JP7558546B1 - Self-care system for stress-related illnesses or mental disorders caused by stress - Google Patents

Abstract

[Problem] To provide a self-care system for stress-related diseases or mental disorders caused by stress, applying technology similar to electronic commerce and technology developed in diagnostic medical equipment, etc. [Solution] A system for self-care for stress-related diseases or mental disorders caused by stress, the system including a user's information processing terminal, a storage device that stores work sets corresponding to each of a plurality of themes based on acceptance and commitment therapy or mindfulness, and a theme evaluation scale for evaluating the effectiveness of each of the plurality of themes, and a control unit that controls the system, the control unit prompts the user to execute the work set via the user's information processing terminal, evaluates the effectiveness of the user according to the theme evaluation scale of the work set after the user executes the work set, and if the evaluation result does not meet the standard, provides the user with the work set for the theme again. [Selected Figure] Figure 1

Description

The present invention relates to a program and system for supporting self-care for stress-related illnesses or mental disorders caused by stress, which applies technology similar to electronic commerce and technology developed in diagnostic medical equipment, etc.

Illnesses that arise from psychological or social stress or that are thought to be exacerbated by stress are called stress-related illnesses. Stress-related illnesses are also called psychosomatic illnesses, and if the stress response is not improved and becomes chronic, it can lead to not only mental health disorders but also physical disorders. Mental health disorders related to stress include autonomic nervous system dysfunction, depression, anxiety disorders, panic disorders, adjustment disorders, alcoholism, drug addiction, eating disorders, irritable bowel syndrome, sudden hearing loss, neurosis, migraines, insomnia, and tension headaches. Stress-related physical disorders (psychosomatic disorders) include gastric and duodenal ulcers, essential hypertension, cardiac neurosis, bronchial asthma, hyperarousal syndrome, essential hypertension, coronary artery disease (angina pectoris, myocardial infarction), gastric and duodenal ulcers, ulcerative colitis, psychogenic vomiting, simple obesity, diabetes, muscle contraction headache, spasmodic torticollis, writer's cramp, chronic urticaria, atopic dermatitis, alopecia areata, chronic rheumatoid arthritis, lower back pain, bedwetting, psychogenic impotence, eyestrain, essential blepharospasm, Meniere's disease, temporomandibular joint disorder, and PMS/PMDD. Psychotherapy is used to treat these mental health disorders.

The following technology is known as a medical treatment support system using cognitive behavioral therapy. Patent Document 1 discloses a technology that provides the patient with a treatment scenario consisting of multiple intervention processes, in which the content of the efforts corresponding to the core processes of ACT (Acceptance and Commitment Therapy) are switched at predetermined intervals, and modifies the scenario to be provided to the patient from the next time onwards based on the results of a comparison of the six core processes of ACT before and after the implementation of the scenario.

International Application Publication No. 2023/204239

The technology in Patent Document 1 provides a predetermined treatment scenario for the same individual within a specified period of time, but does not evaluate each component technology within that period and modify the scenario. Furthermore, since there is no one-to-one correspondence between ACT core processes and intervention processes, and there is no one-to-one correspondence between intervention processes and evaluation scales, it is not possible to evaluate each ACT core process, and as a result it is not possible to increase proficiency in each core process.

One objective of the present invention is to provide technology that can be used in self-care apps and therapeutic apps, which can improve proficiency in each of ACT's core processes and ultimately improve overall psychological flexibility, since ACT is made up of six independent core processes and is suitable as a self-care function that utilizes information processing devices, particularly ICT devices, but until now there has been no method for mastering the core processes that takes advantage of these characteristics. The second objective of the present invention is to provide technology that can be used in self-care apps and therapeutic apps, which can improve proficiency in each of ACT's core processes and ultimately improve overall psychological flexibility. The second objective of the present invention is that conventional apps (for example, Patent Document 1) are like books that provide a step-by-step curriculum like conventional psychotherapy, and do not actually utilize the benefits of ICT.

In the past, rather than focusing on the proficiency of the core process, attention was focused on the activities different from the core process for each stage in the treatment scenario as shown in Figure 4 of the cited document 1, and only the degree of mastery of the stage was focused on. Also, attention was focused on the change in the mastery of the core process throughout the entire treatment scenario. This is because there was no knowledge that, as proposed by the inventors of the present application, it is possible to associate the core process with a work set, and to use an information processing device to perform evaluation using an evaluation scale for each work set of the core process that has been evaluated, or that the technology of the information processing device can be used to handle the core process for each process executed by the user. In addition, the present invention is characterized by processing the proficiency of the core process specific to ACT using an information processing device, and without the knowledge of the inventors of the present invention, it would not have been possible to solve the problem by simply reusing other conventional technologies.
(Invention 1)
A system for self-care of stress-related diseases or mental disorders caused by stress, comprising:
The system further comprises:
a user's information processing terminal having an input/output unit;
A server including a storage device that stores a work set that is one-to-one associated with each of a plurality of Acceptance and Commitment Therapy (ACT) core processes, and question information of an evaluation scale (ACT core process evaluation scale) that is one-to-one associated with each of the work sets and that is used to evaluate the proficiency of the core processes, and a control device that controls the system;
Including,
The system further comprises:
providing the user with an exercise included in the work set associated with one of the core processes stored in the storage device via the input/output unit of the information processing terminal and having the user execute the exercise;
After the user has performed the work set, provide the user with information on the questions corresponding to the work set performed by the user via the input/output unit of the information processing terminal, obtain answers to the questions by the user, and evaluate the effectiveness of the user's performance of the exercise based on the answers.
If the results of the evaluation do not meet the standard, the system provides the user with and has the user perform exercises of a work set corresponding to the core process performed by the user, which is stored in the storage device via the input/output unit of the information processing terminal.
(Invention 2)
An information processing device for self-care of stress-related diseases or mental disorders caused by stress,
The information processing terminal,
A storage device that stores a work set that is one-to-one associated with each of a plurality of Acceptance and Commitment Therapy (ACT) core processes, and question information of an assessment scale (assessment scale for the ACT core processes) that is one-to-one associated with each of the work sets and that is used to assess proficiency of the core processes;
A control device that controls the information processing terminal;
An input/output unit,
The control device,
providing the user with an exercise included in the work set associated with one of the core processes stored in the storage device via the input/output unit and having the user execute the exercise;
After the user has performed the work set, provide the user with information on the questions corresponding to the work set performed by the user via the input/output unit, obtain answers to the information on the questions by the user, and evaluate the effectiveness of the user's performance of the exercise based on the answers.
If the result of the evaluation does not satisfy the standard, the information processing terminal again provides the user with exercises of the work set corresponding to the core process performed by the user, which are stored in the storage device via the input/output unit, and has the user perform the exercises.
(Invention 3)
A method for providing self-care for stress-related diseases or mental disorders caused by stress, comprising:
The method,
The system further comprises:
a user's information processing terminal having an input/output unit;
A system including a server including a storage device that stores work sets each having a one-to-one correspondence with a plurality of Acceptance and Commitment Therapy (ACT) core processes, and question information of an assessment scale (assessment scale for the ACT core processes) each having a one-to-one correspondence with each of the work sets and for assessing proficiency of the core processes, and a control device that controls the system,
providing the user with an exercise included in the work set associated with one theme of the plurality of core processes stored in the storage device via the input/output unit of the information processing terminal and having the user execute the exercise;
After the user has performed the work set, providing the user with information on the questions corresponding to the work set performed by the user via the input/output unit of the information processing terminal, obtaining answers to the questions by the user, and evaluating the effects of the user's performance of the exercise based on the answers;
and if the result of the evaluation does not satisfy the standard, providing the user with an exercise of a work set corresponding to the core process performed by the user and stored in the storage device via the input/output unit of the information processing terminal and having the user perform the exercise.
A method for providing the user with self-care for stress-related illness or mental disorders caused by stress.
(Invention 4)
A method for providing self-care for stress-related diseases or mental disorders caused by stress, comprising:
The method,
A storage device that stores a work set that is one-to-one associated with each of a plurality of Acceptance and Commitment Therapy (ACT) core processes, and question information of an assessment scale (assessment scale for the ACT core processes) that is one-to-one associated with each of the work sets and that is used to assess proficiency of the core processes;
A control device that controls the information processing terminal;
In an information processing terminal including an input/output unit,
providing the user with an exercise included in the work set associated with one of the plurality of core processes stored in the storage device via the input/output unit and having the user execute the exercise;
a step of providing the user with information on the question corresponding to the work set executed by the user via the input/output unit after the user has executed the work set, acquiring a response by the user to the information on the question, and evaluating an effect of the execution of the work by the user based on the response;
A method for providing the user with self-care for a stress-related illness or mental disorder caused by stress, comprising a step of providing the user with and having the user perform exercises of a work set corresponding to the core process performed by the user and stored in the storage device via the input/output unit if the result of the evaluation does not satisfy the standard.
(Invention 5)
A program for providing self-care for stress-related illnesses or mental disorders caused by stress, the program comprising: a work set corresponding one-to-one to each of a plurality of acceptance and commitment therapy (ACT) core processes; and a memory unit storing information on questions related to an evaluation scale for evaluating the mastery of the core processes (evaluation scale for the ACT core processes), which is corresponding one-to-one to each of the work sets;
A control device that controls the program and the system;
In a system having an input/output unit for inputting and outputting information to and from a user,
a function of providing the user, via the input/output unit, with an exercise included in the work set associated with one of the core processes included in the plurality of core processes stored in the storage unit, and having the user execute the exercise;
a function of providing the user with information on the question corresponding to the work set executed by the user via the input/output unit after the user executes the work set, acquiring a response by the user to the information on the question, and evaluating the effectiveness of the execution of the work by the user based on the response;
a function of providing the user with an exercise of a work set corresponding to the core process performed by the user and stored in the storage device via the input/output unit again when the result of the evaluation does not satisfy the standard, and having the user perform the exercise;
A program for implementing the above in the system. A program for executing the above on the system.
In Inventions 1-5, by executing exercises in a work set (exercise is described as a concept that includes educational content, work, etc.), it is possible to focus on individual core processes and improve the user's proficiency for each core process executed.
(Invention 6)
The system, information processing terminal, program or method according to any one of the above-mentioned inventions 1 to 5, which does not target a specific disease.
Because the present invention is effective against the symptoms of stress-related diseases in general, it can also be applied to specific diseases; however, it is also effective to use it as a self-care tool or support tool for preventing illness by learning ways to cope with stress and improving psychological flexibility, thereby enabling people to cope with stress in their daily lives, without targeting a specific disease.
(Invention 7)
In the system, information processing terminal, program or method of any one of the above-mentioned inventions 1-5, the work set includes a plurality of different exercises that have an effect on the same core process.
A work set may include one exercise, multiple of the same exercises, or multiple different exercises. Since some exercises are suitable for others and have personal preferences, performing multiple different exercises allows the user to obtain a self-care method that is suitable for the user.
(Invention 8)
In the system, information processing terminal, program or method of any one of the above-mentioned inventions 1-5, the provision of a work set corresponding to the core process is used continuously or intermittently by a user.
One use method is to set a specific period of time, like a prescription for a therapeutic app, but it is also desirable to encourage users to continuously carry out work sets that follow the core process, or to suspend the program for a while once a certain level of effect is achieved (for example, ACT is said to be effective for six months after completion), and then evaluate and resume providing the work sets, thereby improving the user's psychological flexibility and leading to the prevention of stress-related illnesses.
(Invention 9)
In the system, information processing terminal, program or method of any one of the above-mentioned inventions 1-5, a plurality of work sets are successively executed by a user, and then a plurality of evaluations are performed.
Work sets can be evaluated either after each work set is executed, or after multiple work sets are executed, all at once. However, since some exercises have an effect on multiple core processes, evaluating multiple work sets all at once after they are executed makes it possible to measure the effects on multiple core processes simultaneously compared to evaluating each work set individually, and also reduces the burden of answering user questions.
(Invention 10)
In the system, information processing terminal, program, or method of inventions 1-5 described above, when a work set corresponding to one core process is repeatedly executed and provided to a user, the system, information processing terminal, program, or method evaluates the work set by raising the reference point.
When a work set of a series of multiple core processes is provided to a user and executed, and then the work set of a series of multiple core processes is provided again and executed, it is assumed that the standard score has been met once, so the standard score that is judged as passing the proficiency level can be raised and evaluated, thereby further improving the proficiency level. Regarding the standard score, information on the number of times and the standard standard score can be stored somewhere in the system and referenced, or the evaluation results of the scale based on the execution of the user's work sets up to the previous time can be compared to estimate the amount of increase expected from one execution of the work set, and the amount of increase per time can be set.

