mr. A used to pick her teeth with a toothpick looking into a hand Cb 6 mirror after meals. We asked the family to bring the hand mirror and the toothpick to which she was attached from their house. +)]X .]X Mrs. A used the hand mirror and the toothpick with a practiced . 0.]X hand. She was gentle at that time. u+ Sense of urgency has decreased around this time. ± It is important to establish the environment in which one can be ± relieved even under the situation of isolation. When vocabulary is limited like this patient, it's difficult to estimate intention. It is effective to introduce the work activity based on the patient’s own background into the occupational therapy at the early time by paying attention to the movement in which the patient can 89G69A 979, 1(.+ spend time gently and by obtaining information from the closest family as early as possible. ± ± Poster sessionNo. P-20 gePs July. 21, 2018 14401540 --2 e Geriatric Care Occupational therapy for patient who desired to initiate supporting professional baseball again: 0) Use of a MOHO with a MTDLP DIDI BI9AE Daisuke Ban1) DH6&u 1) Sugino Neurosurgery Hospital 0) ± Key words: role, MOHO, MTDLP M Case introduction . DI On date X, a woman (age, late 70s) who lived alone slipped on a GDB wet street while returning from supporting baseball, and -)k ,)k developed a humeral greater tuberosity fracture.(Open reduction BBI:UWVV 69A and internal fixation were performed) ; occupational therapy was ±BI9AE initiated on date X+5. DH6&u Evaluation and intervention plan The patient showed ROM with shoulder flexion and extension of M ° 6 40° and 30°, respectively; decreased muscle strength (MMT: 1); M GDB and problems in daily activities such as eating, applying make-up, ))k% 1)k%BBI ,°-%69A and bathing. Based on a MTDLP and OSA-II, the set target was 7RacYVZUVg )) GDBVg Vg the ability to support professional baseball again. Progression and results ⑭M/° GDB.)k%.)k On date X+21, less restriction of daily activities was noted. On BBI -°. date X+42, improvements in ROM and muscle strength were % found. On date X+84, the patient initiated supporting baseball ‐ again, and had sufficient shoulder ROM and 30-s muscular M+ ° ' endurance required to lift and lower an umbrella and use a ± .)k megaphone. Additionally, the patient's route comprising safely ,) leaving her home, riding the subway, and reaching the baseball ± ground was investigated. Furthermore, she could offer practical %‐ support to her companions at the baseball ground when moving items with decreased anxiety; she could fulfill her previous roles. ' Discussion 6 1) Supporting baseball matches was important for her; she ± participated 80 days/year, and the baseball ground was an :eVaRaU+))) Ⅲ ” important place for her to meet friends. Everard et al. (2000) ± reported that "social networks are predictive factors for functional Ⅲ health, and are closely linked to the ability to continue in an ±± occupation." Herein, the baseball ground associated with the patient’s social network as an important health focus. Poster sessionNo. P-21 MSs July. 21, 2018 13301430 QprcsO Geriatric Care Small group occupational therapy in day care: Two cases showing different emotional changes by activities based on Ⅵ” life history ⑤⑥ + Haruna Ogawa1), Kosuke Kojima1), Shintaro Fujii1), Takahiro Taguchi1), Yukari Nishioka1), Shinsuke Kitabeppu1) -. + 1) Nishiyamato rehabilitation hospital, . Key words: small group occupational therapy, day care, emotion FDA Ⅰ E<8 ⑤ E<8⑥ Introduction: In our day care, we introduce small group E6C6H occupational therapy based on the life history of the patients. We ⑤E6⑥ ⑤ report two cases who showed different emotional changes in C6⑥ , small group activity of calligraphy. 6 . Methods: Five patients who showed an interest in the same + 2) activity by interview were selected. We assessed observation record during the activity, subjective measure of emotion and ±7 , interview. The subjective measures of emotion included positive 1) affect (PA) and negative affect (NA) of PANAS. Participants: Case A is a woman in her 90s and she liked writing. She was anxious about calligraphy but had a positive feeling to try. Case B was a woman in her 80s who had a personal relationship 6 with neighbors through a classroom of calligraphy. But she could ± not return to the classroom after injury. E6 2z/ + Result: In case A, both PA and NA increased. She was praised by +z. C6 2z) + .z0 other group members and had a relieved expression, “At first, I C6 + was embarrassed to participate, but I feel happy with writing." In case B, PA decreased and NA increased. She complained about 7 ± the pain of her hand frequently during calligraphy and said, "I E6 could not write a letter as I thought." z- + 0z. Consideration: About the positive change in case A, it seemed that C6 ,z, + 1z) she got to be proud of herself through an objective view on the other members. On the other hand, cases with high expectations E<8 + for activities such as case B, it may be difficult to improve 6 self-efficacy and get benefits from group activity. 7 ± Poster sessionNo. P-22 ce July. 21, 2018 14401540 ee Geriatric Care e Utility of the reasoning sheet as an assistive interview tool for realizing meaningful occupation ― Haruna Fujimoto1), Kanta OHNO2), Kaori KOIZUMI 2) CVVU 1) IMS group Clover no sato 2)IMS group IMS Itabashi Rehabilitation Hospital Key words: reasoning sheet, dementia, meaningful occupation INTRODUCTION Patients with cognitive dementia can experience difficulty in expressing their detailed needs through semi-structured interviews 6 1) 69A such as the Canadian Occupational Performance Measure 69A (COPM). We developed a “reasoning sheet” as an assistive B.)(+/ BBH:/(,) 8DEB interview tool for better examining a client’s value relating to 69A occupation. In this case report, we describe the successful use of CVVU the “reasoning sheet” in a patient with cognitive dementia. CLIENT The client was an 88-year-old woman with chronic subdural hematoma. The FIM and MMSE scores were 50/126 and 16/30, respectively. On admission, she expressed a desire to achieve 6 “autonomy in activities of daily living” through COPM; however, ” they were unable to explore the client’s hopes regarding more meaningful life activities. INTERVENTION PROCESS The occupational therapist (OT) interviewed the client using the “reasoning sheet” and wrote the client’s life story from childhood until the present day on the “reasoning sheet.” As a result of 69A 6 questions included in the “reasoning sheet,” the OT identified the ” client’s desire to maintain a harmonious relationship with her 6 family. The client sought to contribute to the family by cooking. CVVU Thereafter, the client’s OT rehabilitation goals addressed both activities of daily living and cooking skills. The client expressed agreement with these goals. . RESULT The client ultimately left the hospital and entered a nursing home. The OT sent the “reasoning sheet” with her to the nursing home. She could cook with family. CONCLUSION Use of the “reasoning sheet” enables the clinician to systematically visualize the client’s life history and meaning ascribed to his or her occupation. The findings from this case suggest that the “reasoning sheet” is a useful tool for setting rehabilitation goals. ±Ⅰ Poster sessionNo. P-23 MpgeprcO July. 21, 2018 13301430 aP Geriatric Care Improvement of Occupational Dysfunction Case report Focusing on Occupational Form and Advocation 8A 8A Satoshi Takahashi1), Yuki Saito 2) 1) Teshigawara Internal Medicine Clinic ± 8A 2) Sendai Seiyo Gakuin Collage Key words: Occupational Deprivation, Occupation Form Advocation Introduction 0) People exhibit occupational dysfunctions for various reasons. In this report, an occupational therapist explains enabling occupation by altering occupation form and advocate to family members. client and method ⑥ 8DEB ~ A-70-year-old-man with Cervical myelopathy. After surgery, the symptoms improved. However, during training at home it over +⑥ ‐ BBI ,°- BBH:3+2 B stretches the neck and became reoperation. After that, use of this )0 01 +2 Elderly Citizens' Day Service Center began. He lives with his 8A ” wife.He hoped to resume fishing and resume housework for his wife. MMT: 3-4. There is no problem with cognitive function. FIM: 107 points ( motor 78, cognitive 29 ). There is a ” 8A hypoesthesia and instability gait. Family and care manager were ” restricting activities to prevent his injuries. 8A Factors obstructing client performance are functional impairment and occupational deprivation. Therefore, in order to realize the enabling occupation, it is necessary to improve the skill. It is also necessary for families and care managers to understand that the client performs meaningful occupation . The occupational therapist consulted with the client and ~ decided to change the occupation form. As a result of practicing in a new occupation form to achieve fishing and housework performance. After that, occupational therapist advocated the client and care manager that the client is ready for fishing and ± housework and that the client wishes to resume it . Currently the 8A client continues home life while fishing and doing housework. Conclusion 8A explored the form of a new occupational this time. In addition , Occupational Therapists were Able To Regain Valuable Work By Expressing Speech And Evidence To Client Families. 