16．精神障害をもつ人を対象とした地域生活支援 …

1 7316 I 68 1 7 [1] Illness Management and Recovery; IMR IMR Evidence-Based Practices IMR 1 2 45 60 5 10 2009 [2] IMR IMR I II 74II I IMR QOL 35 15 20 SD= IMR IMR Global Assessment of Functioning; GAF [3] Brief Psychiatric Rating Scale.

2 BPRS [4] Patient Activation Measure 13 for Mental Health; PAM13-MH [5] SF-36 Medical Outcomes Study Short Form 36-item Health Survey Acute Version; SF-36 [6] Life Satisfaction Scale; LSS [7] Self-Efficacy for Community Life Scale of Schizophrenia; SECL [8] Client Satisfaction Questionnaire-8;CSQ-8 [9] IMR t 1 GAF p<.001 BPRS p<.01 PAM13-MH p<.01 SF-36 p<.05 LSS p<.001 p<.01 SECL p<.05, p<.001 MSD ** ** ** * ** ** ** ** ** ** ** * ** *p<.05 **p<.01 **p<.001, df=24 Total score Treatment-related behavior Coping with symptoms Social life Social relationships Psychological functioning Total scoreSECL Daily living Physical functioning Environment Social skills Social relationships Vitality Mental healthLSS Life in general Role emotional General health Social functioning Bodily pain 1 MeasureGAFBPRSB aselinePost-treatmentt valuePAM13-MHSF-36 Physical functioning Role physical 75 CSQ-8 SD= 18 IMR n=8 n=10 (IMR ) 2 SF-36 p<.

3 05 LSS p<.05, p<.01, p<.001, p<.01 SECL p<.01 SF-36 LSS p<.01 LSS SECL p<.05 IMR LSS p<.001 LSS SECL p<.01 SF-36 p<.05 IMR IMR IMR IMR MSD MSD MSD * * **. *. *. ** *. *. **. **. ** * * *. * **. * **. * **. * ** ** ** **. * ** ** * **. **. * **. * **. * *p<.05 **p<.01 **p<.001, df=1,16 Social relationships Total score Daily living Treatment-related behavior Coping with symptoms Social life Social relationships Psychological functioning Total scoreSECL Life in general Physical functioning Environment Social skills Bodily pain Vitality Mental healthLSS 2 MeasureGAFBPRSI nter-action (F)Intervention group (N=8)BaselineGroupTimeBaseline Role physical Role emotional General health Social functioningBase-linePAM13-MHSF-36 Physical functioningMain effects (F)PosttreatmentTimeGroupPosttreatmentCo mparison group (=10)Analysis of interaction (F)

4 Com-parisongroupInter-ventiongroupPost-t reat-ment IMR Randomized controlled trial 76 IMR IMR III II IMR 1 17 EBP IMR 2009 11 21 40 I 2 2010 IMR 2010 9 11 170 I IMR IMR 18 2010 10 IV IMR IMR IMR IMR IMR 77 IMR IMR 1.

5 3 2009 2. , , EBP 5 IMR 2009 Gingerich S, Mueser K: Illness management and recovery. SAMHSA, Center for Mental Health Services, 2003 ) 3. American Psychiatric Associaion. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Washington, DC, 1994. 4. Brief Psychiatric Rating Scales 23 357-367, 1995 5. Patient Activation Measure 13-Mental Health; PAM13-MH 52 765-772 2010 6. Fukuhara S, Bito S, Green J, et al: Translation, adaptation, and validation of the SF-36 Health Survey for use in Japan. J Clin Epidemiol 51: 1037-1044, 1998 7. QOL 104 1413-24 1995 8. SECL 43 727-735 2001 9. : Client Satisfaction Questionnaire 8 41 711-717 1999 146,095 (IPS 53,500 SPSS DVD 19,675 2,400 4,830 1,000 1 1,000 4,375 231,875