According to the self-mental care system of the present invention, it is possible to improve the stress coping ability to prevent and improve stress-related diseases, and furthermore, it is possible to alleviate symptoms characteristic of stress-related diseases, so that effective and lasting improvement can be expected. In addition, since the stress coping ability is improved, not only can specific diseases be improved, but secondary effects such as improvement of depressive symptoms and anxiety symptoms that appear as secondary effects can also be obtained. Furthermore, multiple exercises for self-mental care are provided as work sets according to a theme, and evaluation is performed for each theme. If the level of proficiency is low, the same work set is repeated, and the characteristics of the information processing terminal are utilized to automatically perform self-mental care for the user. Furthermore, by likening the theme to the core process of ACT or mindfulness, the core process of ACT is relatively independent and the effect is easy to understand, so that the self-care process can be implemented and evaluated more efficiently.

FIG. 1 is a conceptual diagram showing a system of the present invention. 1A is a diagram showing an example of a database of personal data of a user in a PMS memory according to an embodiment of the present invention, and FIG. 1B is a diagram showing an example of an input screen. 1A is a diagram showing an example of a database of personal data of a user of a sleep diary according to an embodiment of the present invention, and FIG. 1B is a diagram showing an example of an input screen. FIG. 2 shows an example of a database of personal data of a user of a pain diary according to an embodiment of the present invention. FIG. 13 is a diagram showing an example of a pain diary input screen according to an embodiment of the present invention. FIG. 2 is a diagram showing (a) functional blocks of a control program of the system of the present invention, and (b) a control flow. FIG. 4 is a diagram showing an example of a user screen of the system according to the embodiment of the present invention. FIG. 1 is a flow diagram showing an example of repetition of each theme of the present invention.

The present invention is based on the knowledge that in a self-care system for stress-related diseases and mental disorders caused by stress, the effectiveness of symptomatic improvement suggestions can be improved by acquiring a method of dealing with stress, which is the root cause, in addition to symptomatic improvement suggestions brought about by stress-related diseases and mental disorders caused by stress. Furthermore, the effectiveness can be further improved by associating the content and timing of the symptomatic improvement suggestions with the stress-coping methods.
(System configuration including self-care app)
As an embodiment of the present invention, a program installed in a network system installed on the Internet is given. The network system is a server equipped with a large-capacity storage device on a server or a cloud, and a server to which a user terminal such as a notebook computer, a smartphone, or a tablet is connected via the Internet. The server device executes the program according to this embodiment, and provides various information such as a treatment application that enables treatment or mitigation of stress-related diseases and self-care, a self-mental health care application, and disease education related to stress-related diseases to the user via the user terminal using information input from the user terminal and information stored in the server's storage device through data communication with the user terminal. In addition, this system is shown as an example in which the server and the user terminal cooperate to improve the symptoms of the user or patient, but the scope of the present invention also includes a system in which all elements are held only on the server side and the user terminal is used only for inputting and outputting information and displaying information, or a system in which necessary data and programs can be downloaded to the user terminal and all processing can be executed on the user terminal, and a web page that the user can access is provided.
FIG. 1 shows an outline of the configuration of a network system 100 including a user terminal 110 and a server 106. The user terminal 110 includes a communication device 105 for communicating with a server 130 via the Internet 120, a storage device 102 for recording personal information, data, and programs, a display device 103, an input device 104 for receiving input from a user, and a control device 101 for controlling these. The server 130 includes a communication device 131 for communicating with the user terminal 110 via the Internet 120, a large-capacity storage device 133, and a control device 132. The control device 132 is equipped with a communication control program for communicating with the user terminal 110 via the communication device 131, and also stores a program for managing a database constructed in the storage device 133, a dedicated program for managing a symptom record (diary) that records the user's current or past symptoms and conditions (hereinafter also referred to as a symptom diary program), server-side programs for self-care apps and treatment apps, and data such as work and disease education videos that are treatment modules for self-care apps and treatment apps. The control program on the server side cooperates with the self-care application and treatment application on the user side to perform diagnosis, treatment, mitigation, improvement, maintenance, or self-care, and the control device 132 cooperates with the communication control program and the database management program to provide information necessary for self-care and treatment to the user terminal. As a result, diagnosis, treatment, mitigation, improvement, maintenance, or self-care is provided to the user by the server 130. In this example, the self-care and treatment application is divided into a server side part and a user terminal side part, and an example of performing diagnosis, treatment, mitigation, improvement, maintenance, or self-care is shown, but it may be configured so that all necessary programs and data can be downloaded to the user terminal 110 and independently executed by the user terminal 110 (in this case, the control unit of the user's information processing terminal 110 controls and executes the functions of each functional block of the program, and multiple work sets, theme evaluation scales, and disease evaluation scales are stored in the storage device of the information processing terminal 110). Alternatively, the user terminal 110 may function only as an input means and a display means, and the server 130 may be configured to execute the program based on input from the user terminal 110, for example, via a dedicated web page.

(Stress management method)
Methods for helping subjects learn ways to cope with stress have been established through the techniques of psychotherapy and psychological counseling. In the present invention, a method for coping with stress based on cognitive behavioral therapy among the psychotherapies is exemplified, but it goes without saying that other psychotherapies and other techniques can also be applied. Furthermore, by acquiring a method for coping with stress, it is possible to increase stress tolerance on a daily basis and prevent various maladaptive behaviors and symptom problems, which results in improvement of stress-related diseases and symptoms, and also improves the effectiveness of psychological intervention for symptoms. Systematic stress management is a psychotherapy that systematically involves a series of steps such as mindfulness-based stress reduction (basic building (interview, exploring mindfulness, how you see the world and yourself, being with your own body), responding to stress (what is stress, stress: automatic reaction or mindful response, mindful communication, silent day), and caring (caring for yourself, reflecting, moving forward, continuing on), or in the case of problem-solving, specifying the problem, thinking of specific solutions, considering the advantages and disadvantages of each of several solutions, deciding on a solution, implementing it, and evaluating the results of implementing it).