8A 8A ” 8A 8A Poster sessionNo. P-24 eIsaIs July. 21, 2018 14401540 aP Geriatric Care Pool Activity Level helps patient with dementia regain ⑤E6A⑥ participation in occupations in subacute rehabilitation hospital ±± ‐E6A Misato Osakabe1), Kanta Ohno2), Ryousuke Watanabe1), Haruka ± Kurokawa1), Yumie Asaba1) E6A 1) IMS group IMS Itabashi Rehabilitation Hospital ± 2) Tokyo University of Technology school of Health Sciences Department of Occupational Therapy E6A 6 1) Key words: Alzheimer's type dementia, meaningful occupation, Pool Activity Level B0(+/ ⑤ .+(2 2(,. ⑥BBH:30(,)' INTRODUCTION Pool Activity Level (PAL) checklist guides the selection of E6A CE&C=.1(-- appropriate, personally meaningful activities. PAL was translated ⑤ 1(/)⑥ into Japanese, but only few reports of its use exist in Japan. Here we describe the case of PAL use in a Japanese subacute E6A ± rehabilitation unit. CLIENT An 86-year-old woman with acute subdural hematoma had behavioral and psychological symptoms of dementia (BPSD); she CE&C=-(-- was delusion of theft and wandering upon admission. Her ⑤ .(/)⑥ functional independence measure (FIM) score was 72/126, mini E6A ±69D8 6 mental state examination (MMSE) score was 17/30, and Ⅱ neuropsychiatric inventory /nursing home version score 69D8 (NPI-NH) was 58/144. PAL APPLICATION (stage I) We used PAL to reduce BPSD and found an “Exploratory activity level” representing an “Able to perform familiar activities in 1,(+/ ⑤ .2(2 +-(,. ⑥ familiar surroundings” with the precaution that “If >2–3 stages, BBH:3+)(,)'CE&C=(-- ⑤ -(/)⑥ will require activity to be broken into manageable chunks.” We encouraged the patient to participate in regular activities with constant conditions (i.e., time, number of participants). One E6A month later, her NPI-NH score was 14/144. PAL APPLICATION (stage II) The occupational therapist (OT) intervened to identify meaningful ±Ⅰ occupations for the patient. She expressed her love for make-up. The care team and the patient’s daughter shared PAL results; OT asked her daughter to bring her favorite lipstick. We adjusted the patient’s environment to allow her to independently apply make-up. RESULTS The patient independently applied make-up every morning. Scores were FIM: 83/126, MMSE: 20/30, and NPI-NH: 11/144. CONCLUSION Our findings suggest PAL for the implementation of occupational therapy to reduce BPSD. Poster sessionNo. P-25 DEDTNESserl July. 21, 2018 13301430 Mental Health Challenge to Invite His Eyes to the Reality and to the Future Satomi Sato1) 1) Sen-Enn General Hospital, Medical Corporation Houjukai, ± Key words: bedridden, interview, behavior change Introduction: 0) ± The client had difficulty in living alone, and finally became -) bedridden. I report how he recovered and became positive - through sharing his context and values. Outline: ±― The client was 70 years old man. The left side of his body was paralyzed for poliomyelitis. He has teaching experiences but after ”69A B-) his retirement, he shut up at home, became difficult in walking and had to creep about. Finally, he was hospitalized for bedsores. Interview and Recovery Process: DI At first, he was pessimistic and skeptical of Occupational Therapy. DI As I continued the interview and reviewed his context together, he gradually showed his will to take care of himself and also to go shopping. However, he was still ambivalent. First we aimed at self-supported diet and wheel him out for longer time. I also respected his pride and career so that he can be more spontaneous. ” DI At last, he started to show his desire to pass urine by himself. Then we set an objective to do that with urinal. Result: DI We were not able to achieve the objective, but incontinence was dramatically decreased. He achieved self-supported diet and found more purposes to leave his bed and often wheel himself out for enjoying shopping. He started seek fun for the life after ⑤ ⑥ leaving the hospital. Assessment: . . He became to accept the reality and see the future by reviewing and sharing his life and values. I assume he is now more B-1 ” confident with sense of accomplishments and improved his skill and physical strength. ' Poster sessionNo. P-26 MpgMSse July. 21, 2018 14401540 eUe Mental Health Comparison of occupational dysfunction, recovery and difficulty in daily life in inpatients and community-dwelling Ⅵ clients with mental disorders ” ± Aki Watanabe1), Takayuki Kawaguchi1), Mai Sakimoto2) 1) Kitasato University Ⅵ 2) Link Yokohama Home-visit Nursing Station ± 86D9 86D9 86D9 Key words: mental disorders occupational dysfunction G6HL=D96H+')]<6 ± ” Introduction This study aimed to clarify differences in recovery and difficulty in daily life due to high or low occupational dysfunction in .. ⑤ +1 +0 ⑥ 0- ⑤ inpatients and community-dwelling clients with mental disorders. ,0 ,0 ⑥±+ Methods ③ ]<6& The participants were inpatients and community-dwelling clients ③G6H L=D96H+') with mental disorders. To compare the difference between Ⅲ]<6 H ± inpatients and clients in the community, the participants were divided into two groups (high group and low groupbased on average CAOD scores according to each participant's living Ⅵ” environment. Evaluation instruments included the CAOD, RAS, ±Ⅰ WHODAS 2.0, and mGAF. The analysis compared the scores of each evaluation instrument for the two groups classified by living environment. This study was approved by the ethics committee of our institution. Result The participants comprised 55 inpatients (high group: n=28, low group: n=27) and 74 community-dwelling clients (high group: n=37, low group n=37). In comparing between the participants in the two groups, there were significant differences in age and mGAF-F score in the inpatients, whereas in the community-dwelling clients, there were significant differences in age, RAS total score and all sub-items, WHODAS 2.0 items"overall score"and"participation in society", and mGAF, mGAF-S, and mGAF-F scores. Discussion There was no relation between occupational dysfunction and recovery and difficulties in daily life in the inpatients. However, the possibility of a relation between occupational dysfunction and recovery and difficulties in daily life was suggested in the community-dwelling clients with mental disorders. Poster sessionNo. P-27 , Oc July. 21, 2018 13301430 cO Mental Health The improvement of occupational dysfunction and social Ⅲ” functioning through NEAR ” C:6G ± Taichi Matsuoka1), Hiroyuki Hibino1) Ⅲ” 1) Fukui Memorial Hospital ” Ⅰ+)0 Key words: schizophrenia, cognitive functional rehabilitation, occupational C:6G ” dysfunction Ⅲ ” Introduction Cognitive dysfunction is the most relevant factor to social C:6G ―” E8 functioning in schizophrenia. However, factors related to “ occupational dysfunction other than cognitive dysfunction may also be involved in the therapeutic effect of cognitive functional 6 +) rehabilitation on social functioning. When we used the 9 Neuropsychological Educational Approach to Cognitive ± Remediation (NEAR) to intervene with an outpatient with schizophrenia, his occupational dysfunction and social C:6G functioning improved. Therefore, we aimed to investigate the 7 relationship between occupational dysfunction and social + C:6G functioning using NEAR. Written informed consent was obtained ± from this outpatient. Case study ± The subject was a man in his twenties with schizophrenia. Although he had begun to use type B support for continuous employment, he had not yet begun to work. Therefore, he was 86D9 ,)(+, +)(+ introduced to NEAR to improve his cognitive dysfunction and ±C:6G social functioning at a psychiatric daycare facility. NEAR consists 6 of a personal computer session and a language session, which 6 ” were carried out twice a week. We evaluated the status of his occupational dysfunction with the Classification and Assessment of Occupational Dysfunction (CAOD) scale. His initial CAOD score was 30 out of 112 points. Result His CAOD score after three months of NEAR improved to 20 points, and after the completion of NEAR, he was able to obtain C:6G employment through type A support for continuous employment. ”6 Discussion Ⅲ” The improvement of occupational dysfunction through NEAR may have been a factor contributing to this patient’s improved social functioning. Poster sessionNo. P-28 cs July. 21, 2018 14401540 S Mental Health Psychiatric hospitalization occupational therapy for ±Ⅵ acquisition of adaptive behaviors in a woman with Down ” syndrome who became unresponsive to intervention Hiroaki Sakuma1), Kazuhiko Misaki2) .) . Ⅴ 1) Sankei Hospital Ⅵ 2) Saiseikai Otaru Hospital Ⅵ Key words: Down syndrome, Adaptive behavior, Occupational dysfunction 69A ' IntroductionA woman in her fifties who had Down syndrome 69D8 became difficult to deal with at a facility. Intervention was (.B+/(+/ performed for occupational dysfunction to acquire adaptive behaviors. This led to hospital discharge. EvaluationHer aid for decision making in occupation choice (ADOC) satisfaction score was 1/5 for painting, karaoke, and D86 ,,(.