研究報告 日常生活上の刺激に対する意識障害者の感情反応に関する 基礎的研究 Emotional Reaction of the Unresponsive Wakefulness Syndrome Patients the Facial Expression Analysis 肥後雅
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1 研究報告 日常生活上の刺激に対する意識障害者の感情反応に関する 基礎的研究 Emotional Reaction of the Unresponsive Wakefulness Syndrome Patients the Facial Expression Analysis 肥後雅子, 赤澤千春 Masako Higo,Chiharu Akazawa キーワード : 遷延性意識障害, 表情分析, 感情反応 Key Words : unresponsive wakefulness syndrome, facial expressions analysis, emotional reaction 抄録 3 29 Abstract The persistent vegetative state is a clinical condition of complete unawareness of the self and the environment more than three months. In addition, patients in a vegetative state show no evidence of sustained, reproducible, purposeful, or voluntary behavioral responses to visual, auditory, tactile, or noxious stimuli, and show no evidence of language comprehension or expression. However, the family can read feelings from their facial expression. Lorina(2013) showed for the first time that behaviorally nonresponsive patients can use selective auditory attention to convey their ability to follow commands and communicate. It might encourage a family and the nurse who supported a person of vegetative state. A purpose of this study is to catch reaction to daily care for two Unresponsive Wakefulness Syndrome patients. We analyzed patients about emotional reaction by heart rate and facial expression analysis. As a result, We were not able to clarify the plasticity, but we suggested that they reacted for care. 大阪医科大学看護学部 28
2 Ⅰ. はじめに, Medical aspects of the persistent vegetative state Laureys Naci 2013 fmri 3 Ⅱ. 研究の目的 Ⅲ. 用語の定義 1. 意識障害 2. 感情反応 3. 覚醒状態 Ⅳ. 研究方法 1. 研究デザイン : 2. 対象者およびデータ収集期間 29
3 調査手順 Ekman FACS Facial Acton Cording System FACS FACS AU Action Unit 44 AU AU AU 1 AU 18 AU 61 FACS ver6 Noldus 2 FACS Bridges 1932 Valence Valence happy surprised 1/15 FACS Den Uyl, 2005 Terzis V, 2012 Chentsova-Dutton, 2010 Fujiwara, panasonic HC-W570M
4 SK-10LX TM-102 SK-110TRH type1 4. 分析方法 1/15 1 Valence Valence Valence 5. 倫理的配慮 Ⅴ. 結果 1. 対象者属性 A B 対象者に対する刺激 A PT B PT 3. 経時的なValence 値および心拍数の変動 A 2860Lx 48dB Valence 図 1 B 2000Lx 60dB Valence 図 2 Valence 4. と平常時のValence 平均値 ( 100) および心拍数の平均値 ( 表 1,2) A Valence / 31