(Acceptance and Commitment Therapy Techniques)
In recent years, Acceptance and Commitment Therapy (ACT) has been developed as a third generation cognitive behavioral therapy. ACT has six core processes: (1) Acceptance, (2) Defusion, (3) Present Moment Awareness, (4) Self as Context, (5) Contact with Values, and (6) Committed Action. It is a psychotherapy based on modern behavioral psychology including relational frame theory, which applies the acceptance or mindfulness process as well as the commitment and behavior change process ((1)-(4) are related to mindfulness. Therefore, in this specification, the elements of mindfulness are also considered as one of the four core processes of ACT, since they correspond to them). By acquiring the skills corresponding to each of these processes, the patient can develop psychological flexibility and acquire the ability to cope with stress. The inventors of this application propose a method in ACT, because these processes in ACT are separated and the training method for each process is established, which makes it suitable for use in information processing terminals. Note that it is not necessary to strictly classify them as above, and different classifications are acceptable as long as each purpose can be achieved, and it goes without saying that it is not necessary to implement all of them.

(Symptom Memory)
The symptom memory records the user's daily condition using a calendar function and a schedule function. The questions to the user can be changed depending on the psychosomatic disease to be addressed. Also, the necessary questions can be selected according to the user's symptoms. Also, a wide range of psychosomatic symptoms and question lists can be stored in advance in a storage device, and when the user uses the app, the user is prompted to answer the questions, and a list of questions corresponding to the answers is set as daily question items in the symptom memory based on the answers. Since the symptoms of psychosomatic diseases can be self-care by managing the symptom records, it is preferable that the user can request the transition of the answers regarding the daily condition of the symptoms to be displayed on the screen. Figure 2(a) shows an example of a symptom memory database stored in a storage device. This database shows a record in which date and time information is associated with answers to questions obtained from the user (in this case, the answers are entered using a 4-point scale or 7-point scale). Here, typically, not only the questions but also vital data such as body temperature, heart rate, and activity level, and information on social events such as travel, weddings, and drinking parties can be simultaneously associated and stored.

(PMS memory)
Using FIG. 2, the PMS memory will be described as one of the symptom memories. The PMS memory records physical symptoms, mental symptoms, social symptoms, etc., in accordance with the user's menstrual cycle, together with basal body temperature, etc., or EMA (Ecological Momentary Assessment, experience sampling method), in order to grasp symptoms that periodically appear in a woman's body due to the influence of biological rhythms. FIG. 2(b) shows an example of an input screen via a user terminal 110 of the PMS memory as an example of a symptom memory. In the PMS memory, input items are displayed on the display device 103 of the user terminal 110, and an example is described in which input is made using a slider bar based on the presence or absence of symptoms for each item using an input device 104, which is a touch panel provided on the surface of the display device 103 (the question items in FIG. 2(b) correspond to items A, B, etc., in FIG. 2(a). Note that only three items are shown due to space limitations, but it goes without saying that the other items are merely omitted). The display and input method are not limited to this, and free description or check boxes may be used. For example, this PMS memory is entered every day at the same time as measuring basal body temperature, and the basal body temperature and the day's physical symptoms, mental symptoms, and social symptoms (not all of these need to be included, but only the necessary ones) and, in some cases, additional EMA input data (not only data from the PMS memory, but also other measurement results (physical activity measured using an acceleration sensor, heart rate fluctuations measured using an electrocardiogram sensor, sleep time, and food records)) are associated with the menstrual cycle and stored in memory device 102 or memory device 133, or both. The questions recorded in the PMS memory may be those described in the PMS memory (Kawase et al., Journal of the Japanese Society of Psychosomatic Medicine, Vol. 5, No. 1, pp. 31-37), the Menstrual Distress Questionnaire (MDQ), the modified MDQ (polarizer MDQ), the Premenstrual Symptoms Screening tool (PSST), the diagnostic criteria for PMDD in the DSM-IV, the Calendar of Premenstrual Experiences (COPE), the Premenstrual Symptoms Impact Survey (PMSIS), the Diagnostic Inventory of Health and Life Habit (DIHAL.2, for junior high school students to adults), the Menstrual Attitude Questionnaire (MAQ), the VAS (level of menstrual pain), and the like. These scales can be used to diagnose menstrual symptoms. In addition, since it is believed that the psychosocial symptoms associated with menstruation are influenced by the user's psychological and social background, such as whether or not they wish to become pregnant, their views on menstruation/menstrual image, and their maternal/gender role personality, questions regarding the user's basic information, such as whether or not they wish to become pregnant, their views on menstruation/menstrual image, and their maternal/gender role personality, may also be recorded.

(Sleep diary)
FIG. 3(a) shows an example of data of a sleep diary stored in the storage device 133 (or the storage device 102 in some cases). This sleep diary includes items such as the patient's bedtime, time of falling asleep, time of awakening, time of getting up, quality of sleep (e.g., 5 stages), number of awakenings (or time spent awake), time of yesterday's nap, sleep efficiency, actual sleep time, time in bed, next day's work, and intake of sleeping pills and alcohol, and the system including the insomnia treatment app requests the patient to input the values of these items periodically, typically promptly after waking up, via the input screen (e.g., FIG. 3(b)) of the user terminal 110 such as a smartphone. The next day's work may be input after returning home before setting the bedtime. Here, the next day's work is an input value indicating the risk of the next day's work or work content, and corresponds to, for example, work or work that may be physically dangerous due to falling asleep. When this is checked or when the value is 4 or more on a 5-point scale, it is preferable from a safety standpoint to set the bedtime to avoid settings that shorten the actual sleep time (for example, avoid shortening the bedtime when daytime sleepiness is 4 on a 5-point scale). In addition, other parameters such as the number of sleeps may be input and stored. It is also known that there is a correlation between the cycle of human body temperature and circadian rhythm, and it is also known that there is a correlation between the cycle of human body temperature and sleep cycle, so the body temperature may be measured periodically, and a graph of the change in the user's body temperature over the day and the relationship with the bedtime may be displayed graphically, or this change in body temperature may be used to set the bedtime or sleep onset time, or the wakeup time or wakeup time (for example, set the bedtime when the body temperature is decreasing, or set the wakeup time when the body temperature is increasing). In this way, the relationship between the user's vital signs and the bedtime or sleep onset time, or the wakeup time or wakeup time may be displayed, or this data may be used to set these times. 3A shows the stored data as data for three days from July 1 to July 3, but it goes without saying that records for the duration of treatment or for a required period can be stored. In the above example, the data entered into the sleep diary was entered by the user into the user terminal 110, but it may be entered automatically from a user terminal such as a wearable device.

Sleep efficiency is the ratio of the time spent actually asleep to the total time spent in bed or other sleeping place. That is, sleep efficiency is calculated by the following formula:
Sleep efficiency = (time from falling asleep to waking up) / (time from falling asleep to waking up) x 100[%]
Bed time is calculated using the following formula:
Time in bed = Time from time of going to bed to time of waking up. Sleep time is calculated using the following formula.
Sleep time=time from falling asleep to waking up The actual sleep time is calculated using the following formula.
Actual sleep time = time from time of falling asleep to time of waking up - time of waking up.In addition, these times and sleep quality may be obtained by user input, or by data from actigraphy, polysomnography, or wearable devices such as smart beds and smart watches.
Furthermore, this data can be used to check the patient's condition and for the user's self-care by making it possible to call up patient data for a specific day, call up average data, and display data trends over a specific period (as a line graph, etc.) from the user terminal 110 or an administrator's or medical professional's terminal (not shown).

(Pain diary)
FIG. 4 shows an example of the data of the pain diary stored in the storage device 133 (or the storage device 102 in some cases). This pain diary records the degree of pain in the morning, afternoon, and night of the patient, the record of taking medicine in the morning, afternoon, and night, the influence of pain on the daily life in the morning, afternoon, and night, the mood of the day, the weather, the average temperature (the maximum temperature, the minimum temperature, the temperature difference, etc. may be recorded), the average humidity (the humidity in the morning, afternoon, and night may be recorded), the body temperature (the humidity in the morning, afternoon, and night may be recorded), the maximum blood pressure, the minimum blood pressure (the humidity in the morning, afternoon, and night may be recorded), the stress factors such as environmental factors and situations, the events and notes of the day, the presence or absence of menstruation, etc. are recorded as a set for each day. The diary can be used for any chronic pain, chronic headache, migraine, joint pain, lower back pain, etc., and further, it may be configured to record which pain it is. Next, FIG. 5 shows a method of inputting each data via the user terminal 110. First, when the user clicks on the user input field for the input time, a drop box appears that allows the user to select "morning", "afternoon", or "night", and the user inputs one of them. Next, to input the degree of pain at the time of input, the user clicks on the input field and selects "strong", "medium", "weak", or "none" from the drop box to be applied. Next, the user clicks on the drop box for inputting the drug name and quantity, and selects the drug name from "Bufferin", "Loxonin", "Imigran", "Zomig", "Relvax", "Maxalt", "Amaze", "Inderal", etc., and also selects the amount from "1 tablet", "2 tablets", "3 tablets", etc. Next, to record the impact of pain on life, the user clicks on the user input field and selects "large", "medium", or "small" from the drop box that appears. Furthermore, to record the mood of the day, the user clicks on the user input field next to the mood, and selects the emotion or symptom from "depression", "anxiety", "irritability", "throbbing pain", "nausea", "severe pain", "vomiting", "insomnia", or "other". In addition, in the case of women, the user can also input whether or not they have a period. Furthermore, the user clicks on the user field to input the body temperature and blood pressure measured at a certain time every day. Furthermore, the user clicks on the user entry field for the day's weather, selects from "sunny", "cloudy", or "rainy" in the drop box that appears, and enters and stores the input, temperature, and humidity in the user entry field. After all input is completed, the user clicks on the "Done" button (not shown) to overwrite the input values in the list shown in FIG. 4. Although the user manually inputs the weather, temperature, and humidity in the above example, they can be downloaded from local weather information sites. Furthermore, the body temperature and blood pressure may be automatically acquired from a smartphone camera, a smart watch, an earphone-type wearable device, or the like. In addition, a button that is touched each time pain is felt may be provided as an input device and configured to be pressed each time, and the degree of pain may be determined from the strength and number of times of touching, or if it is possible to recognize that the user is in a headache state based on the pulse rate, such vital signs may be used to input the data. In addition, these data may be input by any input method known to those skilled in the art, and the number of items may be increased or decreased. In addition, the date information is automatically acquired from the smartphone here, but it may be possible for the user to input the date information. The list in FIG. 4 shows an example of data from March 1 to March 3, but this is not limited to this, and it goes without saying that data may be added continuously. Furthermore, by linking these data with the user terminal 110 or the terminal of the administrator or medical institution (not shown), it is possible to call up the patient's data on a specific day from these terminals, or to call up and display data that has been compiled and analyzed for easy evaluation, such as average data, or the trend of data over a specific period (as a line graph, etc.), which can be useful for checking the patient's condition and for the user's self-care (data may be sent periodically in addition to being called up). Furthermore, by linking these data with software such as electronic medical records on the terminal of the medical institution, data can be transferred to the software, or specific data can be transferred to the software for use at the medical institution.
The pain diary can also be used as a medication management app, and may be configured to record the time when medication is taken, the name of the medication taken, and the number of medications taken. Here, for frequently taken medications, buttons may be displayed on the input screen so that they can be easily selected, and when the button is pressed to take the medication, the time and number of times it is pressed may be stored. Furthermore, a graph showing the correlation between medication management and pain, or a line graph of both data may be displayed, or this data may be transferred to a medical institution's terminal.