+ family interaction. Her functional independence measurement 68H ,-(1) (FIM), occupational challenge assessment (OCA), and 32)(+1 communication and interaction skills (ACIS) scores were 26/126, D86 33/52, and 34/80, respectively. Her evaluation score for adaptive chV68H behaviors of severe mentally handicapped children (adults) was 90/128. She could neither make a prospect nor respond to change, Ⅰ and showed resistance, crying, violent behavior, serious stickiness, and confirmation behavior. ” ReasoningHer OCA and ACIS scores indicated her tendency ⑤676⑥ of choosing occupation from surrounding influences. Owing to the lack of physicality and comprehension, she could not understand the instruction of care, leading to maladaptive ⑤⑥z behavior and occupational dysfunction. Regarding Applied Behavior Analytics (ABA), we increased desirable behavior while reducing problem behavior. 69D8 -(. (.B ResultsHer ADOC satisfaction score was 4/5 for painting and ),(+/ Ⅰ karaoke, and 1/5 for exchanges with families. Her FIM, OCA, D86 -.(.+ ACIS, and adaptive behavior evaluation scores were 103/126, 68H 0.(1) 45/52, 75/80, and 111/128, respectively. She was discharged in 4 3(+1 - months. 676 ”± DiscussionOn the basis of ABA, an environment that allows % for adaptive performance of meaningful occupation from the viewpoint of occupational dysfunction should be created. Support for repetition of daily challenge and correction can trigger relearning of adaptive behavior acquisition. Poster sessionNo. P-29 July. 21, 2018 13301430 Mental Health Outcomes of Transitional Working Skills Program: A Pilot Study in a context of Coffee Shop at Somdet Chaopraya Institute of Psychiatry

MUTTIKA CHANAMONTREE1), KANNIKA CHAICHANA1), SANSANEE TREESAN1), SUPALAK KHEMTHONG1) 1) ONGART CHIANGKAG

Key words: Emplowerment, Supported Employment, Social Engagement

This study aimed to report Occupational Therapy outcomes in outpatient people with mental illness (n = 5) who has been selected into a pilot program of transitional working skills in an institutional coffee shop. The inclusion criteria were made by a team discussion between a social worker and an occupational therapist. This program was created for enabling life recovery alternatives within a supportive context of enhancing self-responsibility and coping family conflicts with diversionary activities. Job coaching integrated with activity analysis and synthesis was used as a framework in order to improve cognitive awareness and processing toward the purposeful working tasks i.e. graded step-to-step learning of coffee making materials and looking after the coffee shop. Mover over, the participants had been training on social emotional learning skills i.e. working as a team with service minded expression to customers, problem solving and working planning on daily basis, social interactive communication, and emotional coping strategies. In order to maintain working duration of the individuals, the occupational therapist paid attention as a role of job coach providing all essential support, making task choices, and rewarding with paid jobs. By using motivational interviews and progressive observations, this program demonstrated positive outcomes including increased self-esteem in relation with increased social emotional learning skills. However, objective assessment in longitudinal study will be further investigated for a better effectiveness of this program. Poster sessionNo. P-30 MSse July. 21, 2018 14401540 MSse Mental Health Research on actual employment support in psychiatric ,) medical institutions +'+Ⅵ ~ Comparison between psychiatric hospital and psychiatric Ⅵ clinic in A prefecture ~ ⑤ Takayuki Hagawa1), Jun Yoshino2), Emiko Kikuchi2) +)-⑥ ” 6 Ⅵ 1) Koriyama Institute of Health Sciences ” 2) Teikyo Heisei University Graduate School of Environmental Information )1 Ⅵ”+)0 . / Key words: mental disoder, employment support, prevocational rehabilitation Ⅵ⑤⑥Ⅵ⑤ The statutory employment rate of the company was raised and the ⑥ + GeVabZ,'-', ZbYVa mentally disabilities was added to the employment obligation. ‐ LZTgb ‐ However, the turnover rate of mentally disabled people is high (NIVR, 2014). We report on the actual condition of employment )1 ”+. ”⑤ support in psychiatric medical institutions in A prefecture. +,'⑥ ± 2 ” / ”⑤ A research form was mailed to 108 institutions from May 2017 to . ⑥ June 2017, and research participation was agreed in replaying. ” After compiling the answers, we compared the actual status of ” 1'1 employment support in two groups; psychiatric hospitals ” 1',±+ (hospitals) and psychiatric clinics (clinics). We compiled and analyzed responses obtained from 16 ⑤4)').⑥ institutions (11 hospitals, 5 clinics). Employment support was being implemented in all institutions that replied. 18.8% ⑤4)').⑥ aggressively supported the employment, and 81.3% of the ⑤4)').⑥ institutions supported employment as part of the support. In the ” comparison between the two groups, there was a significant difference in occupational support status of occupational ± therapists, implementation of case management, and collaboration with personnel officers of companies (p <0.05). The employment support system of medical institutions is at the seeking stage, suggesting the necessity of building a support and cooperation system in cooperation with external organizations. ” ±” Ⅰ Poster sessionNo. P-31 OsM July. 21, 2018 13301430 eS Others Building Process of OBP focused Rehabilitation Team Nozomu Shiraki1) D7E 1) Medical Corporation Naranomori Izum-chuo Minami Ohisama Visiting Nursing % Station ' BI9AE Key words: Occupation-Based Practice, Team management, Belief conflict D7E ' % Introduction: ' Building synchronized teamwork among diverse professions is important for the realization of effective Occupa-tion-Based , Practice (OBP) This report introduces the team management EI%DI%HI' process through sharing goal setting in team and using ±%” Management Tool for Daily Life Performance (MTDLP). '% Method: ' My rehabilitation team at first had ambiguous goal setting and our ' work was not synchronized, so we reviewed and shared the goal ' setting. We discussed and tried to improve our sense of %%FDA FD9 self-efficacy and motivation to con-tribute to the team. As a result, r' we decided to adopt MTDLP. We first applied MTDLP to six BI9AE clients as our essen-tial task, and set our desired task to ' proactively apply MTDLP to our new clients. Passage: The team members gave me some feedback such as “I became ±% DI %” EI able to do OBP.” On the other, some were still not confident or 'BI9AE % satisfied with the decision to adopt MTDLP. % , Result: ' We have done the trials with 11 clients within 4 months. I believe - we enhanced mutual understanding on diverse professions. .)l,'/ ' Additionally, we assessed belief conflict using Assessment of Belief Conflict in Relationship-14, mean±SD50±3.6 points. % Assessment: % It is natural to predict that a team with diverse professions likely ±' to split up. I assume it is important to share the purpose and find % appropriate solutions together with the team, and I believe this ±'BI9AE will create more effective team-work. But they believe their own ways so understanding and accepting different views is one of the % clear chal-lenges for building stronger and more effective ' teamwork. % ±' % D7E ±% BI9AE ±' Poster sessionNo. P-32 psOe July. 21, 2018 14401540 eSLs Others The use of the pamphlet for clients’ understanding and ± acceptance of occupation-based interventions Shigenori Narushima1), Sawako Saito2), Yukiharu Ikeda2) 1) Tsukuba Memorial Hospital 2) Department of Occupational Therapy, Ibaraki Prefectural University of Health Sciences Key words: Occupation-based practice ‐ Background: There are some clients who refuse occupation-based interventions (OBI). It is indicated that those patients may not understand what occupation is or effectiveness of OBI because occupational therapists do not explain them enough. Using a pamphlet may be effective to make patients understanding the effectiveness of OBI. 0 Objective: It was examined if using a pamphlet was effective for stroke patients with hemiplegia to understand the effectiveness of OBI and to accept of OBI. Method: The participants were 16 stroke patients with hemiplegia ⑤ who were hospitalized in a recovery rehabilitation unit. The participants were explained by their occupational therapist with ⑥ using a pamphlet what occupation is in occupational therapy and the effectiveness of OBI. The pamphlet was made for this study. LZTg ‐ .④ After the explanation with the pamphlet, participants were asked to fill out the questionnaire about understanding what occupation is, understanding of the effectiveness of OBI, and accepting of OBI. Data analyses were implemented Wilcoxon signed-rank test / and descriptive statistics. / Results: 6 participants did not understand what occupation is before the explanation with the pamphlet. All participants / / understood what occupation is after the explanation. ⑤5)'),)⑥ Understanding of effectiveness of OBI after the explanation was significantly higher than before the explanationp=0.030. 