WO2023204239A1

WO2023204239A1 - Treatment assistance system and treatment assistance program

Info

Publication number: WO2023204239A1
Application number: PCT/JP2023/015577
Authority: WO
Inventors: 太祐市川; 敬明佐野; 博司小山; 龍男明智; 美枝酒井
Original assignee: サスメド株式会社; 公立大学法人名古屋市立大学
Priority date: 2022-04-19
Filing date: 2023-04-19
Publication date: 2023-10-26

Abstract

The present invention evaluates patient achievement of the six core processes of ACT on the basis of one or more indicators and, on the basis of an intervention scenario set in accordance with the results of the evaluation, sequentially executes a plurality of interventions that are based on the six core processes. The present invention also uses attribute information, treatment log information, and ACT evaluation information for a plurality of patients that have shown improvement from intervention to identify and store associated factors presumed to be associated with improvement by pattern of change in ACT achievement before and after intervention. When an intervention scenario is to be set for a particular patient, the present invention specifies a pattern of change for which associated factors match the attributes, etc. of the patient and sets the intervention scenario to lead to the same improvement in ACT achievement as the pattern of change.

Description

Treatment support systems and treatment support programs

The present invention relates to a treatment support system and a treatment support program for supporting treatment of a disease.

With the revision of the Medical Products and Medical Devices Law (formerly Pharmaceutical Affairs Law) in the fall of 2014, medical software has come to be treated as medical devices. ) is under development. For example, treatment apps are available that utilize ``cognitive behavioral therapy,'' which treats diseases through lifestyle changes such as reviewing daily actions and ways of thinking. This type of treatment app checks the biological information measured about the patient and the actions the patient inputs, and provides advice and review results.

Systems are also known that are configured to generate an individualized care plan based on a specific therapeutic intervention and provide healthcare assistance to a patient based on the care plan (for example, US Pat. reference). The system described in Patent Document 1 provides care to a patient suffering from a chronic disease, and for a certain patient, data is retrieved from a library database based on data related to the patient stored in a patient database. Selecting at least one predetermined treatment intervention and generating a personalized care plan based on the selected predetermined treatment intervention. The patient's health parameters and/or treatment compliance parameters are then monitored and healthcare assistance is provided to the patient based on the personalized care plan.

Special Publication No. 2020-537264

The present invention aims to improve the method of intervention in a treatment support system that supports the treatment of diseases while performing intervention on patients based on cognitive behavioral therapy.

In order to solve the above problems, the present invention evaluates the patient's proficiency in ACT based on one or more indicators based on all or part of the six core processes of ACT, and the evaluation results Accordingly, an intervention scenario based on the six core processes is set, and a plurality of intervention processes based on the six core processes are sequentially performed based on the set adjusted intervention scenario or the preset basic intervention scenario. After a series of intervention processes are executed based on the intervention scenario, it is evaluated whether or not the intervention had the expected improvement effect, and improvement evaluation information indicating the results of the evaluation is sent to the patient's attribute information and It is recorded for each patient along with ACT evaluation information indicating the results of evaluations performed before and after a series of intervention treatments. In addition, in the present invention, by using attribute information and ACT evaluation information of a plurality of patients whose improvement evaluation information indicates that the expected improvement effect has been achieved, ACT proficiency can be improved before and after execution of a series of intervention treatments. For each pattern of change in degree, related factors estimated to be related to improvement are identified as attribute-related factors from the attribute information. When setting an intervention scenario for a certain patient, the evaluation results and attribute information regarding the patient's ACT proficiency are matched with the pattern of change in ACT proficiency and attribute-related factors to match the patient. A tailored intervention scenario is set up that includes an intervention treatment to lead to an improvement in ACT proficiency similar to the identified change pattern.

According to the present invention configured as described above, it is possible to perform intervention processing for a patient in accordance with the six core processes of ACT and according to an intervention scenario that is set according to the evaluation result of the patient's proficiency in ACT. Become. Further, according to the present invention, attribute information and ACT evaluation information of a plurality of patients for whom an improvement effect was observed as a result of executing a series of intervention processes based on an intervention scenario are used to estimate information related to the improvement. Attribute-related factors are identified for each pattern of change in ACT proficiency, and when setting an intervention scenario for a certain patient, the identification results are used to set the intervention scenario. Thereby, it is possible to set an intervention scenario that focuses on core processes that are expected to be highly likely to be improved, depending on the patient's attributes and ACT proficiency level before the start of the intervention process. As described above, according to the present invention, it is possible to improve the method of intervention in a treatment support system that supports treatment of a disease while performing intervention on a patient based on cognitive behavioral therapy.

1 is a diagram showing an example of the overall configuration of a treatment support system according to the present embodiment. FIG. 1 is a block diagram showing an example of a functional configuration of a treatment support device according to the present embodiment. FIG. 2 is a block diagram showing an example of the functional configuration of a server device according to the present embodiment. FIG. 2 is a conceptual diagram showing a configuration example of a basic intervention scenario. FIG. 2 is a diagram schematically showing an example of patient-related information regarding one certain patient. FIG. 6 is a diagram schematically showing an example in which attribute-related factors and log-related factors are specified for one change pattern related to ACT proficiency. FIG. 3 is a diagram schematically showing an example of information stored in a related factor storage unit. FIG. 3 is a diagram schematically showing an example of information stored in a related factor storage unit. FIG. 3 is a diagram for explaining processing contents of an intervention scenario setting unit. FIG. 3 is a diagram for explaining processing contents of an intervention scenario setting unit.

