腦傷病患的職能治療：矯治取向與以職能為基礎的治療模式之比較

Occupational Therapy for a Patient with Traumatic Brain Injury: Comparing the Effect of Remedial Approach and Occupation-based Treatment Models

李永鑫(Yung-Hsin Li) ； 羅鈞令(Jin-Ling Lo)

《職能治療學會雜誌》 25卷2期 (2007/12) Pp. 65-73

https://doi.org/10.6594/JTOTA.2007.25(2).05

摘要

一位30歲的男性於2005年9月因車禍而致腦傷，自同年11月起接受了10個月的職能治療：前九個月採矯治取向的治療模式，後一個月則採以職能為基礎的治療模式。在前九個月的治療期間，個案的身體功能包括行走以及上下樓梯由不能做進步到只需提示或少許協助即可完成；左上肢只有少許動作恢復。然而，他的進食、沐浴、盥洗、穿衣以及去治療室或回病房卻仍然完全依賴他人幫忙。經改採以職能為基礎的治療模式後，個案的進食與穿衣能力以及去治療室或回病房，在一個月內由完全依賴進展到可以獨立執行，其認知功能亦由Rancho Los Amigos層級Ⅴ進展到層級Ⅶ，個案的自我能力感亦有了顯著的改善。本文比較此兩種治療模式，並討論了造成不同效果之機制。

關鍵字

職能治療 ； 腦傷病患 ； 矯治取向 ； 以職能為目的

並列摘要

A 30-year-old man with traumatic brain injury caused by a car accident in September 2005 received 10-month occupation therapy since November 2005: the first 9-month therapy focused on remediation, the last month focused on daily occupation. In the first 9 months, patient's functional abilities such as walking and stair-climbing improved from total dependence to only needing some supervision or minimal assistance. His left upper extremity had only minimal motor recovery. However, he was still dependent on others for feeding, bathing, grooming, dressing and going to the clinic or back to the ward. In the last month, when the treatment focused on his daily occupations, the patient learned to independently feed and dress himself and walk to the clinic or back to his room independently. His cognition level improved from Rancho Los Amigos Level Ⅴ to Level Ⅶ. His sense of competence also improved. This article compares the two different treatment models and discusses the mechanism for the different results.

並列關鍵字

occupational therapy ； traumatic brain injury ； remedial approach ； occupation Correspondence