3 of , , the participants did not accept OBI before the explanation. After the explanation, all of them changed to accept OBI. Conclusion: Our study indicated that the use of the pamphlet ± improved clients’ understanding of what occupation is, the Ⅰ effectiveness of OBI, and accepting OBI . Poster sessionNo. P-33 eNa July. 21, 2018 13301430 cO Others Importance of occupational resumption in the family’s cooperation ” -Support based on the angle of occupational dysfunction of the family- ±” DI Ⅰ Riho Hosokawa1), Daiki Dobashi1) 1) Medical corporation Syouyoukai Takikawa Neurosurgical Hospital 6 0) 6 Key words: occupational dysfunction ”69A Ⅵ” <9H&H& ●Background ±DI In our case (A), support including that of family members was ⑭69A ― provided from the occupational dysfunction angle. Consequently, Ⅵ” <9H&H& the couple’s target travel resumed post-discharge. Thus, 6 ± intervention at occupational dysfunction suggests efficacy of occupational support for its target and family. DI ” 6 ●Introduction A 70-year-old male with cerebellar infarction presented with slight ataxia, mental function GDS-S-J score 8, and required 86D9 -) 6 moderate assistance in ADL. After 2 months, the patient was 6 almost independent in ADL with a GDS-S-J score 11 and could ” venture out with family support. ●Reassessment and policy The CAOD score was 40; the occupational deprivation score was high. In the hospital environment, A had restrictions over family and outing time, which was difficult to comprehend for both M1- parties. The OT facilitated environmental improvement and DI Ⅳ conducted a tri-party interview for practicing staying out. 6 ●Passage γ )Improvement in physical society According to the tri-party interview, A exhibited increased ⑭M) involvement in house repair and could stay out. 86D9 ,/ 6 ) Improvement in human society γ The CAOD score was 36; occupational marginalization score was DI 6 high. A complained that his family did not understand his condition. The OT was concerned that both lacked common understanding. Thus, the OT explained the clinical condition to 6 both parties. Consequently, the family’s anxiety declined and considered leaving after understanding A’s will. ”69A ●Results and Discussion Ⅵ” <9H&H&86D9 ,. A exhibited slight ataxia with GDS-S-J score 7 and CAOD score 35, with watch-level independence. Perhaps, an angle of ” occupational dysfunction is easy for the family to understand one’s own situation. Poster sessionNo. P-34 epeUNU July. 21, 2018 14401540 Others Ⅵ… A case in which the importance of family is reminded through -) %± the process of reinstatement ⑤LG⑥⑤L:H⑥ '% Yuno Kasuga1), Kazuhiko Nagae1), Shizuyo Kyouzuka1) %‐” 1) Toyama Prefectural Rehabilitation Hospital and Support Center for Children with '%% Disabilities Ⅰ 8D ±' -) % + ⑤1 . ⑥ - Key words: family,reinstated,responsibility '+) …%'M %M Introduction %Ⅵ'M+ Worker Role Interview (WRI) and the Work Environment Impact 'M- ' Scale (WEIS) demonstrated that a woman, had a will to be %69A '% reinstated for her family. Details are reported below. %%±'”% Note: it is approved to use personal information by the patient, ' and there is no enterprise in the COI relation. %DI ' Personal Details % M0 ‐ A woman (aged 40s) has husband and two sons (aged 8 and 5). '%±' She has been a dental hygienist, and her position was chief. On %% date X, She was diagnosed with Neuromyelitis Optica with '' symptoms of dysphagia, double vision and cerebellar ataxia(in %… DIG upper extremity). …%‐ She could walk without help, and ADL was self-supporting. She %±' hoped to resume her job, housework and driving. M2 LGL:H % Progression and results % She passed a driving test. Performing housework safely, she was '% particularly keen on cooking so that she could serve to her family. % However, she was still anxious about being reinstated, even 'M2 'M, ' though she was able to perform some practical operations, such as %LGL:H scaling. WRI/WEIS conducted in X+9 months displayed that she %⑤⑥% wanted to reduce her works in order to have more time for her '7VcYLVaVa9Vverbal declines were reduced, allowing him to reduce the burden on his wife. Due to the 69A Ⅵ decrease in his wifes mental burden, I was able to intervene with ± the goal of returning home. O-0 CGH-() 6 6 6 Ⅵ6 , CGH-() 69A 6 6 Ⅵ Ⅵ ± ± Poster sessionNo. P-42 eOl July. 22, 2018 10401140 Physical Dysfunction An aphasic patient with improved volitional expression and enhanced occupation motivation ” Ei Sugimoto1) 1) Okhotsk kai hospital ± Key words: Occupation, Volition, Aphasia ' We report the case of a patient with severe right hemiplegia and /) dX&BVhVa11 aphasia due to cerebral hemorrhage. The patient was mostly HAI6.)) sedentary in the hospital ward and had occupation imbalance due 69A B- to body function limitations. An interview and evaluation were IK made difficult because of aphasia, and the patient was unable to define a goal. Use of Aid for Decision-making in Occupation Choice (ADOC) software enabled the patient to arrive at answers. ⑥± The results were used to identify occupational interest. We used the Volitional Questionnaire (VQ) to evaluate motivation for 69D8⑤ specific occupation and performed an observational assessment of ⑥⑭⑥± living conditions. We also evaluated daily life Assessment of communication and interaction skills (ACIS). Volition, ” habituation, performance capacity, and environment relevant to ⑤KF⑥ occupation participation under daily living conditions were ⑤68H⑥ analyzed, and occupational therapy intervention was IK ,, 3 implemented. To encourage spontaneity in the occupation ~ ,1 3 environment, occupational therapy was performed with the goal -0 of achieving satisfaction with volitional competence. The patient -2 ± demonstrated improvement in competence as a result of increased 68H ,1 interest in occupation, as well as a desire to accept new challenges ⑥Ⅰ”± and increased active participation. ±± ⑥69D8 ⑭⑥ ± KF3., 68H . 69D8 ±Ⅰ KF68H Ⅰ Poster sessionNo. P-43 seNcr July. 22, 2018 9301030 Physical Dysfunction A client got back a motivated life through sharing the time to brew coffee with an occupational therapist ”⑤DI⑥ Tetsuya Kumata1) ⑤8A⑥8A 1) Kobe rehabilitation hospital DI Key words: Occupation, Favorite items, Motivation Background: In this case study, the occupational therapist (OTR) 1) was in charge of a client (CL) who couldn’t understand the + necessity of occupational therapy. However, we had shared the time to brew coffee and CL continued her important occupation ± after discharge. OTR obtained the consent from her family. Client information: CL was an 80s female and diagnosed with 69A '69A subarachnoid hemorrhage. At home, CL enjoyed having coffee with her husband every morning. Assessment: At the time of the first assessments, motor paralysis DI was not confirmed. In IADL aspect, attention disturbance and memory disturbance were confirmed. In the interview, CL told OTR that cooking was an important occupation for her. ± Progress and Result: At first, CL showed reluctance to some ± 1 training for higher brain dysfunction. 8 weeks after hospitalized, ± we planned to cook together, but CL couldn’t remember it and ) 8A ±DI she made some mistakes when we cooked. 2 weeks later, we planned to brew coffee and OTR told her to bring her favorite items. On that day, CL brought the items and brewed coffee without any mistakes. At that time, we shared the joy. After that, 8A CL became more positive about occupational therapy. ⑤DIG⑥ Discussion: At first, OTR made occupational therapy plans so that DI CL could cook by herself. However, CL couldn’t understand her DI problems and there was the difference of recognition between OTR and her. OTR realized how important it is for clients to do things by themselves. It made CL more positive about DIG DI 8A occupational therapy that we shared the joy. ± 8A ” 8A ” DIG DI Poster sessionNo. P-44 c July. 22, 2018 10401140 Physical Dysfunction ae About cases that promoted understanding of the present situation through practical cooking training ' ~Aiming to acquire role in household~ B86 .) Yuki Aoyagi1) 1) Kitahara Rehabilitation Hospital Key words: cooking training, Hemiplegia, role I was in charge of a man who had a cerebral infarction this time. +' He had severe right paralysis, sensory disorder and aphasia. He .) , Ⅲ was difficult to use his right hand in life. And I heard statements B86 that lacked understanding of the situation from him. 7abv&w&v± He lived with his wife and three daughters. His hobby was 69A cooking. He was cooking for his family. For that reason, I carried out cooking training while adjusting difficulty level to increase ±8DEB ⑤& use frequency of right hand and understand the own situation. &⑥&/&, &&, && &-&, Ultimately aimed at acquiring role in home. Cooking training was ± done once a week in stages. As a result his paralysis improved, the frequency of use of the ,' right hand also increased. Moreover, the amount of assistance during cooking also decreased. The last keema curry was made 69A with watching. He went to do housework for his family. On one hand, he said that he cannot cook properly because his right hand does not move. Through cooking he realized his difficulty in using his right hand. He was able to objectively observe the -' ability to perform at the present time by clarifying the 7ab'w&x&x improvement point and goals. As a result, he was able to acquire the ability to cook, and helped to acquire the role in the family. ± 8DEB - 8DEB &)&)&/&1&1&1 ± .' 