Hereinafter, one embodiment of the present invention will be described based on the drawings. FIG. 1 is a diagram showing an example of the overall configuration of a treatment support system according to this embodiment. As shown in FIG. 1, the treatment support system of this embodiment is a treatment support system that supports the treatment of diseases while intervening with patients based on cognitive behavioral therapy, and includes a treatment support device 10 and a server device 20. It consists of The treatment support device 10 and the server device 20 are connected via a communication network 30 such as the Internet or a mobile phone network.

The treatment support device 10 is configured by, for example, a smartphone, a tablet terminal, or a personal computer, and has a treatment application 1 installed therein that cooperates with the server device 20 to execute various processes to support treatment of a disease. Although only one treatment support device 10 is illustrated in FIG. 1, there are multiple treatment support devices 10 used by multiple patients.

The treatment application 1 performs intervention processing based on six core processes of ACT (Acceptance and Commitment Therapy). ACT is a therapy based on the concept of mindfulness that maintains and restores mental health by creating ``psychological flexibility.'' The basic concept of intervention by therapeutic application 1 based on six core processes is as follows.

1. Defusion: Recognize that "thought" is nothing more than a combination of "words" and "images."
Therapeutic App 1 helps improve negative thoughts about diseases and treatments by encouraging patients to firmly recognize that thoughts are just words and images, and are neither reality nor truth. and reduce stress.

2. Acceptance: Accepting uncomfortable feelings and making room for them.
Rather than rejecting, pushing away, or distracting from negative thoughts and emotions, treatment involves opening and expanding your consciousness to accept what is and create a space within yourself. Prompt through the intervention of app 1.

3. Contact with the present moment: Focus and be aware of the here and now, this moment.
The efficiency and effectiveness of treatment is improved by encouraging the patient to focus on what needs to be done now and to be grateful for what is happening through the intervention of treatment app 1.

4. Self as an observer: Focus on the "noticing self" that objectively looks at the "thinking self".
The thinking self creates distracting thoughts, reduces concentration, and suffers from feelings of self-denial. Through the intervention of therapeutic application 1, the patient is encouraged to become aware of this thinking self and defusion.

5. Values: Clarify the values you value and use them as a guideline for your actions.
Through the intervention of the therapeutic application 1, the patient is encouraged to confirm what is important and valued by the patient, and to allow this to become the engine of action for treatment.

6. Committed action: actually taking action that is consistent with your values.
The intervention of the therapeutic application 1 encourages the patient to think of specific goals for treatment, formulate a plan, and execute them.

FIG. 2 is a block diagram showing an example of the functional configuration of the treatment support device 10 according to this embodiment. FIG. 3 is a block diagram showing an example of the functional configuration of the server device 20 according to this embodiment. The configuration of the treatment support system according to this embodiment will be described in detail below using FIGS. 2 and 3.

As shown in FIG. 2, the treatment support device 10 of this embodiment has a functional configuration including an attribute information input section 101, an attribute information registration request section 102, an ACT evaluation section 103, an intervention scenario registration section 104, and an intervention processing execution section 105. , a treatment log recording section 106, a log registration requesting section 107, a sensor information recording section 108, an intervention effect evaluation section 109, and a communication section 110. The treatment support device 10 of this embodiment also includes an attribute information storage section 111, an evaluation index storage section 112, an intervention scenario storage section 113, a treatment log storage section 114, and a sensor information storage section 115 as storage media.

The functional blocks 101 to 110 can be configured by hardware, DSP (Digital Signal Processor), or software. For example, when configured by software, the functional blocks 101 to 110 are actually configured with a computer's CPU, RAM, ROM, etc., and programs stored in storage media such as RAM, ROM, hard disk, or semiconductor memory operate. This is achieved by doing.

The communication unit 110 communicates with the server device 20 via the communication network 30 and exchanges various information.

The attribute information input unit 101 inputs patient attribute information through the patient's operation on the treatment application 1. The attribute information input by the attribute information input unit 101 includes, for example, the patient's age (or generation), gender, medical history, and employment status (unemployed/housewife/manager/self-employed, etc.). In addition, information such as the patient's basic physical information, family history, social history, preferences, allergies, etc., which may be recorded in the medical record, may be further included. Patient attribute information input by the attribute information input section 101 is stored in the attribute information storage section 111.

The attribute information registration requesting unit 102 requests that the patient's attribute information stored in the attribute information storage unit 111 be registered in the server device 20. For example, the attribute information registration request unit 102 transmits a request to register attribute information regarding the patient to the server device 20 via the communication unit 110 through the patient's operation on the treatment application 1 . As will be described later, upon receiving this request, the server device 20 registers the patient attribute information received from the treatment support device 10 in the database.

