早産児の体重測定法 : 「包み込み」によるストレス緩和の検討 <原著>

Body weight measurement for preterm infant : Consideration for relief of stress by "wrapping up"

山田 ひとみ

坂本 裕子

米中 由美

内谷 文子

阿曽沼 洋子

中島 由美子

横尾 京子

日本新生児看護学会誌

Journal of Japan Academy of Neonatal Nursing

本研究は、体重測定時に「包み込み」を行うことにより、早産児のストレスを緩和できるか否かを明らかにすることを目的とした。当施設での裸のままで保育器外へ出す体重測定法(従来法)と、児をタオルで囲い頭部以外の身体を布で覆った状態で出すという体重測定法(包み込み法)を、早産児4事例において、各方法12場面(4名×3回)を交互に行った。体重測定前の児の状態を安静とし、体重測定中・体重測定後0～5分の5分間・体重測定後6～10分の5分間の各時期を、行動学的側面(ストレスサイン・state)から比較検討し、以下の結果を得た。ストレスサインにおいては、体重測定中では14項目中7項目で有意差が認められ、体重測定後0～5分の5分間・6～10分の5分間においても体重測定中よりは少数であるが、有意差が認められた。stateにおいては、包み込み法では体重測定中に全く上昇が見られないという結果が得られた。これらより、「包み込み」は体重測定中の早産児のストレスを緩和するのに有用であると示唆された。今後もあらゆるケアにおいて、児のストレスサインを適切に読み取り、対処法を探索していく必要がある。

The purpose of the present research was to clarify whether or not the stress of preterm infants can be relieved by "wrapping up" during measurement of their body weight. The body weights of four preterm infants were measured using alternately our facility's traditional method, whereby babies are taken naked as they are from the incubator ("traditional method"). and a method whereby the infants were taken out clothed in a towel so that their bodies except for the head were covered in fabric ("wrap-up method"). Each infant's body weight was measured 3 times using the two methods, making a total of 12 cases. Before weight measurement the infants were put into a restful state; subsequently they were examined for behavioral aspects (stress signs and state) during (a) weight measurement. (b) the 5 minute period immediately after weight measurement (minutes 0 to 5). and (c) the subsequent 5 minute period (minutes 6 to 10). Below are the results of the comparison that was made of the behavioral aspects in each of these periods. A significant difference occurred in stress signs during weight measurement, with just 7 out of 14 signs being observed with the wrap-up method. During the 1st (minutes 0-5) and 2nd (minutes 6-10) 5 minute periods following weight measurement the number of stress signs observed was small compared to those occurring during weight measurement, but again there was a significant difference. As regards stress state, the result obtained was that no increase whatever was observed during weight measurement when the wrap-up method was used. These results indicate that the wrap-up method is useful for relieving stress in premature babies during body weight measurement. In the future it will be necessary to read accurately the stress signs in babies under all types of care and to explore methods to remedy such stress.

早産児

体重測定

包み込み

身体境界

自己鎮静行動

preterm infant

body weight measurement

wrapping-up

body boundary

selfsedating behavior

医学 [ 490 ]

日本語

日本新生児看護学会

Copyright (c) 2002 日本新生児看護学会

[ISSN] 1343-9111

[NCID] AA11269499