NICUを退院した乳児をもつ母親の育児満足感について : 退院時の看護ケア再考 <原著>

本稿の目的は、大鼓らが開発した育児満足感の形成要因を分析することによって、ハイリスク児の母親を対象とした質問紙の適用を検討することであった。方法は、Neonatal Intensive Care Unit(NICU)を退院して1歳になる118人の乳児の母親を対象として、郵送法による質問紙調査を行った(回収率76.3%)。分析は、育児満足感を規定する領域I(養育態度)を従属変数、領域II～IX(仕事の阻害感、落ち着き、自己評価、乳児の気質、育てられ経験、ネットワーク、父親の協力度、夫婦関係)を独立変数とし、ステップワイズ法による重回帰分析を行った。その結果、養育態度の変動は、8つの独立変数により約30%が説明された。夫婦関係及び父親の協力度と、養育態度との間には、いずれも2変量問に正の相関関係があった。育児満足感に有意な影響力を有する領域は、乳児の「泣きのなだめやすさ」「機嫌のよさ」などを尋ねる「気質」と、母親自身の「冷静さ」「落ち着き」の程度を尋ねる「落ち着き」のみであった。一方、母親の育児不安は、育児満足感の合計点とかなり負の相関関係があった(r=-0.500, p<0.01)。ハイリスク児を対象とした質問紙の適用については、母親の「自己評価」のCronbach's a係数が低く、内的一貫性を高める質問項目の再検討が必要であった。臨床研究として、乳児の「気質」の質問項目に影響すると考えられる疾患、特に神経系の病態や心肺機能に関する医学情報を含めた包括的な研究デザインが今後の研究課題となる。

The objective of this study was to examine the suitability of a questionnaire developed by Ohyabu and targeted at mothers of high-risk infants by analyzing factors contributing to their sense of satisfaction with childrearing. The survey was conducted by mailing the questionnaire to 118 mothers of one-year-olds who had once been in neonatal intensive care units (completion rate: 76.3%). A multiple regression analysis (Stepwise method) was performed with Field I (childrearing attitudes) forming a sense of satisfaction with childrearing as a dependent variable and Fields I1 -1X (a sense of alienation from work, calmness, self-evaluation, infant's temperament, one's own experience of being raised. network, spousal support, relationship with spouse) as independent variables. As a result, the eight independent variables were found to account for 30% of the variations in childrearing attitudes. There was a positive correlation between childrearing attitudes and either spousal support or the relationship with the spouse. Those fields significantly affecting the sense of satisfaction with childrearing and positively correlated to childrearing attitudes were infant temperament, such as an easily calmed crying infant or an even-tempered infant, and the mother's state of mind, such as her level of "self-possession" and "calmness". While on the other hand. a significant negative correlation was found between a mother's uneasiness with childrearing and the total score of feeling a sense of satisfaction with childrearing (r = -0.500. p < 0.01). The analysis revealed a low Cronbach's alpha in the mothers' self-evaluation, which suggests the necessity of reexamining the question headings that enhance internal consistency before implementing the questionnaire for high-risk infants. As a clinical study, further research is necessary to establish a comprehensive study design, including medical information on diseases that are deemed to affect questions in the infant temperament field, in particular information on the pathology ...