8DEB Poster sessionNo. P-45 OC July. 22, 2018 9301030 geO Physical Dysfunction A case who felt a sense of loss taking photos was improved. ⑤ 8A⑥ Naoki Kuwajima1) %'% 1) Seikeikai Secomedic Hospital % ' Key words: self-efficacy, participation, satisfaction %%' A case’s meaning occupation was that he took photos of the 1) '' seasons, and displayed an exhibition. After, he was hospitalized with hydrocephalus due to brain tumor. And, he was unable to '7ab3%% take photos and felt a sense of loss. So, I provided him to taking w%=9H&G3- %73/. %% photos at the occupational therapy. And, his self-efficacy and ) '6ZUWa satisfaction increased. 9VTZbZ]R[ZXZDTTdRcZ8YZTV⑤ 69D8⑥ At first, I gathered information from his wife and interviewed + s him. And meaning occupation was selected that taking photos by % him. Next, His motivation was changed by partial participation of ' taking photos at the gardening hall. In the latter, I asked him to post his photo at the rehabilitation room, and I supported that he 8A ' select photo and preparation. As a result, his self-efficacy and taking photos satisfaction was %' increased, he made a contractive comment, and his care of 8A % activity of daily living was reduced. 69A %” ' 8A %% ' 8A Ⅰ% ' 7ab3x%y%x%=9H&G-z+ 7/.z1. '69D8 +z- % ' % ' 8A % '7RUdaR ' %% %'8A %' Poster sessionNo. P-46 25 Tae July. 22, 2018 10401140 Physical Dysfunction A case in which the use frequency and efficiency of paralyzed “ upper limb in ADL improved by applying Transfer package 69A IaRbWVaRT[RXV Tsutomu Kodama1), Hiroko Kodama1), Shingo Yamane 2) 69A 1)Merry Hospital 2)Institute of Biomedical and Health Sciences,Hiroshima University /) Key words: Transfer package ± + Introduction ”±dX&]RhVaRbbVbb]VcB6 I was in charge of the client with moderate right hemiplegic upper .-(//HI: - 0,Bca6TcZeZchAXB6A limb as a result of cerebral infarction. I intervened based on 6DJ(FDB,')0(+'01B2,/0+/ Transfer Package. As a result, use frequency of his right upper 8DEB limb in ADL increased. I received permission from the client to - ± present his case to the conference. Case introduction The client was in him seventies and right-handed. Before the ‐ onset, he lived independently and his hobby was playing golf. He ” was admitted to the convalescent rehabilitation ward. FMA; 54/66, STEF; right 41, left 73, MAL; AOU 3.07, QOM 2.78, ” MAS; elbow 1, hand 1, forearm 1, FIM; 93. His needs were to write a letter with his right hand. Intervention B6 .-z/HI: -z2, 0,z22 We found out that he wasn’t able to wash his face effectively, etc., B6A6DJ,')0z.')FDB+'01z-'+1 B therefore we determined the intervention to achieve his goals in 2,z++ 10 ,.8DEB daily life. I started the intervention to improve the stability of 1 0 rotator cuff. I prescribed training menu and encouraged him to practice voluntarily. He became to be able to self-monitor. , Results FMA; 61, STEF; right 93, left 99, MAL; AOU 5.0, QOM 4.28, MAS; elbow 0, hand 0, forearm 0, FIM; 122. He has been able to ± write letters clearly and nearly consistant in terms of size and quality. He had new need that he would like to play golf. Consideration We achieved the result effectively because he observed himself carefully every day. I thought that presenting a clear objective and comprehensive therapy was resulted in using his right hand consciously. Poster sessionNo. P-47 MSsNe July. 22, 2018 9301030 Physical Dysfunction - 1 A report of occupation based practice from early hospitalization in rehabilitation Sachihiko Nakayama1), Takayuki Hayakawa1), Hiromu Dan1) 1) Heisei Hospital ±⑤DTTdRcZ&7RbVUEaRTcZTV D7E⑥ Key words: OBP,fracture,role 1) Introduction ⑤8RRUZRDTTdRcZREVaWa]RTVBVRbdaV We used “OBP” for client who lost the role in the home and do 8DEB⑥6bbVbb]VcWBcaRUEaTVbbH[Zb⑤ pessimistic remarks such as "concern about cooking and 6BEH⑥‐8DEB washing" and "whether to enter the facility”. Progress , 6BEH ” Client is an 80-year-old woman with bilateral radius distal end fracture. We verified the effectiveness of intervention using COPM, and AMPS. At the beginning, as an important occupation + ” at COPM, three items were mentioned: “want to cook”, “want to wash”, and “want to clean”. As a result of AMPS, increase in function impairment and compensating motion, and decrease in efficiency were confirmed. And, as a parallel program of recovery 8DEB ,.'0 model, compensating model, learned model, actual practice ,'0 / 6BEH o)' exercises using washing machines twice a week and cooking '1XZc '+ '2XZc practice of noodles in ADL room were carried out. Results As a result of COPM, the performance score increased from 3 to 5.7, and the satisfaction score improved from 3.7 to 6. As a result D7E ± of AMPS, motor skills changed from - 0.1 to 1.8 logit, process skill changed from 1.2 to 1.9 logit. Discussion By using OBP, it was possible to provide meaningful occupation, leading to reacquisition of role and early discharge from the hospital. Poster sessionNo. P-48 MSse July. 22, 2018 10401140 -2 fPN Physical Dysfunction Turning point between changing hospital and discharge in acute phase brain disease % BHL -What should the occupational therapist provide?- '%” ±'% Koyuki Yoshimura 1), Saori Mitsuya1) ±'%” 1) Teine Keijinkai Hospital %% %' Key words: Returning home 6 In acute phase brain disease, adjustment of changing hospital is 0) %' started as needed in an early stage after the admission. It may be ±' 69A 69A ''[VhVab changing hospital depending on the circumstances of patients and ''B their families even if function recovery is good and the medical ,% +% ,- ' staffs judges that discharge is possible. We compared the case that 7 changed hospital with the case that became available for a 0) %''69A discharge and analyzed the difference in our intervention methods. '±'―% As a result, occupational therapists provided various information ''[VhVab ' about rehabilitation process to the patients, the family and other 7a'b w%± medical staffs from an early stage, and it was found to be 'Ⅵ'B important to support the discharge with a common view.Written /2% +0% 2/ ' informed consent was obtained from the patient's. 6 %' ±% % %' % 'B % 02% +/% ). % % ' 7 %% '% %'B 0-% +0% ) '% %%' %[VhVab % '% % '%6 B %” ±' % ±' Poster sessionNo. P-49 afce July. 22, 2018 9301030 N Physical Dysfunction pse Is group activity necessary for occupational therapy in Rehabilitation specialized ward? From the result of questionnaire of occupational therapists. DIG ± Megumi Sato1), Yoshitaka Hashizume 1), Toshiki Ikeya1), Masao Matsumoto1) 1) Shintotsuka Hospital DIG Key words: group activities, dementia, BPSD DIG DIG Occupational therapists (OTR) in the Rehabilitation specialized ward often do treatment focusing on Behavior and psychological ‐ symptoms of dementia (BPSD) and emotional. +2 + DIG+- It is said group activities are effective. However, we were often - difficult to carry out group activities because of the shortage of manpower, the low priority of preparations and the difference in +2 + recognition of necessity. - Therefore, we have set up activities in the occupational therapy − DI γ room so that OTR can treat patients by group activities. We prepared colored pencils and coloring of Christmas ornament at + 10'.④ the desk of the occupational therapy room in December 2017. DIG/)④,)④ Then, 60% occupational therapist used the activity and 30% OTR 2)④r utilized it as group activity. 90% patients who participated in the 2 rr1 r group activities had dementia. We wanted to know what purpose DIG DIG OTR used for the group activity and what they think about group Ⅲ activity necessity. So, we did a questionnaire survey. First, the purpose of OTR used group therapy for treatment was DIG "providing fun" and "interaction with others". Next, all OTR answered that treatment by collective activity is necessary, DIG because we can evaluate social interchange skills and emotions. Due to we prepared the activities, OTR got the opportunity to use group activities for treatment. In order to continue collective 69A activities, it is necessary to have OTR who plans the activity. ” Furthermore, we have to observe the progress using social interchange skills and emotion evaluation by using ACIS and DIG DBD. DIG ± 68H 979 Poster sessionNo. P-50 - prs July. 22, 2018 10401140 OP Physical Dysfunction Goal setting by ADOC-H made possible a change in consciousness to rehabilitation of upper limb paralysis: a case report ”” Yuri Hirano1), Yoshitaka Hashizume1), Toshiki Ikeya1), Masao ±69D8&= Matsumoto1) 1) SHNTOTSUKA hospital Key words: ADOC-H Stroke Repetitive facilitation exercise /) . 