The ACT evaluation unit 103 evaluates the patient's proficiency in ACT based on one or more indicators based on all or part of the six core processes of ACT. For example, the ACT evaluation unit 103 presents the patient with a questionnaire consisting of a combination of multiple questions and options, calculates a score according to the results of the answers to each question, and evaluates the ACT proficiency level based on the score. Evaluate. A higher score means a higher level of proficiency in ACT. For example, the ACT evaluation unit 103 classifies the patient's ACT proficiency level as either “low” or “high” depending on the magnitude of the calculated score. Note that the proficiency level may be ranked into three or more levels.

Here, the questionnaire is created in correspondence with the core process, and the score calculated based on the questionnaire is one aspect of an index according to the core process. The questionnaire data is stored in the evaluation index storage unit 112. For example, data of six questionnaires corresponding to six core processes by ACT is stored in the evaluation index storage unit 112. The ACT evaluation unit 103 presents these six questionnaires to the patient and obtains responses, calculates a score for each questionnaire, and evaluates the ACT proficiency level for each of the six core processes.

Alternatively, you can use less than six (for example, one) questionnaires that can be used to assess the proficiency of the six core processes individually, or a questionnaire that can comprehensively assess the proficiency of the six core processes. The proficiency level of ACT may be evaluated for each of the six core processes based on the results of the responses by presenting the results to the patient. As an example of a questionnaire that can be comprehensively evaluated, it is possible to use, for example, MPFI (Multidimensional Psychological Flexibility Inventory). In addition, by presenting less than 6 questionnaires corresponding to some of the core processes to the patient and obtaining responses, a score is calculated for each questionnaire, and ACT The proficiency level may be evaluated. For example, it is possible to use questionnaires regarding the following indicators: FFMQ (Five Facet Mindfulness Questionnaire), CPAQ (Chronic Pain Acceptance Questionnaire), VQ (Valuing Questionnaire), and AAQ-II (Acceptance and Action Questionnaire).

The ACT evaluation unit 103 performs a series of intervention processes before the intervention process execution unit 105 executes a series of intervention processes based on an intervention scenario to be described later (before the start of the intervention period), and after executing the series of intervention processes (before the start of the intervention period). Evaluate ACT proficiency at least twice (after completion). The reason for evaluating the ACT proficiency level before and after performing a series of intervention processes is to recognize how the ACT proficiency level has changed due to the intervention.

The ACT evaluation unit 103 transmits information indicating the evaluation result of ACT proficiency (hereinafter referred to as ACT evaluation information) together with patient identification information to the server device 20, and registers the ACT evaluation information in the server device 20 in association with the patient. request that For example, when the ACT evaluation unit 103 evaluates the ACT proficiency of a certain patient, it transmits a request to register ACT evaluation information to the server device 20 via the communication unit 110. As will be described later, upon receiving this request, the server device 20 registers the ACT evaluation information in the database in association with the patient whose attribute information is stored.

The intervention scenario registration unit 104 transmits ACT evaluation information of a certain patient who is about to start treatment to the server device 20 to request setting of an intervention scenario, and receives the intervention scenario set by the server device 20 in response. and register it in the intervention scenario storage unit 113. An intervention scenario is information that defines procedures and methods for executing multiple intervention processes for a patient in accordance with the six core processes of ACT. The method of executing the intervention process includes at least one of information such as the timing of executing the intervention process, the frequency of repeated execution, and the method of notifying the patient.

The intervention scenario set by the server device 20 is created by adjusting a part of the basic intervention scenario. In the following, this will be referred to as an adjusted intervention scenario. A method for setting the adjustment intervention scenario by the server device 20 will be described later. The intervention scenario storage unit 113 stores information on a basic intervention scenario in advance when the treatment application 1 is installed on the treatment support device 10, and also stores information on an adjusted intervention scenario received from the server device 20 at any time thereafter. Additional information is stored.

FIG. 4 is a conceptual diagram showing a configuration example of a basic intervention scenario. In the example shown in FIG. 4, during a predetermined intervention period (e.g., 8 weeks), the intervention process corresponding to each core process is performed while switching the content of the effort corresponding to the core process every predetermined unit period (e.g., one week). The content defines that the steps are to be executed sequentially. One intervention process may be defined to be linked to one initiative content, or a plurality of intervention processes may be defined to be linked to one initiative content.

The intervention process includes, for example, a process that prompts the patient to perform a predetermined action corresponding to the core process. Predetermined actions include, for example, drinking meditation, eating meditation, observing your hands, daily mindfulness, creating a life compass (worksheet with a list of important things, etc.), activities that lead to your life compass, and developing a certain way of thinking. This includes exercises such as viewing the cards shown, reciting specific ideas, exercise such as walking, and housework. Note that the examples listed here are just examples, and the invention is not limited to these.

The intervention processing execution unit 105 executes a basic intervention scenario or an adjusted intervention scenario stored in the intervention scenario storage unit 113 (an adjusted intervention scenario set by an intervention scenario setting unit 203 of the server device 20 described later or a preset basic intervention scenario). Based on the intervention scenario), multiple intervention processes based on six core processes are sequentially executed.

Here, the intervention processing execution unit 105 executes the intervention processing based on the basic intervention scenario during the initial period from the start of operation of the treatment support system until the intervention processing is executed for a certain number of patients. Execute. That is, during this initial period, the intervention scenario registration unit 104 does not request the server device 20 to set an intervention scenario, or does not obtain an adjusted intervention scenario from the server device 20 even if it requests it. In this case, since the adjustment intervention scenario is not stored in the intervention scenario storage unit 113, the intervention processing execution unit 105 executes the basic intervention scenario stored in advance in the intervention scenario storage unit 113.

