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ID 28527
file
title alternative
Patterns in infant behavior during immunization injections : From the viewpoint of relations between family and medical staff
creator
Chaen, Tomoko
Nakagomi, Satoko
subject
予防接種
年少幼児
対処行動
immunization injections
young infant
coping behavior
NDC
Medical sciences
abstract
本研究は, 予防接種における2歳から3歳の年少幼児の行動を類型化し, 行動の持つ意味を親や医療者の関わりの視点から考察し, 予防接種への対処を助けるために必要とされる看護ケアについて検討することを目的とした. 対象は日本脳炎の予防接種を受けた健康な2歳から3歳の年少幼児とした. データ収集は平成14年7月26日から同年9月12日までの1.5か月に行い, M小児科医院外来で行った. データ収集方法は, ビデオカメラを用いて, 第1回および第2回の日本脳炎予防接種の来院時点から帰院までの幼児の一連の行動と親, 兄弟, 医療者の行動を含めて撮影・録画した. データ分析は, 画像は事例別に全行動を言語で記述し, 予防接種に対する反応に関連する行動を抽出し, 幼児の予防接種に対する反応の出現時期(嫌がる時期, 泣き始める時期, 痛いと言う時期, 泣き止んだ時期), および, 幼児と医療者・親・兄弟との関わりを抽出し, 予防接種を受ける対象の行動の類型化を行った.

その結果, 予防接種における年少幼児の行動は, 嫌がり・泣き始め・泣き止みの時期, 痛いという表現, 第1回・第2回の行動の相違点から, 3つに類型化した. タイプⅠの行動は, 第1回・第2回とも注射針刺入までに嫌がり泣き始め, タイプⅡの行動は, 第1回・第2回とも注射終了後に痛いと言って泣き始め, タイプⅢは, 第2回においてのみ注射針刺入時に痛いと言い液注入時に泣き始めるという行動であった. 年少幼児でも, 他者と注射の方法や意義について理解できること, 嫌がり・泣きがあってもがんばろうとしていたこと, 痛みに耐えようとしても耐えられないと泣いてしまうこと, 注射を見ることで不安が増強すること, 反応の内容や強さは個人差があることが考えられた.

年少幼児の予防接種におけるケアとしては, 1)がんばるという心構えを支えること, 2)痛み体験を受け止め, がんばったことをほめる, 3)痛みを緩和すること, 4)注射部位の固定・注射の準備の仕方, 5)個別なアセスメントを行うことが示唆された.
abstract
The purpose of this research is to find patterns in the behavior of infants during immunization injections and to ascertain the care needed when dealing with infants at vaccination. The subjects were five infants (aged from 2 years 11 months to 3 years 8 months old) who received immunization injections for Japanese encephalitis. The data was collected using a video camera of a series of interactions between the subjects, parents, siblings, and the medical treatment staff from their arrival at the clinic to their departure. Semi-structured interviews with the parents were also used to obtain information about the background of the subjects.

As a result of inductive and descriptive analysis, the behavior of infants during immunization injections could be classified into three types. Infants of type I showed their dislike of the injection and cried before the prick of the needle at both the first and second injections. Infants of type II complained that it was painful and began to cry after the injection was over at both the first and second injections. Infants of type III said that it was painful at the prick of the needle but cried only during the second injection.

Infants could talk with others about the meaning and the method of the vaccination. They tried to bear with the discomfort even though they disliked it and wanted to cry.When they could not endure it, they cried with pain. Seeing the syringe increased their anxiety. There were also individual differences in the strength of their reaction.

Based on the infants' backgrounds and their behavior according to type, points relating to the care of infants during vaccination were enumerated as follows: 1) Child's determination to do his/her best. 2) Understand the infant's experience of pain and praise his/her endurance. 3) Consider methods of easing the pain. 4) Devise a method choosing the injection spot and for preparing the materials of the injection. 5) Individual assessment and correspondence.
journal title
Journal of health sciences, Hiroshima University
volume
Volume 6
issue
Issue 2
start page
102
end page
110
date of issued
2007-09-28
publisher
広島大学保健学出版会
issn
1347-7323
ncid
SelfDOI
language
jpn
nii type
Departmental Bulletin Paper
HU type
Departmental Bulletin Papers
DCMI type
text
format
application/pdf
text version
publisher
department
Graduate School of Health Science
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