Example 1
In this embodiment, a self-care application for menstrual symptoms (especially PMS) is illustrated. The application is configured with a stress management part (stress care) in the first half and a symptom management part in the second half (if only stress care is intended, the application can be the first half only). The application is controlled by a software program stored in either the server 130 or the user's information processing terminal 110, or both. The program is composed of the functional blocks of FIG. 6(a), and controls the devices having the functions of FIG. 1 to provide the user with the functions of the software program. The software program typically operates according to the flow of FIG. 6(b). The input/output block 601 is a block that controls the display device 103 and the input device 104, presents information (including work, etc.) to the user, and accepts user input. The evaluation block 602 is a block that performs a predetermined evaluation from the information input from each block. The schedule management block 603 has a calendar function, associates date information with various information, and performs processing in cooperation with the memory management block 605. The work provision block 604 is a block that, when it receives a request for work provision from the control block 606 according to the flow of the program, transmits the work to the input/output block 601 in cooperation with the memory management block 605. The memory management block 605 is a block that controls the memory devices 102, 133 of the system, and returns information such as requested work and data in response to requests from the control block 606 and other blocks. The control block 606 is a block that controls the execution of this program. An example of a home screen according to this program is shown in Figure 7. FIG. 7 shows an information processing terminal 110 which is a user's smartphone, a main window 701 which displays the user's predicted menstrual period, vital data, weather, atmospheric pressure and their forecasts, and the state during the menstrual cycle, a function window 702 for activating a specified function by touching a tile (icon) 706 on the touch panel (hidden tiles can be viewed by scrolling horizontally, and these function buttons are fixed), a search window 703, and an information window 704 for viewing specified information or activating a function by touching a tile (icon) 705 on the touch panel (hidden tiles can be viewed by scrolling vertically, new information or icons corresponding to functions are added to tiles in the information window at the top of the screen, old information is moved to the bottom of the information window, and the specified information is displayed in a search window 703). A fixed number of tiles can be viewed (in this embodiment, 18 tiles can be viewed, and old tiles are controlled to be deleted from the tiles in the information window. In this embodiment, old information is organized by category and date in the archive folder that opens when the archive function in the function window is activated, and is set so that it can be viewed). In this embodiment, the tiles of information displayed are managed in the memory of the storage device, and the memory is numbered 1-18 starting from the most recent information, with 1-3 displayed from the left at the top of the information window, 4-6 displayed in the second row, and so on. When a request is made to display new information, the new information is stored in 1, and the original information 1 is rewritten in memory 2, the original information 2 is rewritten in memory 3, and so on.

Next, the flow of the software program will be described with reference to FIG.
(650) The user touches an icon representing this program on the touch panel of the display device 103 of the information processing terminal 110 controlled by the input/output control block 601 to start up a login screen (not shown), and the home screen of Fig. 7 is displayed. (651) The schedule management function block 603 requests the memory management block 605 whether or not there is an input to the PMS memory at the timing when the data for the day should be input, and the memory management block 605 searches the database of the storage device 133 or the storage device 102 and returns whether or not there is a record. If there is no record, the schedule management block 604 presents questions that the user should store in the PMS memory via the input/output block 601, and upon receiving the user's input, sends it to the memory management block 605, and adds it to the database that stores the personal data for each user stored in the PMS memory. (652) The self-care function is started when the user starts the self-mental care app, or when conditions such as a change in the user's vital data or a specific user input on SNS or the like are met and the app is requested to start, or when the app is specified to start at that timing as a program description, etc. The schedule management block 603 requests the control block 606 to provide educational content (typically video, but may also be text or audio content, or interactive content such as chatbots or games as exercises) about disease education and psychotherapy (in the case of ACT, metaphors and psychoeducation about trapped thinking, psychoeducation about psychological flexibility and values, psychoeducation about behavior in line with values, psychoeducation about acceptance and avoidance of experiences, psychoeducation about fusion, attention training, psychoeducation about the self as a context, psychoeducation about the ineffectiveness of avoidance of experiences, etc.) for multiple PMS and menstrual symptoms at a predetermined time interval and in a predetermined order, here, every morning, according to a list that determines the order in which these contents are provided. In response to this request, the control block 606 makes a request to the storage management block 605, the storage management block reads the corresponding content from the storage device 133 or the storage device 102, transmits it to the control block 606, the control block 606 transmits it to the input/output block 601, and the input/output block provides the corresponding content to the user via the display device 103 and the input device 104 as necessary. The actual screen moves from the main window in FIG. 7 to a page providing the corresponding content, and in the case of a video, for example, the corresponding content video is provided as a new tile in the upper left corner of the information window on the screen (not shown). The main window is moved to by touching the "Back" button (not shown) on the screen or by ending the content. In addition, the schedule management block 603 monitors the execution status by the user, and if it is interrupted midway, it is stored as the execution status, and the control block 606 controls so that it resumes from the interrupted point again the next time it is started. If the user completes the corresponding content, it moves to the next process. When the schedule management block 603 detects that the previous content has not ended when attempting to provide new content according to the list of the provision schedule, it can request the control block 606 to control so that the previous content is displayed again in the upper left corner instead of providing new content. The content of this application can be in the form of text such as a chatbot, audio, video, game, etc., but a content group using one of these or a combination of these depending on the content may be provided, or one content may be created in multiple formats and set in advance or selected by the user each time. In addition, the user's usage history, for example, the usage history of the application, may be monitored and recorded using the monitoring device 106, and if the user frequently watches videos, the content may be provided in the form of a video, and if the user frequently uses SNS, etc., the content may be provided in the form of a chatbot.

(653) In this embodiment, the core processes based on ACT are "self as context," "acceptance," "defusion," "this moment," (for each of the above processes, 10 exercises are prepared as intervention processes (a work set is prepared that corresponds one-to-one to each core process (a "work set" is, for example, a unit for managing the aforementioned 10 exercises collectively), and generally, an exercise (work) corresponds to multiple core processes, but in this invention, an exercise included in a work set is set to correspond to one core process for which the exercise has an effect), but the number is not limited to these (for the aforementioned four core processes, the work set may contain one exercise, but it is preferable to have multiple exercises. This is because it is preferable to provide multiple exercises rather than just one exercise in one process, so that the user does not get bored and can find one that suits the user), and six of them are used: "self as context," "acceptance," "defusion," "this moment," (for each of the above processes, 10 exercises are prepared as intervention processes (a work set is prepared that corresponds one-to-one to each core process (a "work set" is, for example, a unit for managing the aforementioned 10 exercises collectively), and generally, an exercise (work) corresponds to multiple core processes, but in this invention, an exercise included in a work set is set to correspond to one core process for which the exercise has an effect), but the number is not limited to these (for the aforementioned four core processes, the work set may contain one exercise, but it is preferable to have multiple exercises. This is because it is preferable to provide multiple exercises rather than just one exercise in one process, so that the user does not get bored and can find one that suits the user), "value," and "commitment." In addition, information content on psychological education and disease education, and work such as completing worksheets are also included as types of exercises). Here, three are used, but the present invention is not limited to these, and any process based on the six processes of ACT may be used (for example, the three processes of "mindfulness", "defusion", and "acceptance" or the four processes of "self as context", "acceptance", "defusion", and "now, in this moment" may be used). The scales used below are merely examples, and it goes without saying that well-known scales can be used depending on the purpose. First, the control block 606 provides the user with information such as questions of the questions of the PMDD assessment scale. That is, the control block 606 requests the corresponding scale from the memory management block 605, and the memory management block 605 reads the information of the corresponding scale from the memory device 133 or the memory device 102 in accordance with the request and transmits it to the control block 606, which then transmits it to the input/output block 601, which then displays the questions of the questions of the scale on the display device 103, and the user answers via the input device 104. For the items, it is convenient to select a selection method that can be processed with a numerical value, such as a 4-point, 5-point, or 7-point method in which answers such as "Agree", "Somewhat agree", "Not so much agree", or "Disagree". Then, from the answer results (typically a total score, or a total score for each factor included in the scale), the evaluation block 602 requests the memory management block 605 for a list showing the correspondence between the scale, known scores, and symptoms stored in the memory management block 605, and the memory management block 605 reads the corresponding list from the storage device 133 or storage device 102 and returns it to the evaluation block 602, and the evaluation block compares the score of the user's answer result with this list to evaluate the user's condition. After that, the evaluation block 602 transmits the result to the memory management block 605, and the memory management block 605 stores it in a database that stores personal data for each user in the storage device 133 or storage device 102 (hereinafter, the acquisition and evaluation of the scale answers are performed in the same manner). Next, to measure psychological flexibility, the AAQ-II scale is used, and the user's answers are obtained in the same manner as above, and stored in the user's personal data. It is also possible to prompt the user to answer scales such as the MPFI, CompactACT, FFMQ, and CFQ, and store the answers in the user's personal data and use them as base data.