69A 69A 7GH Recently, as the plasticity of the brain became clear, it became ww possible to encourage the recovery of upper limb paralysis, which had been considered difficult until now. On the other hand, some patients stick to function recovery of upper limb paralysis and living life out of rehabilitation. Therefore, therapist’s involvement in the treatment process is important. ± Our hospital provides rehabilitation to improve upper limb 69D8&= function for hemiplegic patients after stroke. However, it is sometimes difficult to set goals for acquiring occupation, sticking 6 to improvement of function. Therefore, we used a ADOC-H and set goals, we were able to encourage a change of consciousness for acquisition of occupation, and it became possible to share the goal. As this factor, I think that interviews using illustrations of ADOC-H made it easy to recall life, focusing on occupation and 6 − sharing of goal. Although ADOC-H is aimed to encourage the use of paralysis hands, it was suggested as effective as a means to promote a change in consciousness towards focusing occupation. ” ” ± ” ±69D8&= 69D8&= ± Ⅰ Poster sessionNo. P-51 epre July. 22, 2018 9301030 Physical Dysfunction Case of the inclusion Body Myositis that led to the %χ± introduction of the self-help tools by shared volition '% ' Natsuki Inoue1) '' 1) Saiseikai Higashikanagawa Rehabilitation Hospital 1) %%%' Key words: volition, the self-help tools, IBM 69A % ' 69A ' Introduction %% Self-help tool was necessary and introduced it case with Inclusion ' Body Myositis but assent was in charge of the case that was not DI provided. I shared volition and introduced self-help tools along % volition for case. %+) %+ Case '0) The case 80sWomen, the ADL before hospitalization lives '% together with a husband in private residential home. 7B ' Evaluation The case was born as the second daughter of the farmhouse. Case '' was given husband and marriage that were a dominant husband, % daughter two and performed housewife. Case entered with a .% -'6bbVbb]VcW former husband facilities one year before. It was stated, "I wanted BcaRUEaTVbbH[Z6BEH )')XZc to make a disease better" in the interview and 'XZc ±' Dressing(satisfaction 5), Excretion (satisfaction 4) AMPSmotor DI skill 0.0 process skill 1.1 ±% Methods '” The aim watches the second lunar month, excretion with self-help ' instrument tools. It was decided that the training carried out arms function training and introduction self-help tools. . ” ResultOT introduced arms function training and introduce '6BEH self-help tools (wrist supporter etc) AMPS became motor skill 0.7 )'0XZc '+XZc process skill 1.2. but case did not reach the purchase. OT asked it about self-help tools. Therefore the case was proved .,) '% to put value in care of former husband. OT carried out an introduction, training by Button Aid for assistance of the husband '% on the basis of it. became Dressing(satisfaction 7) Excretion (satisfaction 6). Case led to the purchase. 0 / DiscussionIt was thought that it led to the introduction of self-help tools to have shared volition. Poster sessionNo. P-52 ssQ July. 22, 2018 10401140 Physical Dysfunction Practice of occupational therapy based on value for distal radial bone fracture case wishing to return to work ” D7E+') ⑤ Ryota Kimura1) DIEB⑥ 1) Isogo Central Hospital .) Key words: Value based OT ⑤ DI⑥ Case50's, female, right-handed. Occupation is a care workers. DI +)k )k Diagnosis is left radial distal fracture. EE9.]] ” OT evaluationThe range of motion of the hand joints is 20 degrees of flexion, 10 degrees of extension, 15 mm of PPD. She ± seemed to be impatient with the consultation of early DI D7E+') DIEB DI reinstatement. OT processIn order to carry out OT practice with OBP 2.0 DI and OTIPM, we clarified the hope and target of the case itself and tried to share the prospect. ⑤⑭⑥⊿ PO2W, intervention was made mainly by calming inflammation and reducing the swelling of the fingers. she returned to work at PO8W. After return to work, personal care was no problem but she felt uneasy about physical care. For that reason, we confirmed the value of work and work content to the case, and made two types of splints of different materials.OTR also provided guidance on the assistance method with the sprint attached. ⑭ ) Result ROM did not matter. Grip is right 30 Kg, left 28 Kg. Also, as she experienced OT, she is more opportunities to support patients and remarks were said that her values changed. DiscussionThis time, in supporting assistance to reinstatement, ,)X +1X physical care that took a load on the wrist joint was the most problematic. Furthermore, she felt impatience from the beginning, DI and the mental side was also a problem, such as the fact that the herself feels the difference with the vocational ability before the ± disease even after reinstatement. ± Therefore, not only improving the physical function, but also practicing OT suitable for the case, such as making splints Ⅵ± suitable for the case and acquiring assistance methods leads to a ” change in values, leading to a care workers in a state more than DI pre-illness I think that it was linked to engaging. Poster sessionNo. P-53 Nls -2 e July. 22, 2018 9301030 Physical Dysfunction Examination of Occupational therapy for patients with acute + stroke through a factor analysis study Jun Nakayama1), Daisuke Kimura1) ” B 1) KANSAI UNIVERSITY OF WELFARE SCIENCES ‐ ‐ Key words: acute stage, stroke, Structural Equation Modeling ± 8Hu IntroductionThe causal relationship between FIM items, + ⑤ including cognitive function and self-care, and early ambulation H:B ⑥ days has not been examined previously. This study aims to B ± conduct multifactorial simultaneous analysis of FIM items at the onset of JCS II in acute stroke using covariance structure analysis 8H uⅠ± ,/ 2 weeks from stroke onset. ③ 0+'+ + Materials and MethodsThe subjects were 36 patients capable B B of understanding JCS II instructions after having a lower B consciousness level after stroke onset. The average age was 72.2 years. Evaluation items were the number of early ambulation H:B days and FIM at 2 weeks. Factor analysis was first performed on n+ <6<%GBH:6 FIM items. Next, a causal hypothesis model was constructed, which aggregates the causal structures that FIM items influence ”” the number of early ambulation days using the obtained factor as a latent variable in one system. Then, the hypothesis model was subjected to SEM analysis. ResultsThe relevance index of this causal model was H:B acceptable, with χ2 = 42.96 (P = 0.27), GFI = 0.78, and RMSEA n+ 3-+'2/)E5)'+/0<)'0006<)'/+ = 0.06. The standardization coefficient, indicating a direct effect GBH:6)')/ ±” from “transfer function” to “early ambulation days,” was -0.35. Ⅰ&)',. The direct effect value from “cognitive function” to “number of ±”&)'- ± leaving days” was -0.14. The indirect effect value from “transfer ” function” to observation variable “conscious level” to “early &)'+ ± ambulation days” was -0.12. ConclusionFor reducing early ambulation days, it is important to improve transfer function and initiate cognitive function even if Ⅰ the consciousness level is not improved. ”” Poster sessionNo. P-54 eNOUrkae July. 22, 2018 9301030 Physical Dysfunction The process by which a woman with extremely pessimistic ⑤69A⑥ thinking regained her sense of self ⑤69D8⑥ Naoaki Sakata1) 69A 1) Shin-Kaminokawa Hospital Key words: ADL, ADOC , purulent spondylitis 6 0) N O ±N+ &+ Introduction N- We used the Aid for Decision-making in Occupation Choice (ADOC) in an attempt at goal-sharing with a woman who made a ⑤⑥⑤.+ ,1 ⑥ large number of pessimistic statements. She shifted toward a ”⑤B⑥ -, more optimistic viewpoint as the course progressed, and ±± eventually began to speak hopefully. ⑤⑥ Case and life history ” A 70-year-old woman with purulent spondylitis required assistance with all activities of daily living (ADL) due to being 69D8 ⑤ underweight (152 cm, 38 kg) and having marked muscle atrophy +(.⑥~⑤+(.⑥⑤(.⑥⑤(.⑥ in all four limbs. She lived in an apartment with her husband and ⑤ (.⑥ enjoyed kimono-making and cooking but had been requiring assistance when moving for the past six years. She went outside less often, and her husband started doing the housework. ± Course ±0 At admission: 1. Daily life (satisfaction: 2/5), 2. Transfer (2/5), 3. , Excretion (1/5), 4. Mobility (1/5), and Cooking (1/5) “I am 6 s depressed because I can’t do anything by myself.” +1 At discharge: 1. Daily life (satisfaction: 4/5), 2. Transfer (4/5), 3. Excretion (4/5), 4. Mobility (3/5), and 5. Cooking (3/5) “I want to go shopping with my husband.” “I had fun cooking for the 6 -0 . first time in five years.” .0 Discussion 02 We allowed the patient to regain movement using step-by-step B10 ⑤ -(.⑥~⑤-(.⑥ compensatory techniques. This was based on the patient’s current ⑤-(.⑥⑤,(.⑥⑤,(.⑥ level of physical skill and taking into consideration her sense of ” self-competence, as well as incorporated cooking, which the 6 patient considered an important task. We created a narrative for the future using these components and led the patient to a more ± optimistic outlook. Poster sessionNo. P-55 S July. 22, 2018 10401140 H 1- Physical Dysfunction H Support for role reacquisition ~ Cases supporting AMPS and ADOC along the Oumi DIEB recovery occupational therapy pass~ ⑤⑥ 8A Takeyoshi Nakano1), Nozomi Ishiguro1) 1) Oumi Onsen Hospital 6 .) Key words: ADOC , AMPS, pass ⑭ ⑤⑥ [Introduction]We introduces a recovery period occupational M,) therapy pass based on the OTIPM. As a result of being involved B-1 69D8 along this pass, we were able to role reacquisition of the client himself. 