On the other hand, after the intervention process has been executed for a certain number of patients (after the initial period has passed), the intervention process is executed based on the adjusted intervention scenario set by the server device 20. In this way, the reason why the adjusted intervention scenario is used after the initial period is to analyze the data accumulated through intervention processing for more than a certain number of patients when setting the adjusted intervention scenario in the server device 20. This is because it is necessary. Note that there is no problem in executing the intervention process based on the basic intervention scenario after the intervention process has been executed for a certain number of patients.

Here, a certain number may be set in advance. In this case, until data of a predetermined number of patients are accumulated in the server device 20, the server device 20 does not set the adjustment intervention scenario even if there is a request from the treatment support device 10. Alternatively, an operation manager of the treatment support system, a doctor, or the like may appropriately determine an appropriate number while monitoring the data accumulation status. In this case, an operations manager or the like who has determined that a reasonable amount of data has been accumulated instructs the server device 20 to start setting an adjustment intervention scenario. Until this instruction is input, the server device 20 does not set the adjustment intervention scenario even if there is a request from the treatment support device 10.

The treatment log recording unit 106 generates treatment log information regarding actions performed by the patient as prompted by the intervention process by the intervention process execution unit 105, and sequentially records the generated treatment log information in the treatment log storage unit 114. The treatment log information includes, for example, the name of the action performed by the patient, the date and time of the action, and information specified by the treatment application 1 as a result of the action (for example, a score calculated from the execution result of a worksheet).

Here, in the case of an action performed by the patient using the treatment application 1, the treatment application 1 can automatically generate treatment log information through the executed processing of the treatment application 1. On the other hand, if the patient performs an action without using the treatment application 1, the patient inputs necessary information into the treatment application 1 after performing the action, thereby generating treatment log information. For example, after the intervention process execution unit 105 executes the intervention process, the treatment log recording unit 106 records the treatment log after a period of time longer than the time normally expected for the patient to complete the behavior prompted by the intervention process. The treatment log information may be input by providing a notification prompting the patient to input the treatment log information.

The log registration request unit 107 requests that the patient's treatment log information stored in the treatment log storage unit 114 be registered in the server device 20. For example, when treatment log information regarding a certain patient is stored in the treatment log storage section 114, the log registration requesting section 107 transmits a registration request for the treatment log information to the server device 20 via the communication section 110. As will be described later, upon receiving this request, the server device 20 registers the treatment log information in the database in association with the patient whose attribute information is stored.

The sensor information recording unit 108 sequentially records sensor information acquired by a sensor (not shown) in the sensor information storage unit 115. The sensor includes, for example, at least one of a pedometer, a GPS, a heart rate monitor, a blood pressure monitor, a calorie consumption meter, and the like. The sensors used in this embodiment are for detecting information that can measure or estimate the amount of activity of a patient, and the sensors listed here are examples thereof. Note that the sensor information recording unit 108 does not need to constantly record the sensor information acquired by the sensor in the sensor information storage unit 115, but rather stores the sensor information acquired at predetermined interval intervals in the sensor information storage unit 115. 115.

The intervention effect evaluation unit 109 evaluates the treatment log information stored in the treatment log storage unit 114 and the sensor information storage unit 115 after the intervention process execution unit 105 executes a series of intervention processes based on the intervention scenario. Based on at least one of the sensor information, it is evaluated whether or not the intervention had the expected improvement effect. The expected improvement effect of the intervention is that the patient will acquire the concept of ACT and be able to engage in behavioral activities that are not constrained by pain, resulting in an improvement (increase) in the amount of activity.

An increase in activity can be determined by factors such as an increase in the number of steps taken, an expansion of the range of activity, and an increase in activity time (increase in the number of working days and time spent on housework) before and after performing a series of intervention processes. be. For example, the average number of steps per day measured by a pedometer after performing a series of interventions increases compared to the average number of steps per day measured by a pedometer before performing a series of interventions. In this case, it is possible to determine that the amount of activity has increased. Furthermore, if the moving distance of the patient's current position measured by GPS increases before and after executing a series of intervention processes, it is also possible to determine that the amount of activity has increased. Furthermore, if the patient's activity time recorded in the treatment log information increases before and after executing a series of intervention processes, it is also possible to determine that the amount of activity has increased. Furthermore, in addition to the amount of physical activity, we also evaluated whether the expected improvement effect was achieved by measuring the amount of static activity that does not involve physical activity, such as listening to music or drawing pictures. Good too.

The intervention effect evaluation unit 109 may determine that the intervention has had the expected improvement effect when an increase in the amount of activity is shown for any one element, or may determine that the intervention has had the expected improvement effect when an increase in the amount of activity is shown for any one element. It may be determined that the intervention has had the expected improvement effect if an increase in the amount of activity is shown for the patient. Alternatively, it is possible to set in advance factors to be targeted for improvement for each patient, and determine that the intervention has had the expected improvement effect if an increase in activity level is shown for the targeted factor. You can also do this.