Next, exercises based on each core process of ACT are provided. In memory 133 or memory 102, there are exercises such as "Self as Context" (well-known exercises such as the observer exercise, MCT (Metacognitive Therapy) free association task, and the chessboard metaphor to understand the self as observer/perspective = self as field/context), "Acceptance" (well-known exercises such as the ice squeeze exercise to open up to painful internal events and take the time to do so), "Values Clarification" (10 exercises to clarify the values of what actions you will take on an ongoing basis), and "Values Clarification" (10 exercises to clarify the values of what actions you will take on an ongoing basis). The following exercises are stored: "Self as a Context," "Acceptance," "Defusion," and "Now" (well-known exercises such as the Bass Exercise, which allows you to distance yourself from or separate yourself from your inner happenings and observe them, and the exercise to rephrase "I have the idea that..."); "Now" (well-known exercises such as the sound of an orchestra instrument, the appearance, taste, smell, and texture of a gummy, and the sensations of various parts of the body, which allow you to connect with and immerse yourself in what is happening in the moment); and "Committed Action" (well-known exercises such as work that encourages value-based commitment to take effective action guided by your own values). In this embodiment, as mentioned above, 10 exercises are prepared for "Self as a Context," "Acceptance," "Defusion," and "Now" and one work each for "Clarifying Values" and "Committed Action" (it goes without saying that the number of exercises and works is not specified and can be changed as appropriate). In addition to the exercises and work, if the order in which they are performed is specified, the information is also stored in the storage device 133 or the storage device 102. Educational content related to each core process may also be provided.

Next, the implementation of exercises and other work in flow 653 will be described.
The execution order of each process is not specified, but for example, the order may be determined in advance and stored in the storage device 133 or the storage device 102, or the scales of CompACT, MPFI, FFMQ, and CFQ may be measured (scale evaluation is performed by providing the user with questions on the scale items via the functions of the information processing terminal and obtaining the answers), and the relatively weak processes may be started first, or when starting flow 653, questions on the evaluation scale items regarding the process that the user is interested in among the six processes may be provided to the user, and the order may be determined based on the user's answers. Also, questions to investigate the user's characteristics such as BIG5, Enneagram, and MBTI may be asked to the user in advance, and the order and the processes to be provided may be determined according to the user's characteristics. For example, if emotional stability is low in BIG5, "acceptance" and then "defusion" may be provided, and if curiosity is high, "right now, this moment" and "defusion" may be provided, which can increase the effect of the user's exercise. In addition, instead of asking the user questions via an information processing terminal, a known technology for evaluating characteristics such as BIG5 from the usage history of a smartphone (for example, JP 2022-189376 A) can be used to make a judgment without increasing the burden on the user (also, known technologies for determining behavioral characteristics from the history of "tweets" of other SNS users can be used.). (The program (scenario) provided may, for example, evaluate six core processes using MPFI or the like, continuously perform processes with relatively low proficiency, evaluate the core processes, and provide corresponding work sets in order from the core processes with relatively low proficiency until all of them reach a predetermined proficiency, and when all are achieved, stop providing the work sets for a predetermined period (for example, six months, one year), and then evaluate the proficiency of the core processes again and repeat the operation of providing work sets for those with relatively low proficiency, or provide a work set that follows a certain number of core processes according to a predetermined theme of the purpose of treatment.)
In this embodiment, the exercises are set to start in the order of "Now, this moment" and "Defusion", which are important processes in many cases. Also, the cooperation between each block of the software program and each function of the hardware is the same as described above, so details are omitted. Also, prior to execution of the exercise provision program, the control block 606 can prompt the user to answer scales such as the MPFI, FFMQ, and CFQ, and the answer results can be used as a base.

First, the schedule management block 603 provides the "drink tea" exercise (exercise and work are treated as the same in this specification) included in the work set of "this moment, right now". In other words, it requests the control block 606 to display an icon for starting the "drink tea" exercise in the latest tile (upper left) of the information window at 10:00 a.m. on the start date. The schedule management block 603 records the execution status of the exercise by the user. As with the educational content, if the user has not executed the exercise, the schedule management block 603 may not only provide the exercise according to the schedule, but also control the exercise that has not been executed or has been suspended to be placed again in the latest tile. In addition, in order to count the number of times the user has executed the exercise, for example, a button for the number of executions can be provided on the exercise page, and the number of times the exercise has been executed can be accumulated each time it is touched, and points can be awarded according to the number of executions to provide an incentive. Next, as described above, at 10:00 a.m. the next day, the schedule management block 603 displays the next exercise, "be aware of your feet and read a text" in the latest tile according to the schedule list. Furthermore, the 10 exercises stored in the list up to the 5th day are provided to the user in a predetermined order every morning, and the user is encouraged to perform them. On the 6th day, the mastery (effectiveness) of the "now, this moment" process is measured using a subscale (Present Moment Awareness) of the MPFI (Multidimensional Psychological Flexibility Inventory) (the scale is not limited to this, and other scales used in ACT such as MAAS (Mindful Attention Awareness Scale), CompACT (Comprehensive assessment of Acceptance and Commitment Therapy processes), and FFMQ can also be used). In this embodiment, the evaluation block 602 compares this evaluation result with the previous evaluation result of the user (stored in the personal data), and if improvement is observed or if this is the second time the 5-day work set of this process has been performed, it is set to proceed to the next process. This setting can be modified as needed, such as not obtaining the scale, proceeding to the next process without evaluating the scale, repeating the same process until the evaluation result not only improves but also improves to a predetermined degree (since there are 10 exercises in the work set of this process, the same exercises will be repeated from the third time (because one series of exercises is provided with 5 exercises), but other methods of providing them may be used, such as providing them randomly), etc. In this case, the control block 6060 evaluates the questions on the evaluation scale after the work set is performed, and performs a process of determining and deciding whether to repeat the work set of the core process that was performed or to proceed to the work set of the next core process based on the evaluation result and the judgment condition information stored in any storage device of the system or described in the program itself. This judgment condition information includes information for judging whether to proceed to the next process, such as a threshold value for judging that the proficiency of the executed work has achieved a predetermined goal, or when the evaluation score does not reach the threshold value and the execution of the work set of the same core process has been a predetermined number of times, for example, when it has been repeated three times, proceed to the next process regardless of the evaluation score, or proceed to the work set associated with the next core process regardless of the evaluation score because the execution period of the work set exceeds a predetermined number of days (the judgment information includes at least one of the above information, but is not limited to this and may include other conditions to enable judgment). In addition, this threshold value may be set to change depending on the user and the number of times it has been executed. Judgments can be made in the same manner below. In addition, the judgment result of whether to repeat the work set of the core process or proceed to the work set of the next core process may be provided to the user via the input/output device of the information processing terminal, and the user may judge whether or not the repetition is necessary, and control may be performed according to the user's instructions.

Next, the schedule management block 603 requests the control block 606 to provide the exercise of the work set "Defusion" in the same way as the above-mentioned "This Moment". Here, the MPFI subscale (Defusion) can be used for the evaluation. The evaluation is performed by reading out questions of the scale items stored in one of the storage devices of the system, providing them to the user via the user's information processing terminal, obtaining the user's answers, and tallying them up. The scale is not limited to this, and other scales used in ACT, such as ComACT and CFQ (Cognitive Fusion Questionnaire), can also be used. In other words, a scale is used to evaluate the proficiency of the core process associated with the work set performed by the user (generally, work affects multiple core processes, but in this embodiment, an evaluation scale is set to be associated with each work set). Then, the evaluation result is evaluated in the same way as the proficiency of the core process described above, and it is determined whether to end this core process (execution of training) and proceed to the next core process (execution of training), or to repeat this core process again. If the next core process is to be proceeded to, the work set of the next core process is provided.

Then, the schedule management block 603 requests the control block 606 to provide the exercises of the "Acceptance" work set in the same way as for "This Moment" described above. Here, the MPFI subscale (Acceptance) is used for the evaluation. (The scale is not limited to this, and other scales used in ACT, such as APQ (Acceptance Process Questionnaire), can also be used.) Then, in the same way as for the proficiency of the core processes described above, this evaluation result is evaluated, and a decision is made as to whether to end this core process and proceed to the next core process, or to repeat this core process again. If proceeding to the next core process, the work set of the next core process is provided.

Next, the schedule management block 603 requests the control block 606 to provide the exercises of the "Self as Context" work set in the same way as the above-mentioned "This Moment." Here, the MPFI subscale (Self as Context) is used for the evaluation. (The scale is not limited to this, and other scales used in ACT, such as SACS (Self-as Context Scale) or FFMQ (Five Facet Mindfulness Questionnaire), can also be used.) Then, in the same way as the proficiency of the core processes described above, this evaluation result is evaluated, and a decision is made as to whether to end this core process and move on to the next core process, or to repeat this core process again. If the next core process is to be progressed, the work set of the next core process is provided.