6BEH )'+XZc&)',XZc [Case introduction] The case is a male in his 50s who worked as the manager of a restaurant, and was responsible administrative 69A activities at two clubs, including business operations and cooking, %69D8 prior to being diagnosed with cerebral hemorrhage. [Initial evaluation]On the initial Aid for Decision-Making in M2, 69A Occupation Choice (ADOC), he selected items related to work. ± Assessment of Motor and Process Skills (AMPS) test revealed a 69D8⑤ +(.⑥~⑤,(.⑥ motor 0.2 logit and process −0.3 logit. ⑤+(.⑥⑤,(.⑥⑤+(.⑥ [Progress] At 93 days post-onset, the patient was able to walk 6BEH +')XZc 'XZc independently. ADOC results were as follows: Cooking (satisfaction (2/5); Driving (3/5); Work (2/5); Carrying items (3/5);and Phone (2/5). AMPS revealed improved exercise 6BEH tolerance to 2.0 logit, process to 1.1 logit. However, in the subject of fried rice a lot of skill deterioration was observed. We collaborated with the patient's workplace and driving schools in M0) order to the patient's role reacquisition. 6BEH [Final evaluation] ADOC: Cooking (3/5); Driving (3/5); Work (3/5); Carrying items (3/5); and Phone (3/5). AMPS revealed 69D8⑤,(.⑥~⑤,(.⑥⑤,(.⑥ exercise 1.4 logit, and process 1.7 logit. He was able to cook ⑤,(.⑥⑤,(.⑥ 6BEH seven dishes in 3 h. Additionally, he was able to resume driving. '-XZc '0XZc [Consideration] The goals of role reacquisition were achieved by 0 sharing the thought/present condition of CL at each time in a recovery period with many changes. ” 8A Poster sessionNo. P-56 eeSacQ - 1 July. 22, 2018 9301030 Physical Dysfunction A case of implementing COPM and AMPS before and after surgery for brain tumor in addition to functional evaluation ±” Michika Hirota1), Michi Tochikura2), Masumi Takahashi1), Takuya ⑤ Hirose1) 8A⑥” 1) Department of rehabilitation,Tokai university hospital ± 2) Department of rehabilitation medicine,Tokai university school of medicine 8RRUZRDTTdRcZREVaWa]RTVBVRbdaV⑤8DEB⑥ 6bbVbb]VcWBcaRUEaTVbbH[Zb⑤6BEH⑥ Key words: COPM, AMPS, brain tumor 8A [Introduction] 8A Client (CL) is a housewife in her 60s who underwent surgery for /) + brain tumor removal. In this case, we implemented Canadian ⑤⑥ Occupational Performance Measure (COPM) and Assessment of Motor and Process Skills (AMPS) as evaluation tools before and after surgery in addition to functional evaluation. 8DEB⑤((⑥ )(0(0 [Case summary] )(/(. )(0(0 ± COPM test results were as follows 1) to have a meal (importance ±6BEH 10/performance 7/satisfaction 7), 2) do the laundry (10/6/5), and Bca)')EaTVbb)'1 ± 3) cooking (10/7/7). CL often says “All right, I can do it” because she did not have full recognition of her illness. For the AMPS 7adbca]bcRXV scores, motor logit was 0.0, and process logit was 0.8. Overall, xyBZZBVcRHcRcV:gR]ZRcZ +1(,) distracted attention was conspicuous. The Brunnstrom stages ± were U/E V, and finger VI. Mini Mental State Examination score was 28/30. 8DEB [Intervention] The OT program included elements mentioned in the COPM, for 8DEB⑤(⑥ 0(1 2(1 example, practice to hold a bowl with her left hand and to fold 0(1 clothes. [Reevaluation] 6BEH Bca'+EaTVbb'+ COPM test results were as follows 1) performance 7/satisfaction 8, 2) 9/8, and 3) 7/8. She accurately evaluated herself. For the ‐ AMPS scores, motor logit was 1.2 and process logit was 1.2. She +/ concentrated on performing the tasks and smoothly performed them. Other evaluation results did not change. She was discharged on the 26th postoperative day. At present, she can do 8DEB 8A housework without help. 8A [Discussion] In this case, we can promote CL’s awareness by sharing about 6BEH ” how meaningful is work for her. In addition, we were able to more accurately evaluate the improvement in life skills using AMPS. Poster sessionNo. P-57 ,- pse July. 22, 2018 10401140 Physical Dysfunction The impact of NEURO-15 on performance skills in the C:JGD&. chronic phase of stroke ⑤ aIBH⑥ . ± Shingo Yamane 1), Takuya Ojimo2), Hiroaki Tamashiro2), Naoki ‐” Urushidani2), Takatsugu Okamoto2), Hideaki Hanaoka1) 1) Hiroshima University C:JGD&. 2) Nishi-Hiroshima Rehabilitation Hospital ‐ +) C:JGD&. Key words: Neuro-15, AMPS, CVA cYV 6bbVbb]VcWBcaRUEaTVbbH[Zb6BEH NEURO-15 is a 15-day program that combines low-frequency ”dX&BVhVa6bbVbbVc⑤ B6⑥ repetitive transcranial magnetic stimulation (rTMS) and intensive LWBcadTcZIVbc⑤ LBI⑥ cYVHZ]VIVbc occupational therapy for patients with chronic hemiparesis Wa:eRdRcZX=RUdTcZ⑤ HI:⑥ ]UZWZVU following stroke. Though the evaluation of upper-limb function 6bYfacYHTRV⑤B6H⑥ has been used in the past to verify the effects of NEURO-15, the C:JGD&. reacquisition of performance skills required for daily living has ”6BEH 69A not been sufficiently evaluated. Therefore, we conducted this study with an objective of clarifying 6BEH 69A the effectiveness of NEURO-15 from the viewpoint of regaining ± )', ± performance skills in daily living. + We conducted the Assessment of Motor and Process Skills (AMPS) and evaluated upper-limb function before and after cYVLBIXVaWa]RTVcZ]V HI: NEURO-15 to evaluate performance skills in activities of daily living (ADL) in 20 patients with chronic hemiparesis after stroke. Our results found that not only upper-limb function performance, ± but also ADL performance skills changed significantly. Significant difference was found in the Wolf Motor Function Test ± (WMFT) log performance time, the Simple Test for Evaluating ± Hand Function (STEF), and paralysis of the dominant hand between those who improved and not improved on the AMPS. ± This study showed the effectiveness of NEURO-15 in patients C:JGD&. ” with chronic hemiparesis after stroke from the viewpoint of 6BEH 69A regaining performance skills. C:JGD&. Ⅰ ' Poster sessionNo. P-58 e July. 22, 2018 9301030 ae Physical Dysfunction Effects of task-oriented practice aiming at re-acquisition of 69A toileting ability and reflection in a convalescent stroke patient %' - Verification using single case design - ⑤ 8A⑥ % Mika Takanami1), Mika Takanami1), Minako Shirai1), Kazuhiko % Misaki1) ‐' 1) Saiseikai Otaru hospital , 8A '1) % Key words: reflection %”' 6&7&8&7 '6 ObjectiveFor a client entering the recovery stage following ⑤ DIG⑥% cerebral infarction with sequelae, we implemented task-oriented '7 practice, encouraged reflection with the goal of re-acquiring %8A toileting ability, and verified the effect with a single case design. '8 8A MethodThe A-B-C-B design was adopted. A (baseline ± DIG % period): An OTR provided advice and assistance, and practiced '% toileting movements with the client. B (reflection period): they +. % - discussed short-term goals and their timing, and reflection was ' DIG encouraged. C (non-reflection period): Intervention was provided %'% only when the client herself was in danger of error or falling, and % reflection was not promoted. The variables were the total points ‐⑤ .⑥ of the toileting performance evaluation chart, visual judgment on ' <Rbb %8YV the trend line of the central division method was used for effect %)'1 RaXV ' judgment, and the randomization test was used to examine ' differences between mean values before and after each 7 period.Glass was calculated to quantify and judge the effect, %8 ' and a value equal to or above 0.8 was considered large. Results 7+ ' and DiscussionThe mean differences in values before and after 7&65,'1/%8&75/'/%7+&85.'. ±%± each period were significant (p <0.01), and the effect was large in ⑤4)')⑥' 75'1+%85.'.2%7+5'+. all periods. The trend line suggested that the effect of period B1 RaXV ' persisted at the beginning of period C, but reduced in the latter half. It showed an upward trend in the subsequent period B2, ' suggesting that in the re-acquisition of toileting ability in this case, %⑤8 ⑥ 7 task-oriented training while encouraging reflection would be ±%' more effective than iterative exercise practice. 7+ ±%± %% %± Ⅰ' Poster sessionNo. P-59 1 July. 22, 2018 10401140 e Physical Dysfunction Benefits of combined evaluation of the assessment of motor and process skills with blood oxygen saturation measures in ± patients with respiratory disease: a case study ⑤ 8A⑥ 6BEH Takuya Hirose1), Mitsuhiko Kodama2), Masumi Takahashi1), Michika HD+ Hirota1) 1) Department of rehabilitation, Tokai university hospital 8A 2) Department of rehabilitation medicine, Tokai university school of medicine 0) EI Key words: AMPS, Respiratory disease ,. DI 8A [Introduction] This study discusses the benefits of combining the assessment of motor and process skills (AMPS) with blood oxygen saturation 0+ 6BEH )'0 (SpO2) measures when assessing clients with respiratory disease. '/ ± [Client profile] The client was a male in his 70s. He developed lobar pneumonia +') HD+ 1)④ and septic shock. Occupational therapy (OT) intervention ) ]Z commenced 35 days after onset. ⑤ 7aXbTRV +⑥ 8A [Method] The AMPS was administered 72 days following symptom onset. 