5 大阪医科大学看護研究雑誌 第 7 巻 2017 年 3 月 大阪医科大学看護研究雑誌 第 7 巻 2017 年 3 月 図 $ 氏の動画撮影中の 9DOHQFH 値 の 分間の平均値および心拍数の変動 図1 A 氏の動画撮影中の Valence 値 100 の 1 分間の平均値および心拍数の変動 および は変動していた部分を示す 注 注 〇および は変動していた部分を示す 9 図2 B 氏の動画撮影中の Valence 値 ( 100) の 1 分間の平均値および心拍数の変動 図 % 氏の動画撮影中の 9DOHQFH 値および のは変動していた部分を示す 分間の平均値および心拍数の変動 注 注 〇および は変動していた部分を示す 表1 A 氏のの Valence 値 100 および心拍数の平均値 表1 $ 氏のの 9DOHQFH 値 および心拍数の平均値 平常時 聴覚刺激 リハビリ 端座位 おむつ交換 平常時 -11.6聴覚刺激-8.5 リハビリ-10.2 端座位 -13.4おむつ交換 㻙㻝㻢㻚㻜 㻙㻝㻠㻚㻜 㻙㻝㻝㻚㻢 㻙㻤㻚㻡 㻙㻝㻜㻚㻞 㻙㻝㻟㻚㻠 㻿㻰 㻟㻞㻚㻢70.5 㻞㻝㻚㻥69.5 㻝㻤㻚㻡 66.6 㻞㻜㻚㻣 63.5 㻝㻠㻚㻜 70.5 㻝㻤㻚㻜 69.7 㻣㻜㻚㻡 㻢㻥㻚㻡 㻢㻢㻚㻢 㻢㻟㻚㻡 7.8㻢㻥㻚㻣 㻣㻜㻚㻡 㻿㻰 㻣㻚㻤 㻡㻚㻢 㻟㻚㻣 㻢㻚㻝 㻢㻚㻟 㻟㻚㻞 表 % 氏のの 値 および心拍数の平均値 表 2 9DOHQFH B 氏のの Valence 値 100 および心拍数の平均値 㻿㻰 9.2 㻿㻰 平常時 触覚刺激 平常時 㻙㻥㻚㻜4.0 㻟㻡㻚㻝 64.0 㻢㻡㻚㻢 㻙㻝㻞㻚㻤 34.3 㻠㻚㻜 64.7 㻢㻠㻚㻜4.4 㻥㻚㻞 清拭 触覚刺激 10.3 㻟㻚㻟 27.5 㻟㻠㻚㻟 㻢㻠㻚㻣 㻤㻚㻜 㻠㻚㻠 洗髪 聴覚刺激 吸入 気管吸引 部分浴 おむつ交換 リハビリ 清拭 洗髪 聴覚刺激 吸入 気管吸引 部分浴 㻝㻜㻚㻟 㻙㻞㻣㻚㻜 33.9 㻙㻞㻜㻚㻥 33.0 㻙㻝㻡㻚㻞 35.7 㻙㻟㻚㻠 38.4㻠㻢㻚㻠 21.9 㻞㻣㻚㻡 㻟㻡㻚㻣 60.8 㻟㻟㻚㻜 㻟㻤㻚㻠 73.1 㻞㻝㻚㻥65.7 㻟㻟㻚㻥 8.1 㻢㻝㻚㻢2.9 㻢㻜㻚㻤 8.5 㻢㻣㻚㻞 0.7㻣㻟㻚㻞 4.2 㻣㻟㻚㻝 㻢㻡㻚㻣 㻠㻚㻣 㻞㻚㻥 㻤㻚㻡 㻜㻚㻣 㻠㻚㻞 㻤㻚㻝 32 端座位 おむつ交換 リハビリ 端座位 㻙㻤㻚㻢 25.7 㻙㻣㻚㻣 32.1㻙㻠㻚㻡 㻞㻟㻚㻢 㻞㻡㻚㻣 65.2 㻟㻞㻚㻝 0.0㻢㻝㻚㻜 8.8 㻣㻟㻚㻤 9.9㻢㻡㻚㻞 㻜㻚㻜 㻤㻚㻤 㻥㻚㻥
6 Valence / A B Valence / Valence / B Valence 100 Valence 100 Ⅵ. 考察 1. 経時的な Valence 値および心拍数の変動からみた各刺激に対する感情反応 /15 Valence A 1 PT 図 1 Valence B Valence B Valence 2. の Valence 値および心拍数からみた感情反応の傾向 Valence 100 A B PT Boly
7 1 Valence Valence 2001 Ⅶ. 結論 2 9 Valence A B 文献 Boly M (2004) : Auditory proccessing in severely brain injured patients: differences between the minimally conscious state and the persistent vegetative state. Archives of Neurology, 61, Bridges KMB (1932) : Emotional Development in Early Infancy, Child Development, 3(4), Chentsova-Dutton YE, Tsai JL (2010) : Self-focused attention and emotional reactivity the role of culture, J Pers Soc Psychol, 98, Den Uyl MJ, Van KuilenburgH (2005) : The facereader: online facial expression recognition in Proceedings of Measuring Behavior 5 th International Conference on methods and Techniques in Behabioural Research, Wageningen, Ekman P, Friesen WV (1978) : Manual for the Facial Action Coding System. Palo Alto: Consulting Psychologists Press. Fujiwara T, Mizuki R, Miki T,et al. (2015) : Association between facial expression and PT symptoms among young children exposed to the Great East Japan Earthquake: a pilot study, Frontiers in Psychology, 6, Laureys S (2007) : Eyes open, brain shut. Scientific American, 296, Medical aspects of the persistent vegetative state (1)(1994) : The Multi-Society Task Force on PVS. N Engl J Med, 330 (21), Naci L, Owen AM (2013) : Every Word Count for Nonresponsive Patients, JAMA Neurology, 70(10), Terzis V, Moridis CN, Economides AA(2012) : The effect of emotional feedback on behavioral intention to use computer based assessment, Comput Educ, 59,
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