The intervention effect evaluation unit 109 transmits information indicating the evaluation result of whether or not the improvement was effective (hereinafter referred to as improvement evaluation information) together with the patient's identification information to the server device 20 in association with the patient. Request to register evaluation information. For example, when the intervention effect evaluation unit 109 evaluates whether or not the intervention has had the expected improvement effect on a certain patient, the intervention effect evaluation unit 109 sends a request for registration of improvement evaluation information to the server device 20 via the communication unit 110. Send. As will be described later, upon receiving this request, the server device 20 registers the improvement evaluation information in the database in association with the patient whose attribute information is stored.

As shown in FIG. 3, the server device 20 of this embodiment includes a patient-related information recording section 201, an improvement-related factor identification section 202, an intervention scenario setting section 203, and a communication section 204 as functional configurations. Furthermore, the server device 20 of this embodiment includes a patient-related information storage section 211, a related factor storage section 212, and a basic scenario storage section 213 as storage media.

The functional blocks 201 to 204 can be configured by hardware, DSP, or software. For example, when configured by software, the functional blocks 201 to 204 are actually configured with a computer's CPU, RAM, ROM, etc., and programs (treatment (including support programs).

The communication unit 204 communicates with the treatment support device 10 via the communication network 30 and exchanges various information.

The patient-related information recording unit 201 stores patient attribute information, ACT evaluation information indicating the results of evaluation performed by the ACT evaluation unit 103 before and after executing a series of intervention processes, and intervention information after executing a series of intervention processes. Improvement evaluation information indicating the results of the evaluation performed by the effect evaluation unit 109 and treatment log information specified when executing a series of intervention processes for a patient are recorded in the patient-related information storage unit 211 for each patient. Patient attribute information, ACT evaluation information, improvement evaluation information, and treatment log information are stored in the patient-related information storage unit 211 in response to requests for registration from the treatment support device 10 at respective timings.

That is, the patient-related information recording unit 201 records patient attribute information in the patient-related information storage unit 211 in response to a registration request from the attribute information registration requesting unit 102 of the treatment support device 10. In addition, in response to a registration request from the ACT evaluation unit 103 of the treatment support device 10, the patient-related information recording unit 201 stores the ACT evaluation information obtained before and after executing a series of intervention processes in the patient-related information storage unit 211. Record. In addition, in response to a registration request from the intervention effect evaluation unit 109 of the treatment support device 10, the patient-related information recording unit 201 stores improvement evaluation information obtained after executing a series of intervention processes in the patient-related information storage unit 211. Record. In addition, in response to a registration request from the log registration requesting unit 107 of the treatment support device 10, the patient-related information recording unit 201 stores the treatment log information specified when executing a series of intervention processes in the patient-related information storage unit 211. Record sequentially.

FIG. 5 is a diagram schematically showing patient-related information regarding one patient. In FIG. 5, attribute information is information transmitted by the attribute information registration requesting unit 102 of the treatment support device 10. The treatment log information is information transmitted by the log registration requesting unit 107 of the treatment support device 10. These pieces of information are the same as the attribute information and treatment log information stored in the attribute information storage unit 111 and treatment log storage unit 114 of the treatment support device 10, but the patient-related information storage unit 211 stores attributes related to multiple patients. It differs from the attribute information storage unit 111 and the treatment log storage unit 114 in that information and treatment log information are stored.

The ACT evaluation information is information transmitted by the ACT evaluation unit 103 of the treatment support device 10, and here an example is shown in which the ACT proficiency level is evaluated for each of six core processes. "X" indicates that the patient's proficiency in ACT was evaluated as low, and "〇" indicates that the patient's proficiency in ACT was evaluated as high. The improvement evaluation information is information sent by the intervention effect evaluation unit 109 of the treatment support device 10, where "x" indicates that the intervention was evaluated as not having the expected improvement effect, and "〇" indicates that there was no improvement. This indicates that the project was evaluated as being effective.

The improvement-related factor identification unit 202 collects attribute information, ACT evaluation information, and treatment logs of a plurality of patients whose improvement evaluation information stored in the patient-related information storage unit 211 indicates that the expected improvement effect has been achieved. Using the information, for each pattern of change in ACT proficiency before and after a series of intervention treatments, related factors estimated to be related to improvement are determined from attribute information and treatment log information, respectively. Identify as a factor.

That is, the improvement-related factor identification unit 202 extracts a plurality of patients for whom "〇" is recorded in the improvement evaluation information shown in FIG. Those with the same pattern of change in ACT proficiency before and after the intervention as indicated by the evaluation information are grouped together. As illustrated in Figure 5, when the ACT evaluation information is information indicating the results of evaluating ACT proficiency for each of the six core processes, how did the proficiency for each core process change before and after the intervention? Patients whose information matches in all six points are grouped together.

Then, the improvement-related factor identification unit 202 analyzes the attribute information of each patient for each group, and identifies attribute information that is estimated to be related to improvement as an attribute-related factor. For example, the improvement-related factor identification unit 202 selects attribute information of a type commonly held by a predetermined percentage or more of patients, which is estimated to be related to improvement, among multiple types of attribute information regarding multiple patients belonging to a group. identified as attribute-related factors. This is an image in which when a predetermined percentage or more of patients' age, gender, medical history, and employment status are in their 50s, the attribute information of 50s is identified as an attribute-related factor. Alternatively, for each of multiple types of attribute information, attribute information that is a superordinate concept of content common to attribute information regarding a predetermined percentage or more of patients is generated, and this is identified as an attribute-related factor that is estimated to be related to improvement. It's okay. This is an image in which, for example, regarding the age of patients, when a predetermined percentage or more of patients are in their 50s or younger, attribute information that is conceptualized as a higher-level concept of 50s or younger is identified as an attribute-related factor.