6BEH The client scored 0.7 logit on the motor scale and 1.6 logit on the process scale. SpO2 decreased to 80% and his pulse rate Ⅰ increased to 110. Dyspnea as assessed using the modified Borg scale (Borg rating = 2). He reported no remarkable subjective 69A 69A symptoms. We noted the client’s AMPS score and decreasing SpO2 during task performance. OT provided guidance pertaining HD+ to activity and environmental modifications. The client repeatedly practiced ADL and IADL tasks. OT monitored SpO2 fluctuations )+ 6BEH '1 before and after movements using a pulse oximeter. '. [Result] 8A 69A69A By 102 days post symptom onset, the client’s AMPS score was HD+ 2)④ 1.8 logit on the motor scale and 1.5 logit on the process scale. , With guidance, he was able to adequately execute ADL and IADL tasks. His dyspnea decreased and SpO2 stabilized at 90%. 8A HD+ ± The client was ultimately discharged 113 days post symptom ± onset. 6BEH HD+ Ⅰ [Discussion] 6BEH Decreased SpO2 was noted, and absent subjective symptoms HD+ suggested a risk of hypoxemia during the performance of ADLs and IADLs. By noting the client’s AMPS score and SpO2 Ⅰ fluctuations, we could educate him on activity and environmental modifications. Our results suggest that AMPS combined with physiological examinations better informs the rehabilitative process. Poster sessionNo. P-60 MSsOe July. 22, 2018 9301030 aI Physical Dysfunction The case that occupation-based practice in acute phase was effective for achieving goals. ⑤D7E⑥ ± DI Yuji Tashiro1) 1) Southern TOHOKU General Hospital ⑤6 ⑥ D7E Key words: occupational-based practice acute Introduction Recently,occupation-based practice(OBP) has been 6 0) ⑤ recommended.But there are barriers to intervention in the acute ⑥7GH xxx phase,so it's difficult.This time,I was intervened in the case that ± restarted the concert of Hawaiian music.From this experience,I report on the effect of OBP in acute phase. The client has agreed upon this publication. ⑤69D8 ⑥ Case The client is in his 70s.He was hospitalized due to a cerebral infarction.His disability was mild,but it was difficult to expand ~ activities from higher brain dysfunction. ⑤(.⑥ Assessment ⑭⑤, ⑥ Interview (ADOC:11th Days):He served as chairman of a Hawaiian music club,exercises and regular concerts were necessary occupation for to live (satisfaction 1/5). 6 Analysis for Hawaiian music(13th days):It became distracting attention to open space.The sound is broken by weakness holding strings,and it took some time to switch the code.The singing was a small and slowly.He said"The lyrics couldn't be remembered." Intervention First practice divided playing and singing and done writing tasks to remember the lyrics.Next,practice place were changed from private room to open space for graded to correspond to external 6 stimulus.Last,He carried out the concert at the ward. Result(concert:30th days) ⑤,) ⑥ He was able to playing 3 songs although there was a little mistake. ± He said"It was bad performance but so fun!"(Satisfaction 3/5) 6 Discussions The acute phase is the first time to doing occupational therapy,and ⑤ its image has great influence on the recovery and community ,.⑥ rehabilitation.In starting occupational therapy,must be focused on important occupations of him.Because it was a process of promoting functional improvement and becoming empowerment ± himself as occupational being by occupation-as-means and ±6 occupation-as-end. ” ± Poster sessionNo. P-61 POaIse July. 22, 2018 10401140 Physical Dysfunction A case study of resuming a braille translation through ± intervention with occupational based practice Mana Fujita1), Masatoshi Tahara1), Goro Shinjo1),Arata Kawakami1) 1) Saiseikai Higashikanagawa Rehabilitation Hospital Ⅵ Key words: braille, COPM, OBP (Introduction) We intervened focusing on a braille translation for a client who 8DEB lost and gave up his purpose in life. We report about our ⑤“⑥ intervention and after discharge. 1) +) (Methods) We assessed the satisfaction and performance about braille translation by COPM before and after intervention and every 3 8DEB ) months after discharge. ” (Case Profile) BBH:+1 IBI&6 -1 IBI&7 0/ ‐ The case was a man in his 80's with atherothrombotic cerebral 86I 2,'1H9BI infarction of the right pons. He'd continued braille translation as a -.'- 0) ± volunteer for over 20 years. He was hoping to resume braille translation. (Evaluation) Ⅰ He had many mistakes when translating braille. The importance ±” score was 10, performance score and satisfaction score were 1. The left hemiplegia was moderate, MMSE was 28 points, TMT-A was 48 seconds, TMT-B was 176 seconds. The achievement rate of "Ka" cancelation test was 93.8%, and SDMT ‐‐ was 45.4%, which was over 70's average. (Intervention) 8DEB ) 1 1 Firstly, we intervened with the goal of translating braille correctly. IBI&6 +- IBI&7 ,+ We intervened by a cognitive simulation task and handed a 2/'-H9BI -/', homework to habitually translate braille. Secondly, we aimed to 8DEB ) 2 deliver accurate braille transcripts to readers. We translated braille 2 together, discussed the mistakes and examined the alternative means. ③” (Results) ” The importance score was 10, performance score and satisfaction score were 8. TMT-A and TMT-B were improved. Cancellation test and SDMT didn't change. After 1 year, COPM scores were maintained. ‐ (Conclusion) He had good cognitive function, but it was insufficient for braille translation. After intervention, his translate skill improved, and confidence was increased. Poster sessionNo. P-62 e July. 22, 2018 9301030 p Physical Dysfunction Allen Cognitive Level Screen-5: A Client Reacquires Her 6V ⑤68A⑥ Familiy Role ±6V Ryosuke WATANABE 1), Kanta OHNO1), Misato OSAKABE1) &.⑤68AH&.⑥ 1) IMS group IMS Itabashi Rehabilitation Hospital 68AH&. ]UV,') .'1 ]UV Key words: ACL, elderly, theory 68AH&. BACKGROUND Based on the Allen Cognitive Level (ACL) theory, the Allen Cognitive Level Screen-5 (ACLS-5) evaluation method has been 6 1) developed to measure cognitive ability by quantifying it from + ± mode 3.0 to 5.8. Additionally, information about the B1/(+/ ⑤.)(2 environmental setting and assistance methods suitable for each +/(,. ⑥=9H&G1(,) 68AH&.]UV-'/ mode can be determined. This case report describes a client’s ]UV-'/ experiences of reacquiring her role through the ACLS-5. CLIENT AND INTERVENTION PROCESS An 84-year-old woman with a thoracic compression fracture was living with her son, and her household role especially involved ± cooking. Evaluation scores were the following: FIM: 86/126; motor subscores: 50/91; cognitive subscores: 26/35; HDS-R: ± 18/30; ACLS-5: mode 4.6. For this mode, cooking requires ± 6 guidance and attention to hot things and heavy things; support is 6 needed to solve new problems in the kitchen and to manage safety. 68AH&. When I observed the client’s cooking, she manifested increased ± effort in transporting cooking utensils and dishes due to a decline in mobility. Therefore, she required supervision in the kitchen. B.(+/ ⑤1,(2 Her son said that, considering her burden, he would take charge of ,+(,. ⑥=9H&G+.(,) 68AH&.]UV-'/ housework. With her son, I shared ACLS - 5 results and my + observations of her cooking so that she could safely engage in cooking again. ”③ RESULTS ‐ At discharge, evaluation scores were the following: FIM: 68AH&. 115/126; motor subscores: 83/91; cognitive subscores: 32/35; HDS-R: 25/30; ACLS-5: mode 4.6. The client has been cooking 68AH&. safely. ③± CONCLUSION Ⅰ Findings from this case suggest that ACLS-5 estimation of cognitive ability is useful for encouraging families’ understanding of their member’s ability and needs. Poster sessionNo. P-63 OrOl July. 22, 2018 10401140 a er Physical Dysfunction A case of promoted self-recognition through occupation spreading to life ± 6 Emi Inoue1) 1) Visiting Nursing Station WAZAKEA Key words: self-recognition, experience, MTDLP 6 0) M Introduction DV I cooperated and shared a common goal with Mrs. A of physical M+ DIG BBI +, movement practice to help her better understand herself in taking 69A ⑤&⑥ the first steps towards success. About Mrs. A A female (age 70+) who underwent surgery X-years ago for cervical spondylotic myelopathy. The kitchen and bathroom in her house are narrow and wheelchair inaccessible. When 6 changing to OTR in X + two years, she performed ADL at home ± with a wheelchair; except for self-bathing. Her knee flexion occurred frequently during walking. However, she was optimistic, ⑤ .() ,()⑥ “I can do this by myself.” Occupational Therapy Evaluation ⑤ ,() ,()⑥ I utilized MTDLP. Our goal was self-hair washing in the kitchen (execution level: 5/10, satisfaction level: 3/10) and self-body washing in the bathroom (execution level: 3/10, satisfaction level: 3/10). Her mindset was, “I can do it if I try.” Progress/Results 0 We worked together to figure out fall prevention and by seven weeks, she accumulated experience,she was able to recognize her condition. Furthermore, she was able to wash her hair and body ⑤+ with an attendant by the 11th week. During re-evaluation (the ⑥ .() 0() /() 12th week), hair washing (execution level: 5/10, satisfaction level: 1()BBI ,- + 7/10) and body washing (execution level: 6/10, satisfaction level: 8/10). After 12 weeks, she was able to walk to the kitchen carefully alone and wash her face and dishes. Consideration Mrs. A shared life goals with the OTR and accumulated