ICF(International Classification of Functioning Disability:国際生活機能分類)の視点に基づいて介護計画の内容を見直すにあたり、最も配慮すべき構成要素1つ選びなさい。

1  身体構造
2  個人因子
3  心身機能
4  環境因子
5  活動


猫 Cat

答え 4

1 × 身体構造は生理的(身体的)な構造を意味します。事例を読む限りでは、なじみの店で買い物するにあたり、Gさんの身体構造に対して特に配慮すべき事項があるとは考えにくいです。
2 × 個人因子は、個人に関わる特性を意味し、思い(~したい)、嗜好(~が好き)、性格、生活歴等があります。GさんがH介護福祉職に発した「ほしい物を選んでも、自分で支払わないと買った気にならん」という思いも個人因子であり、重視しなければなりません。このGさんの思いを介護計画によって実現するためには、人が並んでいるレジを避けたり、時間がかかってもGさん自身が支払うようにしたりといった介護福祉職の対応を見直す必要があります。この場合、介護福祉職はGさんにとって環境因子となります。
3 × 心身機能は、心理的および生理的(身体的)な働きの程度を意味します。事例を読む限りでは、なじみの店で買い物するにあたり、Gさんの心身機能に対して特に配慮すべき事項があるとは考えにくいです。
4 〇 環境因子は、利用者本人以外の人(他の利用者や介護福祉職等)、使用している福祉用具のサービス・制度等を意味します。環境因子である他の客から「遅い、早くして」と言われたため、やはり環境因子であるH介護福祉職がGさんに代わって買い物の支払いをしたものの、それに対してGさんは「自分で支払わないと買った気にならん」と言っておられ、Gさんの満足度は低いです。ですから、Gさんが自分で支払いができるよう、空いているレジに並ぶなど、介護福祉職の対応も含めて環境因子に配慮すべきと言えます。 
5 × 活動には、移動、食事、排泄、入浴、口腔ケア、着替え等のADL(日常生活動作)に加え、調理、掃除、洗濯、買物、金銭管理、服薬管理等のIADL(手段的日常生活動作)も含まれます。Gさんがなじみの店で買物することは活動であるから、Gさんの活動自体を見直すのではなく、Gさんが支払いも含めて自分で買物できるよう、空いているレジに並ぶなど、介護福祉職の対応も含めて環境因子に配慮することが必要となります。


From the 31st National Examination Question for Care Workers

Problem 65
Mr. G (79 years old, male) is living in a dementia-friendly communal living care (group home). With the short-term goal of “shopping at a familiar store (2 months)”, we planned and implemented shopping three times a month. The first time was good, but the second time, the person behind me at the cash register said, “Slow, fast,” and the H care welfare worker paid. Mr. G told H care worker, “Even if you choose what you want, you don’t feel like buying it unless you pay for it yourself.”
When reviewing the contents of the long-term care plan from the perspective of the ICF (International Classification of Functioning Disability), select one of the components that should be considered most.

1 Body structure
2 Personal factors
3 Body Function
4 Environmental Factors
5 Activities

The correct answer is ↓

猫 Cat

Answer 4
This is a question regarding the review of the long-term care plan from the perspective of the ICF (International Classification of Functioning, Disability).

1 × Body structure means a physiological (physical) structure. As far as I read the case studies, it is unlikely that there are any particular considerations regarding Mr. G’s physical structure when shopping at a familiar store.
2 × Personal factor means characteristics related to an individual, and includes thoughts (wants), tastes (likes), personality, and life history. The thought that Mr. G gave to the long-term care welfare worker, “Even if you choose what you want, you don’t feel like buying it unless you pay for it yourself” is also an Personal factor and must be emphasized. In order to realize Mr. G’s thoughts through a long-term care plan, it is necessary to review the response of the long-term care welfare staff, such as avoiding the cash register where people are lined up and paying for Mr. G himself even if it takes time. In this case, the long-term care welfare job is an environmental factor for Mr. G.
3 × Mental and physical function means the degree of psychological and physiological (physical) work. As far as I read the examples, it is unlikely that there are any special considerations for Mr. G’s mental and physical functions when shopping at a familiar store.
4 〇 Environmental factors mean people other than the user (other users, long-term care welfare workers, etc.), services and systems of welfare equipment used. Another customer, who is an environmental factor, said, “Slow, fast,” so the environmental factor H, a long-term care welfare worker, paid for shopping on behalf of Mr. G, but Mr. G said, “I am. I don’t feel like I bought it if I didn’t pay for it. “Mr. G’s satisfaction is low. Therefore, it can be said that environmental factors should be taken into consideration, including the response of long-term care and welfare workers, such as lining up at a vacant cash register so that Mr. G can pay by himself. It was
5 × Activities include ADL (Activities of Daily Living) such as movement, meals, excretion, bathing, oral care, and changing clothes, as well as IADL (Activities of Daily Living) such as cooking, cleaning, laundry, shopping, money management, and medication management. Operation) is also included. Since it is an activity for Mr. G to shop at a familiar store, instead of reviewing Mr. G’s activity itself, care and welfare such as lining up at an empty cash register so that Mr. G can shop by himself including payment. It is necessary to consider environmental factors, including how to deal with jobs.