わが子の合図をよみとる敏感性を高める看護援助 : 産褥早期の母子相互作用のアセスメントから  [in Japanese] Promoting a mother's sensitivity to cues with assessment of mother-newborn early postpartum interactions  [in Japanese]

産褥早期に実施した母子相互作用に焦点をあてた看護介入の効果を検討することを通して,わが子の合図をよみとる敏感性を高める看護援助を明らかにすることを目的とした。初産の褥婦10名(介入群)を対象とし,母子相互作用のアセスメントを行い,分娩後入院中の授乳場面および面接による介入と退院後の家庭訪問による介入を実施した。介入前後の質問紙調査の結果,産褥1ヵ月時において,介入群は,非介入群(n=13)よりも母親役割の自信尺度「合図のよみとり下位尺度」得点が有意に高かった(p<0.05)。介入対象者への看護場面(52場面)を質的に分析した結果,わが子の合図をよみとる敏感性を高める効果が認められた看護援助は,『わが子の表情・行動・生理的反応への気づきを促す』『わが子の哺乳欲求をよみとる能力を高める』『新生児期の行動特徴の理解を深める』『わが子の合図やリズムの特徴をつかむことを促す』『わが子からの合図であるという認識を強化する』『わが子の要求を解釈する体験を共有し,合図のよみとりを保証・修正する』ことであった。

This study aimed to identify nursing intervention to promote a mother's sensitivity to reading their infant's cues during the postpartum period. Low risk first-time mothers participated after providing informed consents. Participants completed questionnaires on the first day, 5〜6 days and 1 month postpartum. The intervention group (n=10) was provided with an original nursing intervention with assessment of the mother newborn interactions while staying in hospital and during a home visit 2 weeks postpartum, in addition to routine care. The intervention group scored significantly higher than the controls (n=13) in a subscale "Sensitivity to infant's cues" of the Postpartum Maternal Confidence Scale at 1 month postpartum (p<0.05). Qualitative analysis based on a framework from our previous study was conducted with observational data. Nursing interventions that promote a mother's sensitivity to reading an infant's cues were identified; to stimulate noticing the looks, actions and reactions of their infant, to improve the ability to recognize the suckling desires of their infant, to promote an understanding of the physiological and behavioral character in their newborn baby, to encourage appreciation of the characteristics of the signs and rhythms of their infant, to enhance the recognitions as being signals from their infant, to share the experiences of reading their infant's demands and to ensure a mother's correct interpretation of signs.