記憶障害のリハビリテーションのあり方  [in Japanese] Theoretical frameworks of memory rehabilitation  [in Japanese]

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Abstract

記憶のリハビリテーションのあり方を考える際,2つの理論的枠組みが重要である。1つは目標を設定する際の枠組みであり,機能障害よりも患者の日常生活上の問題点 (能力障害) の改善に力点を置き,個々の症例の重症度や障害の特徴をふまえ,テーラーメイドに記憶の代償手段や効率的な学習技法を組み合わせていく。もう1つはリハビリテーションの目標を遂行する過程での枠組みであり,記憶障害患者と健常者との認知過程の相違点に注意することである。ことに誤りなし学習の有効性が繰り返し報告されているが,一方で,患者の能動的参加を促進することも重要である。患者の労力の喚起が新連合の学習にとって有用であることを,知覚同定型の新しい手がかり漸減法を用いた訓練課題で示した。誤りを喚起せずに患者の心的処理労力を動員することは,記憶障害患者の新しい学習にとってもっとも良好な条件となると考えられた。

wo theoretical frameworks could be postulated in organizing memory rehabilitation ; one in the process of goal formation and the other in the process of realizing actual interventions. In planning goals of rehabilitation for memory impaired individuals, therapists should focus on the patients' daily problems (disabilities) rather than on their impairments. Considering severity and characteristics of each patient's memory problems in everyday life, therapists should integrate various techniques including direct trainings, mnemonics and external memory aids to optimize patient's abilities. The other framework is valid throughout the process of goal-oriented rehabilitation interventions. Therapists should bear in mind that errorless learning techniques have been shown to be particularly effective for training amnesic subjects, which is quite different from try-and-error type learning in normal individuals. Prevention of errors during acquisition of information leads to better memory than does learning under errorful conditions. However, active participation of the patients is also another important factor. An advantage of a new version of errorless learning was demonstrated, which encourages patient's active participation. Twelve amnesic patients showed significantly better memory performance via the use of fragment-type perceptual identification than seen under standard errorless conditions. This finding highlights the value of encouraging patient's cognitive efforts to optimize their new learning.

Journal

  • Higher Brain Function Research

    Higher Brain Function Research 23(3), 181-190, 2003-09-30

    Japan Society for Higher Brain Dysfunction

References:  25

Cited by:  6

Codes

  • NII Article ID (NAID)
    110001130245
  • NII NACSIS-CAT ID (NCID)
    AA1182424X
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    13484818
  • Data Source
    CJP  CJPref  NII-ELS  J-STAGE  NDL-Digital 
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