Furthermore, the improvement-related factor identification unit 202 analyzes treatment log information for each patient for each individual group, and identifies treatment log information that is estimated to be related to improvement as a log-related factor. For example, the improvement-related factor identification unit 202 identifies types of treatment log information that a predetermined percentage or more of patients have in common, among multiple types of treatment log information regarding multiple patients belonging to a group, as being related to improvement. Identified as a putative attribute-related factor. Alternatively, for each of multiple types of treatment log information, treatment log information is generated in which content common to treatment log information regarding a predetermined percentage or more of patients is conceptualized, and this is identified as a log-related factor estimated to be related to improvement. You may also do so.

Figure 6 shows that for one change pattern related to ACT proficiency, related factors estimated to be related to improvement are identified as attribute-related factors from attribute information, and log-related factors are identified from treatment log information. FIG. 3 is a diagram schematically showing a specified example. The example in Figure 6 shows that before the start of the intervention, ACT proficiency in all six core processes is rated as low "x", but after the intervention ends, the level of ACT proficiency is rated as low, but after the intervention is finished, the level of ACT proficiency is rated as low, and the level of ACT proficiency is rated "x" for all six core processes. and the three core processes of value, indicating a pattern of change that resulted in a high level of proficiency in ACT.

Figure 6 also shows three types of patient attribute information, ``employed,'' ``under 50s,'' and ``one type of medical history or less,'' from among the attribute information of multiple patients for whom ACT evaluation information of such change patterns was recorded. In addition to identifying three attribute-related factors, we also identified ``Program progress delay is less than XX days'', ``Meditation implementation rate is XX% or more'', and ``Worksheet input is 100 days or more'' from treatment log information of multiple patients. An example is shown in which three log-related factors "%" were identified.

The improvement-related factor identification unit 202 records the attribute-related factors and log-related factors identified as described above in the related factor storage unit 212 for each pattern of change in ACT proficiency. 7A and 7B are diagrams schematically showing examples of information stored in the related factor storage unit 212. 7A and 7B schematically show an example in which the attribute-related factors and log-related factors identified by the improvement-related factor identification unit 202 are stored in association with each other for each of the four change patterns (1) to (4). .

The intervention scenario setting unit 203 stores the ACT proficiency evaluation result in the basic scenario storage unit 213 for a certain patient who is about to start treatment, according to the evaluation result of ACT proficiency sent from the intervention scenario registration unit 104 of the treatment support device 10. By adjusting the basic intervention scenario, we set up a tailored intervention scenario based on six core processes. In the adjustment intervention scenario, ACT proficiency is improved in the same way as the change pattern of ACT proficiency stored in the related factor storage unit 212 for intervention processing regarding at least one of the six core processes. This is an intervention scenario that includes an intervention process to guide the intervention.

For example, the intervention scenario setting unit 203 uses the ACT proficiency evaluation results of a certain patient performed by the ACT evaluation unit 103 and the attribute information of the certain patient to determine the ACT proficiency level stored in the related factor storage unit 212. By comparing the change pattern and attribute-related factors, a change pattern that matches a certain patient is identified. Then, an adjustment intervention scenario is set that includes an intervention process to lead to an improvement in ACT proficiency similar to the identified change pattern.

Here, the change pattern is identified as follows. That is, the intervention scenario setting unit 203 determines the relationship between a certain patient's attribute information and attribute-related factors, and the evaluation result and change pattern regarding the ACT proficiency level of a certain patient before any change (before execution of a series of intervention processes). A pattern of change that matches a certain patient is identified from the perspective of its relationship with the evaluation results regarding ACT proficiency shown as information on ACT. For example, if a certain patient's attribute information and attribute-related factors match, and a certain patient's evaluation result regarding ACT proficiency matches the evaluation result regarding ACT proficiency shown as information before change in the change pattern. Identify a change pattern that matches a certain patient.

Note that if there are multiple applicable change patterns, select one arbitrary change pattern from among them. Alternatively, a change pattern in which the number of core processes in which the ACT proficiency level is improved before and after a series of intervention processes is improved may be selected to be the largest or the smallest. On the other hand, if no corresponding change pattern is found, the matching conditions regarding the consistency of attribute information or the consistency of evaluation results regarding ACT proficiency are relaxed to identify a change pattern that matches a certain patient. You can also do this.

FIG. 8 is a diagram for explaining the processing content of the intervention scenario setting unit 203. The example in FIG. 8 is based on the consistency between the evaluation results regarding patient A's attribute information and ACT proficiency level and the attribute-related factors for each change pattern stored in the related-factor storage unit 212. This shows a situation in which change pattern (1) is identified. That is, in this example, patient A's three attribute information and three attribute-related factors match, and are shown as information before change in the evaluation result and change pattern (1) regarding patient A's ACT proficiency level. The evaluation results regarding ACT proficiency are consistent. As a result, change pattern (1) is identified as a change pattern that matches patient A.