Next, the schedule management block 603 requests the control block 606 to perform the exercise of the work set "Clarifying values", thereby carrying out the value work. The schedule management block 603 requests the control block 606 to display a tile for starting the value work exercise in the latest tile of the information window at 10:00 the next morning. When the tile is touched by the user, the control block 606 selects one to three areas that the user considers important from 10 value areas (work/occupation, friends/social life, etc.) on the screen, and further controls the input/output block 601 to input "behaviors" that the user recognizes as valuable within the selected areas in free description. The control block 606 further transmits the input "behaviors" to the memory management block 605 and stores them. The MPFI subscale (Contact with Values) is used to determine whether or not the user is performing actions in line with values. (The scale is not limited to this, and other scales used in ACT, such as the VQ (Valuing Questionnaire), can also be used.) Then, the results of this assessment are evaluated in the same way as the proficiency of the core processes described above, and a decision is made as to whether to end this core process and move on to the next core process, or to repeat this core process again. If the decision is to move on to the next core process, a work set for the next core process is provided.

Next, the schedule management block 603 requests the control block 606 to perform the exercise of the work set "committed action", thereby carrying out the value work. The schedule management block 603 requests the control block 606 to display a tile for starting the value work exercise in the latest tile of the information window at 10:00 the next morning. When the tile is touched by the user, the control block 606 displays the values entered in the above-mentioned clarification of values at the top of the screen, and displays a window at the bottom for entering actions in line with short-term, medium-term, and long-term values. The control block 606 transmits the entered actions to the memory management block 605 and stores them. Whether or not the committed action is being performed is determined using the subscale (Committed Action) of the MPFI in the same way. (The scale is not limited to this, and other scales used in ACT, such as VQ (Valuing Questionnaire), can also be used.) Then, the evaluation result is evaluated in the same way as the proficiency of the above-mentioned core process, and it is determined whether to end this core process and proceed to the next core process, or to repeat this core process again. Then, if you move on to the next core process, we provide you with a work set for the next core process.

Here, the control block 606 again measures the user's MPFI (or another scale, if used, that scale may be used) and AAQ-II, and graphically displays the changes in the AAQ-II score and the values of each of the six core processes, for example, a line graph showing the progress of the AAQ-II score and a hexagonal radar chart showing the progress of the scores of the six core processes, allowing the user to visually understand the effectiveness of this program. The changes in this graph over time can be checked at any time by calling up the user's personal data. It is also preferable to display the latest data and past data in different colors for easy understanding.

As described above, a systematic basic program for dealing with stress based on ACT was provided. Next, the evaluation block 602 evaluates the evaluation results of the six processes described above (measurement results using MPFI, FFMQ, CFQ, or other scales of the six core processes of ACT), and performs the core processes for which the user has relatively low scores for "self as context," "acceptance," "defusion," and "here and now," in descending order of their scores, in the same manner as for each of the processes described above. After one month of provision, the evaluation block 602 evaluates the psychological flexibility and the proficiency (effectiveness) of each core process using MPFI (or CompACT, AAQ-II, FFMQ, CFQ, VQ, etc.) and AAQ-II. Here, if necessary (when the degree of achievement of values is low and values need to be reviewed, or when goals are achieved and resetting is required), the above-mentioned core processes of "clarification of values" and "committed actions" are performed again. When this turn ends with this execution, the process of performing the core processes in descending order of their scores based on the evaluation results of the six core processes is repeated. If the AAQ-II score reaches a certain level even after this repetition, and psychological flexibility is recognized to have been acquired, the execution of the exercises is stopped, and the AAQ-II and the six core processes are evaluated periodically, for example, once a month, and when psychological flexibility or the proficiency of any of the core processes is reduced, or when the AAQ-II is evaluated and psychological flexibility is reduced, the provision of the above-mentioned exercises can be resumed. In addition, it is possible to appropriately determine which of the six core processes of ACT is repeated, and for example, the core processes to be provided and the order of the core processes are determined according to the pattern of the evaluation points of the core processes to be provided, and the multiple patterns, the core processes to be provided, and the order of the core processes (if there are two or more) are listed and stored in a storage device, and the evaluation block 602 compares the user's evaluation points with this list to determine the next core process to be provided, and after the provided core process (group) is completed, the next core process is determined by performing an evaluation using a scale. In addition, a model can be constructed through machine learning using training data that includes the evaluation score patterns of multiple core processes of the user and the change in evaluation score after execution of each core process provided thereafter, and the initial evaluation score patterns of the user can be input into this model to suggest a recommended core process (group), and the execution and evaluation of these core processes can be repeated.

(654) Next, the second function of the evaluation block 602 will be explained using the example of self-care for disease-specific symptoms of PMS. The evaluation block 602 is also a block that has the function of analyzing the personal data of the PMS memory entered by the user. In addition, the system includes a function for calculating and predicting the next menstrual period based on the past menstrual period data input by the user, and a function for analyzing the association of the mental and physical symptoms of PMS and symptoms such as abdominal pain input by the user with the menstrual period (for example, if an analysis of past input shows that the user tends to complain of mental symptoms such as "irritability" from four days before the menstrual period and physical symptoms such as "abdominal pain" for three days after the menstrual period, a prediction of the next menstrual period, as well as a prediction of "irritability" four days before and "abdominal pain" for three days after the menstrual period, are calculated and transmitted to the schedule management block 603. The schedule management block 603 reads out a list of intervention dates and times and intervention processes (processes for carrying out psychotherapy, processes for improvement based on psychology) for each disease stored in the storage device 133 or the storage device 102, and controls the system so that the predicted date is set as the intervention date for PMS in the list related to PMS, and the set intervention program is provided on that date and time. In this embodiment, when a result of predicting that the next menstrual period is April 10, the list shows that "defuse" is scheduled for April 6, and the list shows that "defuse" is scheduled for April 6. Write that the core process of "John" (training) will be provided for four days until the day of menstruation. Also, write that the "Now, This Moment" process will be provided for three days on April 10th. For many mental and psychosomatic disorders, there are effective interventions for the statement of the symptoms. For example, in the case of PMS, it is expected that fusion such as "I'm irritated and I hit people with it, and I feel disliked by them" will occur, so "defusion" exercises are effective, and for pain associated with menstruation, it is expected that past pain will be recalled and the unpleasant symptoms will be aggravated, so "Now, This Moment" exercises and "mindfulness" exercises are effective. These exercises can be the same as the exercises used to cultivate psychological flexibility mentioned above, but it is more convenient to use modified versions according to the symptoms of the disease. (For example, it is convenient to create a version of the exercise "Tea" where "Tea" is replaced with "Menstrual pain" and repeated out loud for 20 seconds.)

The schedule management block 603 manages both the core process exercises for cultivating psychological flexibility and the core process exercises for self-care of symptoms specific to the disease. When both are performed in parallel, a situation occurs in which the former core process exercise and the latter core process exercise are provided at the same time. In this case, the schedule management block 603 simply provides both exercises, suspends the former exercise and performs the latter exercise, provides the latter core process exercise instead of the former core process exercise of "defusion" if the exercises provided at the same time have the same theme, for example, "defusion", provides both exercises but shifts the time of providing them, and since the order of providing may be important depending on the core process or exercise, the above-mentioned list records exercises that would cause problems if the order of providing them is reversed. For example, if exercise C must not precede exercise D in the defusion exercise, when it is decided that exercise D will be provided in the latter, the schedule management block 603 adjusts the core process or changes the order of providing the exercises so that the former exercise C precedes it, thereby avoiding this. In parallel with these functions, the schedule management block 603 cooperates with the control block 606, memory management block 605, and input/output block 601 to input data to the PMS memory and EMA every day, and to acquire and record data from the monitoring device. Finally, evaluation is periodically performed using a scale, such as the PMDD scale, to evaluate symptoms specific to the disease. The evaluation results are stored in a storage device as personal data, and it is preferable to make it possible to display the progress of changes upon request from the user.

In this embodiment, each core process and a set of work to master that theme (core process) are packaged, so it is easy to measure the mastery (effect) of each process, psychotherapy can be provided automatically on an information processing terminal, and it is easy to repeat. In addition, reliability and accuracy of confirmation of effect are increased by measuring with a scale with evidence that corresponds one-to-one to each core process.
From the viewpoint of the present invention, it is preferable that the psychotherapy includes all the elements necessary for acquiring stress coping skills, such as the six core processes for cultivating psychological flexibility in ACT, or the four core processes related to mindfulness in ACT. However, since each core process is related to the other, it is also possible to provide several core processes as a work set (a set of exercises) (for example, the three processes of "defusion", "mindfulness", and "value clarification"). In this case, it is convenient to have three or more core processes from the viewpoint of confirming the level of proficiency (it is even more convenient if each of these core processes has an evaluation scale). However, it goes without saying that it is not necessary to include all the necessary elements (for example, the six core processes of ACT) depending on the purpose of the application to be created. In this embodiment, for the purpose of explanation, PMS, which has a part for cultivating stress coping skills and a part for relieving symptoms specific to the disease, is used as an example, but if the purpose is only stress coping, the system can be configured with only the part for stress coping. In addition, when using a configuration in which the core process of this embodiment is repeated according to the level of proficiency, it can be designed to end after a predetermined period, end when the evaluation of psychological flexibility reaches a predetermined level, end when the evaluation of psychological flexibility reaches a predetermined level, but periodically (for example, every 6 months, a period during which the effects of ACT are said to last), and if it falls below a predetermined level, provide the core process exercise again, or, without setting a specific end point, when a certain core process is mastered, provide the next core process exercise with a relatively low level of mastery (the threshold for evaluating the mastery of the core process may be gradually increased). In the latter case of continuing continuously, ACT is effective not only in terms of mental self-care because it is effective in healthy people, but also commercially preferable because it can be provided through subscription services, etc.

