入院中の双胎妊婦へのケアに関する助産師の認識

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URI http://shark.lib.kagawa-u.ac.jp/kuir/metadata/28643
Title
入院中の双胎妊婦へのケアに関する助産師の認識
Title Alternative
Midwives' Recognition of In-patient Care for Pregnant Women with Twins
File
Description

〔原著〕

要旨
[目的]
 入院中の双胎妊婦へのケアについて助産師がどのように認識しているかを明らかにすることを目的とした.
[方法]
 総合周産期母子医療センター2 施設で勤務する,助産師習熟段階レベルⅢを認証された助産師9 名を対象に半構造化面接
を行い,質的帰納的に内容の分析をした.香川大学医学部倫理委員会の承認後に実施した.
[結果]
 対象者9 名の平均年齢は39.0 歳,平均助産師経験年数は12.4年.分析結果より9カテゴリーが抽出された.助産師は【双胎妊婦は急変リスクが高いことを念頭におく】を意識し,【双胎妊婦とまず信頼関係を築く】ことを重要と考えていた.そして,助産師は【二児の児心音を短時間で正確に聴取することを最優先する】,【双胎妊婦は不快症状が強く現れやすいため意識して安楽な生活を工夫する】等,安楽に過ごす入院生活の重要性を認識していた.また,【双胎妊婦が分娩経過を受け止めることが大事】であると考え,個別的に分娩経過を説明していた.更に,【双胎児への愛着を促すことを常に意識している】,【双子の育児をイメージ出来ることを大切にする】の思いがあり,妊娠中から産後の育児を見据えて双胎妊婦と家族に働きかけていた.更に,助産師はこれらのケアに【十分介入出来ていないので満点をつけることはない】が,【双胎妊娠の思いを受け止め,頑張りを認めて全力で寄り添いたい】を合わせて認識していた.
[考察]
 助産師は双胎妊婦特有の急変リスクに伴う身体的・精神的負担を考慮して,安全・安楽な入院生活の重要性,および双胎の分娩経過と双子育児がイメージできる重要性を認識していた.そして,助産師は自己のケアに対して十分関われていないが,全力で寄り添いたいという目標を掲げていた.
[結論]
 助産師は双胎妊婦へのケアに対して十分関われていないが,全力で寄り添いたいと認識していた.
キーワード:助産師,双胎妊婦へのケア,認識

Summary
 [Aim] To identify midwives’ recognition of in-patient care for pregnant women with twins.
 [Methods] The data were obtained by semi-structured interviews with 9 midwives from 2 Perinatal Medical Centers, who were certified with Level III competency for midwifery practice. They were analyzed using a qualitative and inductive approach. This study was conducted with the approval of the ethics committee of Kagawa University, Faculty of Medicine.
 [Results] The mean age of the 9 subjects was 39.0 years old, the mean years of work experience as a midwife was 12.4 years, and 9 categories were extracted by analyzing the data. The midwives placed importance on [considering a higher risk of acute deterioration in twin pregnancy] and [establishing a trusting relationship with women pregnant with twins]. They also recognized the importance of comfortable hospitalization by [giving top priority to check to 2 heartbeats quickly and accurately] [making them feel at ease since they experience more marked physical discomfort].Furthermore, they also encouraged the women and their families to focus on the care of their coming twins by helping them [acknowledge the process of giving birth to twins], [stay mindful by promoting the women’s affection toward their twin babies], and [envision taking care of their twin babies]. Concerning their midwifery care, they responded that[ they were not sure if their interventions were satisfactory], but they[ wanted to do their best to support them by acknowledging their feelings and efforts].
 [Discussion] The midwives recognized the importance of comfortable hospitalization, helping pregnant women acknowledge the process of giving birth to twins and envision taking care of their twin babies, in consideration of a higher risk of acute deterioration in twin pregnancy.
 [Conclusions] Midwives felt that they were not sufficiently engaged in care for women pregnant with twins, and they wanted to make every support to them.

Keywords: midwife, care for pregnant women with twins

Author
著者 赤垣 衣美
著者(ヨミ) アカガキ エミ
著者(別表記) Akagaki Emi
著者 佐々木 睦子
著者(ヨミ) ササキ ムツコ
著者(別表記) Sasaki Mutsuko
著者 石上 悦子
著者(ヨミ) イシガミ エツコ
著者(別表記) Ishigami Etsuko
Publication Title
香川大学看護学雑誌
Publication Title Alternative
Nursing journal of Kagawa University
Volume
23
Issue
1
Start Page
11
End Page
21
Publisher
香川大学医学部看護学科
Publisher Aalternative
School of Nursing, Faculty of Medicine Kagawa University
Published Date
2019-03-29
ISSN
2189-2970
NCID
AA12029628
Resource Type
Departmental Bulletin Paper
Language
jpn
Text Version
publisher
Set
香川大学
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