In this case, the intervention scenario setting unit 203 sets an adjustment intervention scenario that includes an intervention process to lead to an improvement in ACT proficiency similar to the identified change pattern (1). In other words, an intervention that will lead to an improvement in the ACT proficiency evaluation from "x" to "〇" for three of the six core processes: defusion, contact with the present moment, and value. Establishing a coordinated intervention scenario comprising a treatment. For example, the intervention scenario setting unit 203 sets an adjustment intervention scenario that includes an intervention process related to the log-related factors stored in the related factor storage unit 212 in association with the identified change pattern.

When change pattern (1) is identified as shown in Figure 8, "Program progress delay is less than XX days," "Meditation implementation rate is xx% or more," and "Worksheet input is 100%." Three log related factors are stored in the related factor storage unit 212 in association with change pattern (1) (see FIG. 7A). Therefore, the intervention scenario setting unit 203 sets an adjusted intervention scenario that includes intervention processing related to these three log-related factors. In the example in Figure 8, the adjustment intervention scenario includes ``reminder push notifications to avoid delays in program progress,'' ``recommended display for drinking meditation,'' and ``reminder notifications for events that prompt you to enter a value worksheet.'' This shows that the settings are to be made.

FIG. 9 is a diagram showing an example of setting an adjustment intervention scenario for another patient B. The example in FIG. 9 is based on the consistency between the evaluation results regarding patient B's attribute information and ACT proficiency level and the attribute-related factors for each change pattern stored in the related factor storage unit 212, as shown in FIG. 7B. This shows a situation in which change pattern (4) is identified. In addition, in the example of FIG. 9, intervention processes related to two log-related factors stored in association with change pattern (4) are "reminder notification for event that prompts input of value worksheet" and "meditation event". This indicates setting up a tailored intervention scenario that includes "recommending that the program be implemented at night (or displaying a reminder notification at night)".

Note that the intervention process that leads to the improvement of ACT proficiency in the same way as the identified change pattern is not limited to the example of an intervention process related to log-related factors. For example, among the six core processes, an intervention scenario in which the degree of intervention related to the core process whose ACT proficiency evaluation has improved from "x" to "○" is strengthened compared to the basic intervention scenario is called an adjusted intervention scenario. You may also set it. As a method of strengthening the degree of intervention, for example, a method of increasing the frequency of repeated execution of the intervention process, a method of increasing the number of reminder notifications, etc. may be used. When setting the adjustment intervention scenario using such a method, it is possible to omit that the patient-related information recording unit 201 records treatment log information in the patient-related information storage unit 211.

As explained in detail above, in this embodiment, the patient's proficiency level of ACT is evaluated based on one or more indicators based on all or part of the six core processes of ACT, and the evaluation results are Accordingly, an intervention scenario based on the six core processes is set, and a plurality of intervention processes based on the six core processes are sequentially performed based on the set intervention scenario. This makes it possible to perform intervention processing for a patient in accordance with the six core processes of ACT and according to an intervention scenario that is set according to the evaluation result of the patient's proficiency in ACT.

In addition, in this embodiment, a series of intervention processes are executed using attribute information, ACT evaluation information, and treatment log information of a plurality of patients whose improvement evaluation information indicates that the expected improvement effect has been achieved. For each pattern of change in ACT proficiency before and after, attribute-related factors and log-related factors that are estimated to be related to improvement are identified, and the results are stored in the related factor storage unit 212. When setting an intervention scenario for a certain patient, the evaluation results and attribute information regarding the patient's ACT proficiency are matched with the pattern of change in ACT proficiency and attribute-related factors to match the patient. An adjustment intervention scenario is set that includes an intervention process that leads to an improvement in ACT proficiency similar to the identified change pattern.

According to the present embodiment configured in this manner, attribute information, ACT evaluation information, and treatment log information of a plurality of patients for whom an improvement effect was observed as a result of executing a series of intervention processes based on an intervention scenario are used to Attribute-related factors and log-related factors that are estimated to be related to the improvement are identified for each pattern of change in ACT proficiency, and when setting an intervention scenario for a certain patient, these identification results are used to intervene. The scenario settings are made. Thereby, it is possible to set an intervention scenario that focuses on core processes that are expected to be highly likely to be improved, depending on the patient's attributes and ACT proficiency level before the start of the intervention process.

Note that in the above embodiment, an example in which a basic intervention scenario is used in the initial period has been described, but the present invention is not limited to this. For example, an intervention process may be set and executed to lead to an improvement in the ACT proficiency of a core process evaluated as having a low ACT proficiency among the six core processes.

Furthermore, in the embodiment described above, after the intervention process execution unit 105 starts processing based on the intervention scenario, the expected improvement effect of the intervention occurs at a timing before the series of intervention processes based on the intervention scenario ends. If it is evaluated that an improvement effect has occurred, feedback may be provided to inform the patient of the improvement.

Furthermore, in the above embodiment, an example has been described in which an adjusted intervention scenario is generated by adjusting the basic intervention scenario, but the present invention is not limited to this. For example, an adjusted intervention scenario may be set without using the basic intervention scenario.

