新生児のagitationに対するケアの実態と介入モデル試案の作成

新生児のagitationに対する認識と介入について,NICU看護婦110人を対象に質問紙調査を実施した.その結果,次の6点が明らかにされた:1)大多数の看護婦がagitationは看護上の問題であると認識していた,2)agitationが問題となる理由は,「エネルギーを消耗させる」が最も多かった,3)agitationがみられる時期は,正期産児は生後2.1±3.9日,早期産児は修正33.3±4.1週であった,4)agitationを起こす新生児の特徴は,慢性肺疾患およびその治療に伴う状況(水分摂取量の制限,不適当な換気条件)であった,5)agitationに対して看護婦がよく行う介入は,なでる,おしゃぶりを与えるなどのなだめの行為であった.逆に,環境調整は少なかった,6)agitationに対して薬が使用されると回答したのは約60%で,催眠・鎮静薬が最も多く使用されていた。これらの結果から、新生児のagitationに対する介入モデル試案を作成することができた。

110 NICU nurses completed a written questionnaire regarding perception and intervention of neonatal agitation.The results were the following 6 points:l)By most NICU nurses,agitation was identified as a problem of caring,2)"Exhaustion of energy" was often considered as problematic feature of agitation,3)The age of the infants in which agitation was most commonly seen in their units was 2.1±3.9 days after birth in full term infants and 33.3±4.1weeks gestational age in premature infants,4)Characteristic features associated with agitated infants were chronic lung disease and associated secondary problems (limitation of fluid intake, insufficient respiration), 5)The nursing intervention most commonly used to manage agitation was soothing,such as touch or giving the infant apacifier.On the other hand,environmental management was minimal,6)About 60 percentresponded that medication was administered to infants for agitation most often a hypnotic or sedative. As a result, we were able to draw up a tentative intervention model of neonatal agitation.