NICU退院児の継続看護に対するニーズの検討 : 政令指定都市A市に在住する母親へのインタビューより <研究報告>

目的: NICUを退院した児の都市部に在住する母親が利用した継続看護の内容を分析し, ニーズを明らかにすることから, 当該地域における継続看護に対する課題を検討することである.

方法: 対象者は, NICU退院後も医療的ケアを要した子どもとその母親2名と, 早産・低出生体重児でNICUを退院した1歳未満の子どもの母親4名とした. データ収集は, 半構成的面接法を用い, 母子の基本的属性, 退院後に受けた継続看護の内容と, それに対する思いや意見をインタビューし, Berelsonの内容分析の手法を用いて分析した.

結果および考察: ニーズの発生した時期により, 「NICU退院を控えた時期のニーズ」と「NICU退院後のニーズ」があった. さらに, この結果より, NICU退院児の継続看護に対するニーズは, 【NICUにおける退院直後の相談機能の充実】, 【状況に合わせた地域ケア活用方法の説明と連携】, 【母乳相談資源を活用しやすくする説明と連携】, 【専門性の高い個別的アドバイスの継続】, 【ピアグループの形成と支援】の5つが明らかになった.

以上より, 都市部に在住しているため活用できる社会資源が多様にあっても, 母親が困ったときにいつでも相談できる窓口の存在とその周知の必要性, および相談内容に応じた適切な情報提供の必要性が示唆された. 加えて, 提供する情報の種類も母乳ケアや専門的なスタッフによるものなど, 幅広く求められていた. また, NICU退院児の母親は, NICU入院中の看護職者との関係性が退院後の相談窓口の選択に影響する可能性があるため, 入院中の関係性の形成が重要であることが示唆された.

Purpose: This study aims to clarify the needs and problems for continuous nursing care to NICU discharged infants and their mothers, who live in a government-decreed city.

Methods: Subjects consisted of four mothers of low-birth-weight infants, who were younger than one year of age, and two mothers of infants, who required additional medical care not related to low-birth weight and were discharged from the NICU.

Data was collected by semi-structured interviews. The mothers were interviewed about their and their infant's characters, and the content of their continuous nursing care as well as their thoughts about the care their infants received. Data was analyzed by Berelson's Content Analysis.

Results and Discussion: The needs for continuous nursing care to NICU discharged infants and their mothers were as follows:

1) Enrichment of NICU consultation immediately after discharging the infant from the hospital;

2) Explanation and improved availability of community nursing according to their specific circumstances;

3) Explanation and cooperation of the breastfeeding consultant;

4) Continuous availability of specialized individual advice; and

5) Formation of a peer support group.

These mothers were in situations where using many of society's resources were difficult. However, they needed access to consultation services on demand. Thus, it is the public's best interest that these mothers receive the appropriate information services. In addition, the mothers requested a wide range of information services, including advice from specialists and information about breastfeeding. Finally, our results suggest that mutual trust between the mothers and the nurses is important during the infant's hospitalization, because this relationship affects the mother's subsequent choice of consultation services.