Furthermore, in the above embodiment, the functional configurations that the treatment support device 10 and the server device 20 each have are shown, but the server device 20 may include some of the functional configurations that the treatment support device 10 has. For example, the server device 20 may include the intervention effect evaluation unit 109. Alternatively, the results of the answers to the questionnaire presented by the ACT evaluation unit 103 may be transmitted to the server device 20, and the server device 20 may evaluate the ACT proficiency level.

In addition, the above-mentioned embodiments are merely examples of implementation of the present invention, and the technical scope of the present invention should not be construed to be limited thereby. That is, the present invention can be implemented in various forms without departing from its gist or main features.

1 Treatment application 10 Treatment support system 20 Server device 101 Attribute information input unit 102 Attribute information registration request unit 103 ACT evaluation unit 104 Intervention scenario registration unit 105 Intervention processing execution unit 106 Treatment log recording unit 107 Log registration request unit 108 Sensor information recording Department 109 Intervention Effect Evaluation Department 110 Communication Department 201 Patient Related Information Recording Department 202 Improvement Related Factor Identification Department 203 Intervention Scenario Setting Department 204 Communication Department

Claims

A treatment support system that supports disease treatment while performing patient intervention based on cognitive behavioral therapy,
an ACT evaluation unit that evaluates the patient's proficiency in ACT based on one or more indicators based on all or part of the six core processes of ACT (Acceptance and Commitment Therapy);
an intervention scenario setting unit that sets an intervention scenario based on the six core processes according to the evaluation results by the ACT evaluation unit;
an intervention process execution unit that sequentially performs a plurality of intervention processes based on the six core processes based on the adjusted intervention scenario set by the intervention scenario setting unit or the preset basic intervention scenario;
After a series of intervention processes are executed by the intervention process execution unit based on the intervention scenario, an intervention effect evaluation unit evaluates whether or not the intervention has the expected improvement effect;
The patient's attribute information, the ACT evaluation information indicating the results of the evaluation performed by the ACT evaluation unit before and after executing the series of intervention processes, and the intervention effect evaluation after executing the series of intervention processes. a patient-related information recording unit that records improvement evaluation information indicating the results of the evaluation conducted by the department for each patient;
Using the above attribute information and the above ACT evaluation information of a plurality of patients whose improvement evaluation information indicates that the above expected improvement effect has been achieved, mastery of the above ACT before and after execution of the above series of intervention processes. an improvement-related factor identification unit that identifies a related factor estimated to be related to the improvement as an attribute-related factor from the attribute information for each pattern of change in degree;
The intervention scenario setting unit collates the evaluation result regarding the proficiency of the ACT performed by the ACT evaluation unit for a certain patient and the attribute information of the certain patient with the change pattern of the proficiency of the ACT and the attribute-related factors. By doing so, a change pattern matching the certain patient is identified, and the adjustment intervention scenario is set, which includes an intervention process to lead to the improvement of the ACT proficiency in the same manner as the identified change pattern. A treatment support system characterized by:
The intervention scenario setting unit determines the relationship between the patient's attribute information and the attribute-related factors, and the evaluation result regarding the patient's ACT proficiency and the change pattern that is indicated as information before change. 2. The treatment support system according to claim 1, wherein a change pattern matching the certain patient is specified from the viewpoint of a relationship with an evaluation result regarding ACT proficiency.
The patient-related information recording unit further records, for each patient, treatment log information identified when executing the series of intervention processes for the patient;
The improvement-related factor identification unit further uses the treatment log information to identify the related factors estimated to be related to the improvement for each pattern of change in the ACT proficiency level before and after execution of the series of intervention processes. Identifying the attribute-related factors and log-related factors from the attribute information and the treatment log information, respectively,
The intervention scenario setting unit includes the adjustment intervention that includes an intervention process related to the log-related factor as an intervention process to lead to the improvement of the ACT proficiency in the same manner as the identified change pattern. 3. The treatment support system according to claim 1, wherein a scenario is set.
A treatment support program that causes a computer to execute processing to support treatment of a disease while performing intervention for a patient based on cognitive behavioral therapy, the program comprising:
Based on the above patient attribute information and intervention scenario, one or more indicators based on all or part of the six core processes of ACT (Acceptance & Commitment Therapy) will be evaluated before and after performing a series of intervention processes based on the patient attribute information and intervention scenario. ACT evaluation information indicating the results of the evaluation regarding the proficiency level of the ACT performed on the patient based on the above information, and whether or not the intervention had the expected improvement effect after performing the series of intervention processes. patient-related information recording means for recording improvement evaluation information indicating the results of the evaluation for each patient;
Using the above attribute information and the above ACT evaluation information of a plurality of patients whose improvement evaluation information indicates that the above expected improvement effect has been achieved, mastery of the above ACT before and after execution of the above series of intervention processes. Improvement-related factor identification means for identifying related factors estimated to be related to the improvement as attribute-related factors from the attribute information for each pattern of change in the degree of improvement; By comparing the evaluation results and the patient's attribute information with the ACT proficiency change pattern and the attribute-related factors, a change pattern that matches the patient is identified, and the same change pattern as the identified change pattern is identified. A treatment support program for causing a computer to function as an intervention scenario setting means for setting an intervention scenario including an intervention process for leading to improvement in the proficiency level of ACT.