Example 2
In this embodiment, an example in which the present invention is applied to self-care for sleep disorders will be described. Mindfulness-Based Stress Reduction (MSBR) is used as a systematic stress reduction method.
The mindfulness-based stress reduction method consists of (1) body scan (chewing meditation exercise, breathing exercise, body scan exercise), (2) body scan and yoga (body scan exercise, yoga exercise, walking meditation exercise), and (3) sitting meditation and yoga (sitting meditation exercise, yoga exercise). As for the method of providing, text, audio, video, game, etc. can be selected as in the ACT process, but since video is compatible with mindfulness, this embodiment provides video exercises. That is, the storage device 102 or the storage device 133 stores a work set of exercises on the themes (1) to (3), educational video content on mindfulness, and disease education content video on sleep disorders. The configuration of the application program is the same as that of FIG. 6(a), and the functions and operations of each block and the functions and operations of each hardware of the information processing device 110 are the same as those of the first embodiment, so details will be omitted.

The flow of the application program is controlled by the control block 606 in cooperation with each block, as in FIG. 6(b). First, (650) the user logs in to the application and the application is started. Next, (651) the symptom memory stores data such as that shown in FIG. 3(a) as personal data, and inputs the data via an input screen such as that shown in FIG. 3(b). The details of the input are the same as those of the PMS memory. In addition, in this stage, data on the user's answer results based on the FFMQ scale is acquired and also stored in the personal data in order to provide a baseline for verifying the effect of self-care. (652) The control block 606 cooperates with the schedule management block 603 to first provide the user with educational content, (653) the content (1) in the first and second weeks, the content (2) in the third and fourth weeks, and the content (3) in the fifth and sixth weeks. Here, the user is prompted to answer the FFMQ scale again, and the results are obtained. Then, the evaluation block 602 compares and analyzes the results with the base data, and presents the effect to the user graphically. If the comparative analysis results show that the FFMQ score does not reach the required value, the process of providing exercises on the themes (1)-(3) is repeated. Also, it is possible to carry out evaluations using an evaluation scale between (1), (2), and (3), and repeat previous steps if the required standard is not reached.
(654) Disease-specific interventions for sleep disorders include the “here and now” process, mindfulness, cognitive restructuring, stimulant fishing, sleep restriction, progressive muscle relaxation, and sleep scheduling, and these can also be used.
The application of the "Now, This Moment" process can be provided to the user in cooperation with the control block 606 and the schedule management block 603, similar to the application of the "Defusion" and "Now, This Moment" processes in the first embodiment (the same exercises as those in the self-care function for dealing with stress may be used in the present invention, or modified for sleep disorders). The difference from the first embodiment is the timing of application. The timing is when the evaluation block 602 compares the sleep efficiency of the user in the sleep diary with the user's normal sleep efficiency or the exemplary sleep efficiency of the same age group and evaluates that there is a problem, or when the evaluation block 602 evaluates the user's tendency described in the sleep diary and transmits the time when it is evaluated that a sleep disorder is likely to occur to the schedule management block 603, and executes the above process at that timing. In this case, the schedule management block 603 controls in cooperation with the control block 606 so that the exercises of the process are provided during the period when the sleep disorder occurs. As a modified example of this embodiment, when the cognitive restructuring method is provided as the exercise to be provided, a well-known technique (e.g., Patent Document 4) can be provided instead of "Now, This Moment". The schedule management block 603 can adjust the provision of stress coping exercises and disease-specific exercises, as in the first embodiment. Finally, the assessment is based on a scale, but if the intervention is based on the same principle as that provided for stress coping (e.g., "right now" or an adapted version of the exercise for the symptom), the same scale (e.g., MPFI or FFMQ subfactors) may be used, or a scale specific to the symptom of the disease (e.g., BPS, PSQI, ISI, AIS) may be used. In addition, the results of these assessments may be provided to the user over time to increase the user's satisfaction. Each exercise may be repeated according to the level of proficiency, as in the first embodiment.

Example 3
The mechanism of symptoms in many diseases has been elucidated, and it is already known what kind of intervention should be performed to alleviate stress-related diseases (for example, as in the above-mentioned embodiment). However, depending on the disease, the causes of the disease may be complicated and intertwined, and even if a well-known intervention is simply performed, the symptoms of the disease may not improve. The inventors have noticed that in many cases, the major factor in the cause of the disease is not the patient himself, but rather the social factors surrounding the patient, etc. This is why ED (erectile dysfunction) is used as an example of such a disease. In addition, if the symptom alleviation effect is not seen for the above-mentioned diseases, the same cause may be considered, so the method of this embodiment may be used. In the case of ED, since it is a disease that develops with a partner as an essential condition, it has a strong social impact. Therefore, the cause of the symptoms specific to the disease is assessed and an intervention policy is decided. The implementation of the work set for improving stress coping ability is performed in the same manner as described above, so the explanation is omitted.

When applying to ED, first, before executing the self-care app, an assessment is performed on the user to identify the cause of the disease in parallel with the measurement of AAQ-II. The assessment can be performed using an assessment scale in the same procedure as in the above-mentioned embodiment. When evaluating these diseases, a scale for measuring biopsychosocial factors and the state of the disease is required. In this embodiment, as a scale for measuring biopsychosocial factors, the general SF-36, especially the evaluation of partner relationships is required, and the Kansas Marital Satisfaction Scale (KMS) and other well-known scales such as the Adult Social Care Outcomes Toolkit (ASCOT), a social care-related QOL scale, can also be used, and the International Erectile Score 5 (IIEF 5) and CFQ for evaluating the severity of general ED are used. The assessment is performed in the evaluation block 602, and based on the scores of the factors included in these scales, first, the IIEF-5 evaluation score is used to classify the user into group 1 (not ED), group 2 (ED), and group 3 (ED but quite severe), and group 1 is not particularly subjected to disease-specific intervention, and group 3 is deemed to exceed the level of self-care, and a message is issued to the user recommending a visit to a medical institution, etc. For group 2, the KMS scale is further evaluated, and if the marital relationship is evaluated as bad, it is classified into group 2a. Next, if the score on the SF-36 is low and there is no tendency for cognitive fusion in the CFQ, it is classified into group 2b as excessive stress, and otherwise into group 3c as anticipatory anxiety type. The classification method is not limited to this, and it is possible to classify by combining any scale and using conditional branching for each score, or by combining multiple scales and using conditional branching. Next, a predetermined work set is provided by referring to a list (not shown) describing the correspondence between the group and the intervention work set. The procedure for how the schedule management function provides the work set is also described in correspondence, and the schedule management block 603 provides the user with the work set based on that. In addition, the list may be made to store the evaluation results by the scale, and the data may be used as teacher data to build a model through machine learning, and the list may be updated by the model. (This allows the intervention work set, exercises, evaluation scale, condition for conditional branching, conditional branching procedure, etc. to be optimized.) In addition, each exercise may be repeated according to the level of proficiency, as in Example 1.

(Other Examples)
As an application of the present invention, in order to provide a systematic stress coping method, techniques such as "problem-focused coping" and "emotion-focused coping" such as well-known problem solving methods can be used to provide the user with a method of coping with stress in the same manner as in the above-mentioned embodiment. In addition, a process (set of exercises) for self-care of symptoms specific to a disease may be provided in combination with the method. As a process for chronic pain or migraine, "acceptance", "defusion", "now, this moment", etc. can be used (exercises for implementing other psychotherapy for self-care of symptoms such as chronic pain may also be used). In this embodiment, the evaluation block 602 also analyzes the user's pain diary, analyzes the timing of the onset of the user's pain (changes in atmospheric pressure or weather, periodicity, association with events), and transmits the timing to the schedule management block 603, and the schedule management block 603 and the control block 606 cooperate to provide a process for self-care of symptoms of the disease while adjusting it. Applications for self-care of symptoms of other diseases can be similarly configured. For example, in addition to the stress coping methods of these embodiments, a process for self-care of each disease symptom (e.g., acceptance, defusion, and here and now for menopause) can be provided, and the timing of providing the process can be adjusted by the evaluation block 602 and schedule management block 603, while the control block 606 provides the process.

In the above embodiment, the stress coping method providing part and the disease symptom coping part are exemplified by providing exercises based on the same psychological theory and by providing exercises based on different psychological theories, but the exercises based on the same theory are more consistent and effective. However, the disease symptom coping part may not only include performing psychotherapy, but also listening to music based on psychotherapy, exercise other than psychotherapy, and diet therapy. Also, each exercise may be repeated according to the level of proficiency, as in Example 1.

