小児摂食障害予防における養護教諭による学校内での啓発活動  [in Japanese] Educational Activities of School Health Instructors (school nurses) for the Prevention of Eating Disorders in Children  [in Japanese]

目的:小児発症の神経性無食欲症の統合的治療において,養護教諭の参加の効果と意義についてはすでに報告した.最近は,学校内での予防についても注目されてきている.神戸市A地区中学校の養護教諭は,2年間の準備期間の後,2000年から,摂食障害の予防を目指した啓発活動を実施した.A地区で実施された啓発活動の成果をるいそう割合の観点から検討した.方法:るいそう割合(標準体重の80%以下の女児の女児全体における割合)の推移を啓発活動前後で調査した.神戸市において住宅中心であり,るいそうの割合が類似し,A地区と似通った環境で啓発活動を実施しなかったB地区と比較した.結果:1.啓発活動前には,るいそう割合の増加傾向がみられていたが,活動後にはるいそう割合が有意に減少した.2.啓発活動を実施しなかったB地区においては,るいそう割合の変化に有意差を認めなかった.結論:養護教諭の啓発活動を通してるいそう割合が減少し,ひいては小児摂食障害予防の可能性が示唆された.

Objective: We have previously reported on how the participation of school health instructors can directly influence the effect and significance of integrated treatment for childhood onset anorexia nervosa. Recently, the prevention of eating disorders in schools has attracted attention. Beginning in 2000, after two-years of preparation, health instructors of junior high schools in the District A of Kobe City participated in a program of educational activities focused on the prevention of eating disorders. This study investigates the effect of these activities on the percentage of emaciated children. Methods: We investigated changes in the percentage of emaciated students (the proportion of students with weight equal to or less than 80% of standard weight) from District A, Kobe City, after school health instructors began conducting the above educational activities. This was compared with the percentage of emaciated students from District B which closely resembled the residential environment and emaciation percentage in District A, but where these activities had not been carried out. Results: 1. Before beginning the program of educational activities, an increased tendency in the percentage of emaciation had been seen, but the percentage significantly decreased after starting the activities. 2. In District B where activities were not performed, no significant changes in the percentage of emaciation were seen. Conclusions: The decrease in emaciation was directly due to the activities of school health instructors focused on the prevention of eating disorders in children. This indicates that prevention of childhood onset eating disorder is possible.