A Cognitive Rehabilitation of a Case of Memory Disturbances after Diffuse Axonal Injury

頭部外傷によるびまん性軸索損傷により記憶障害を呈した症例に対して，展望記憶の改善を目標として入院から外来，職業評価まで継続した作業療法を施行し,復職に至った過程を報告する。記憶障害の評価に用いたRBMTは本症例の問題点の把握に対して有効であった。特に展望記憶の障害に対しRBMTの検査項目を職業内容に擬似して訓練プログラムを作成したことで症例のメタ記憶の改善が得られた。また，入院期間中だけの訓練にとどまらず，外来での作業療法の継続，実際の職業場面の評価にまで介入したことが奏効した。We conducted an occupational therapy for the patient with memory disturbances to improve prospective memory of the patient. The occupational therapy was done continuously from admission to outpatients clinic. RBMT, which we used an assessment for memory disturbances, was useful for assessing the problem of the patients. Especially for a prospective memory disturbances, we have developed a new training program, which resemble the content of occupation from RBMT, the patient's meta memory was improved. Furthermore, we conducted a training program for a patient, not only admission period but also outpatients clinic and intervened the assessment of occupational scene actually and our approach was thought be effective for the patient