(Other workset execution, evaluation and iterative decision examples)
FIG. 8 shows an example of the evaluation of the effect of each theme (core process) of the present invention and the repetition of each theme. In the figure, this example shows an example of providing three themes, "This Moment", "Defusion", and "Acceptance". The solid lines indicate the transition of the work sets of the themes according to the evaluation points of each theme, and the dashed lines indicate the transition in a predetermined order. For example, A(a,b,c) indicates the implementation of acceptance exercises a,b,c, D indicates the implementation of the defusion work set, and I indicates the implementation of the here and now work set. For example, D<R1 indicates that the result of the evaluation scale for defusion is below the standard value (similar to I<R2 and A<R3).
Here, in FIG. 8(a), exercise ad of the defusion work set (including exercise a to exercise z) is performed, and evaluation is performed according to the evaluation scale. If the standard value is exceeded, the next work set for this moment is provided, and if the standard value is not exceeded, the defusion exercise eh is prompted to be performed again. Similarly, after each theme is performed, the mastery (effect) of each theme is evaluated, and if the standard value is met, the next theme is moved to. This is an example of performing and evaluating each theme (performing the exercises while shifting them as in this example is preferable because the user can continue without getting bored). In addition, in this example, the order is determined in advance as defusion, this moment, and acceptance, and is repeated, but this is not limited to this. For example, after performing the exercises, evaluation is performed on three scales, and the one that is the lowest below the standard point, or the one that is the smallest deviation from the standard point if all are above the standard point, is performed, and modifications known to those skilled in the art are also possible. In addition, the themes and their evaluations are not limited to being performed one by one. Next, FIG. 8(b) shows another example. In this example, an example is shown in which evaluation is performed after three defusion and acceptance are performed at this moment. Then, as an evaluation result, one of the three evaluations that falls below the reference point is performed again, and the process of evaluating it is repeated. As described above, the number of themes and evaluations to be performed consecutively can be set appropriately. For example, evaluations of each of the themes that can be provided are performed, two of the themes with relatively poor evaluation results compared to the other themes are selected, the user is prompted to perform the work set, and then evaluations of each of them are performed again. (In the present invention, "when the evaluation result of the theme evaluation scale does not meet the standard" does not necessarily mean a case where the evaluation result is lower than the reference point, but also includes a case where the evaluation result is relatively lower than other evaluation results, or a case where the deviation from the reference point is small compared to other evaluation results.") In addition, when evaluating, the user may be prompted to answer not only the scale that measures the proficiency and effect of each theme, but also the evaluation scale that measures the severity of stress-related diseases (stored in the storage device of the server or information processing terminal), and the result may be used to evaluate the state of the disease or mental disorder, or to detect progress such as improvement. Even in this case, instead of measuring simultaneously with the scale of the theme, the measurement may be performed after the implementation of successive themes to be provided, after implementing all the themes, or periodically.

The technique of encouraging the user to execute a work set based on the core process of the ACT of the present invention, and repeatedly providing the same work set depending on the level of proficiency, or providing a work set corresponding to a specific other core process, is preferable because when used for a specific stress-related disease, the stress symptoms that cause the specific disease are improved, and the specific disease is improved. In addition, when the present invention is used for self-management of stress symptoms that are not related to a specific stress-related disease, it leads to the prevention and improvement of all stress-related diseases, which is preferable. In the latter case, it is convenient to provide the user with a work set continuously according to the evaluation result of the core process without setting a specific period, as this maintains psychological flexibility well. Here, when the work set is provided continuously, further improvement can be achieved by gradually improving the reference point for judging the proficiency of the core process in the case of multiple repetitions. In addition, when judging the proficiency of the executed core process, even if the proficiency is below the reference point, the system can inquire the user about the user's wishes via an information processing terminal, and if the user wishes to proceed to the next core process rather than repeating it, the next core process can be provided.

The present invention has been described based on several embodiments, but it goes without saying that the elements used in each embodiment can be added to the configuration of other embodiments. Furthermore, in the present invention, an example has been shown in which the evaluation is carried out by quantitatively evaluating an evidence-based scale, but this is not limited to this, and it goes without saying that modifications can be made to the method of presentation, such as changing to audio, video, or game format, shortening the questions in the questionnaire, or using original questions.

100 System of the present invention 101 Control device 102 Storage device 103 Display device 104 Input device 105 Communication device 106 Monitoring device 110 User's information processing terminal 120 Internet 130 Server 131 Communication device 132 Control device 133 Storage device

Claims (5)

A system for self-care of stress-related diseases or mental disorders caused by stress, comprising:
The system further comprises:
a user's information processing terminal having an input/output unit;
A server including a storage device that stores a work set that is one-to-one associated with each of a plurality of Acceptance and Commitment Therapy (ACT) core processes, and question information of an evaluation scale (ACT core process evaluation scale) that is one-to-one associated with each of the work sets and that is used to evaluate the proficiency of the core processes, and a control device that controls the system;
wherein the work set includes a plurality of exercises;
The system further comprises:
providing a part of the exercises included in the work set associated with one of the core processes stored in the storage device to the user via the input/output unit of the information processing terminal and having the user execute the exercises;
After the user has performed the portion of the exercises , provide the user with information on the questions corresponding to the work set performed by the user via the input/output unit of the information processing terminal, obtain answers to the questions by the user, and evaluate the effects of the user's performance of the portion of the exercises based on the answers.
If the result of the evaluation does not meet the standard, the system provides the user with and has the user perform exercises of a work set corresponding to the core process performed by the user and stored in the storage device via the input/output unit of the information processing terminal, the exercises being different from the part of the exercises performed by the user last time. An information processing device for self-care of stress-related diseases or mental disorders caused by stress,
The information processing terminal,
A storage device that stores a work set that is one-to-one associated with each of a plurality of Acceptance and Commitment Therapy (ACT) core processes, and question information of an assessment scale (assessment scale for the ACT core processes) that is one-to-one associated with each of the work sets and that is used to assess proficiency of the core processes;
A control device that controls the information processing terminal;
an input/output unit , wherein the work set includes a plurality of exercises;
The control device,
providing a part of the exercises included in the work set associated with one of the core processes stored in the storage device to the user via the input/output unit and having the user execute the exercises ;
After the user has performed the portion of the exercises , provide the user with information on the questions corresponding to the work set performed by the user via the input/output unit, obtain answers to the information on the questions by the user, and evaluate the effects of the user's performance of the portion of the exercises based on the answers.
If the result of the evaluation does not meet the standard, the information processing terminal provides the user with and has the user perform exercises of a work set corresponding to the core process performed by the user and stored in the storage device via the input/output unit, the exercises being different from the part of the exercises performed by the user last time. A method for providing self-care for stress-related diseases or mental disorders caused by stress, comprising:
The method,
a user's information processing terminal having an input/output unit;
A system including a server including a storage device that stores a work set that is one-to-one associated with each of a plurality of Acceptance and Commitment Therapy (ACT) core processes, and question information of an assessment scale (assessment scale for the ACT core processes) that is one-to-one associated with each of the work sets and that is used to assess proficiency of the core processes, and a control device that controls the system , wherein the work set includes a plurality of exercises,
providing some of the exercises included in the work set associated with one theme of the core processes stored in the storage device to the user via the input/output unit of the information processing terminal and having the user execute the exercises;
providing the user with information on the questions corresponding to the work set performed by the user via the input/output unit of the information processing terminal after the user has performed the portion of the exercises , obtaining answers to the information on the questions by the user, and evaluating the effects of the user's performance of the portion of the exercises based on the answers;
and if the result of the evaluation does not satisfy the standard, providing the user with an exercise of a work set corresponding to the core process performed by the user and stored in the storage device via the input/output unit of the information processing terminal, the exercise being different from the part of the exercises previously performed by the user, and having the user perform the exercise.
A method for providing the user with self-care for stress-related illness or mental disorders caused by stress. A method for providing self-care for stress-related diseases or mental disorders caused by stress, comprising:
The method,
A storage device that stores a work set that is one-to-one associated with each of a plurality of Acceptance and Commitment Therapy (ACT) core processes, and question information of an assessment scale (assessment scale for the ACT core processes) that is one-to-one associated with each of the work sets and that is used to assess proficiency of the core processes;
A control device that controls the information processing terminal;
an input/output unit, wherein the work set includes a plurality of exercises;
providing a part of the exercises included in the work set associated with one of the core processes stored in the storage device to the user via the input/output unit and having the user execute the exercises;
providing the user with information on the questions corresponding to the work set performed by the user via the input/output unit after the user has performed the portion of the exercises , acquiring answers to the information on the questions by the user, and evaluating the effects of the user's performance of the portion of the exercises based on the answers;
A method for providing the user with self-care for stress-related illness or mental disorders caused by stress, comprising the step of providing the user with and having the user perform exercises of a work set corresponding to the core process performed by the user and stored in the storage device via the input/output unit, the exercises being different from the part of exercises previously performed by the user, if the result of the evaluation does not satisfy the standard. A program for providing self-care for stress-related illnesses or mental disorders caused by stress, the program comprising: a storage device for storing work sets each corresponding to a plurality of core processes of Acceptance and Commitment Therapy (ACT) on a one-to-one basis; and question information related to an assessment scale (assessment scale for the ACT core processes) each corresponding to a one-to-one basis for assessing proficiency of the core processes;
A control device that controls the system;
an input /output unit for inputting and outputting information to a user , wherein the work set includes a plurality of exercises;
a function of providing the user with some of the exercises included in the work set associated with one of the core processes included in the plurality of core processes stored in the storage device via the input/output unit and having the user execute the exercises;
a function of providing the user with information on the questions corresponding to the work set performed by the user via the input/output unit after the user has performed the portion of the exercises , acquiring answers to the information on the questions by the user, and evaluating the effectiveness of the user's performance of the portion of the exercises based on the answers;
a function of providing the user with and having the user perform an exercise of a work set corresponding to the core process performed by the user and stored in the storage device via the input/output unit, the exercise being different from the part of the exercises previously performed by the user, if the result of the evaluation does not satisfy the standard;
A program for realizing the above in the system.

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