初産婦に対する母乳栄養と産後の不安に向けての支援 : 家庭訪問と電話訪問を比較して  [in Japanese] Support for breast-feeding, anxiety after childbirth to patients with primiparas : Compared with home visits and telephone visits by clinic midwives  [in Japanese]

【目的】退院後,1ヵ月健診までに家庭訪問または電話訪問を行い,産後の不安や母乳栄養と訪問との関係について明らかにする。【方法】対象は産後1ヵ月の初産婦178名であり,家庭訪問群97名,電話訪問群81名とした。調査は1ヵ月健診時に自己記入式質問紙調査にて行った。調査内容は,児の体重,栄養方法,産褥期不安などとした。【結果】1)退院時の栄養法に差は認められなかったが,1ヵ月健診時には家庭訪問群で有意に母乳栄養が増加していた(P<0.01)。2)産褥期不安は,新生児の発達および赤ちゃんの身体については,電話訪問群のほうが心配していた(P<0.05,P<0.01)。3)「夫が出産を望んでいなかったか心配」「家族のなかに出産を喜んでいない人がいる」「すぐに胃の具合が悪くなる」の項目において電話訪問群が有意に高かった(ともにP<0.01)。【結論】家庭訪問により直接的なケアや観察を行うことが,母乳栄養の向上につながることが示唆された。

【Purpose】 This study investigated differences in anxiety and brest-feeding during the puerperal period, comparing women visited by a clinical midwife to women who were telephone home visited. 【Methods】 The subjects, n=178, a home visit group (n=97) and a telephone home visit group (n=81), went to maternity health check-ups in the first month after delivery. The data were collected by questionnaire. The contents of the survey included babys weight, breast-feeding, and anxiety after childbirth. etc. 【Results】 1) Women in the home visit group had significant increased breast-feeding on check-up after delivery (P<0.01). 2) The telephone home visit group worried about the baby's development and body (P<0.05. P<0.01). 3) The telephone home visit group had sighnificantly high scores for "You worry about whether your husband hopes for birth" "Someone in your family isn't happy with your having a child" "You will feel sick to your stomach soon" (both P<0.01). 【Conclusion】 In conclusion, on the home visit group, an effective caring and the observation can be received. It was suggested to lead to the improvement of the maternal nursing.