授乳に関する母親の問題解決行動を促すためのかかわりに関する研究 : 開業助産師のかかわりの原点  [in Japanese] A study of involvement in promoting mothers' problem-solving approaches in breast-feeding : The basis for the involvement of community midwives  [in Japanese]

本研究は,開業助産所の助産師が,母乳哺育を希望する母親に対して退院後の授乳に関する問題解決行動をとれるために行っているかかわりを明らかにすることを目的として行った。データ収集は,助産所の開設者である助産師8名を対象に半構造化面接により行った。データ分析の結果,授乳に関する母親の問題解決行動を促すためのかかわりに関して10のコアカテゴリーが抽出された。そのうち,【まるごと認める】【しょっちゅう側にいてずっとよくみている】という2つのコアカテゴリーがかかわりの原点となっていた。常に母親のことを気にかけている助産師のかかわりには母親を大事に思う気持ちがあり,母親を条件なしに受け入れ,気にかかる存在となっていた。このことが,物理的にしょっちゅう側にいてずっとよくみるというかかわりを誘発する。そして,そのかかわりにより一層母親のことが気になり気にかけるという相互作用の関係が成り立っていると考えられる。このかかわりの原点が,助産師の具体的なかかわりを生み出し,母親の自信につながり,さらには主体的な行動を促すことになっていることが示唆された。

This study was to clarify the role of the community midwife, who is the head of her own maternity home, on mothers who desire to breast-feed in order to take a problem-solving approach toward breast-feeding after being discharged from the hospital. The data were gathered by semi-structured interviews of eight midwives who had materniy home. Through these interviews, those midwives were asked how to involve with mothers to promote their problem-solving approach regarding breast-feeding. As a result of the date, their way of involvement with mothers were divided into the categories. Among these factors, two categories, "full acceptance of mothers" and "watching over mothers at all times", formed the basis of involvemennt. In addition, in order to promote mothers' problem-solving approach regarding breast-feeding, the main purpose of the midwives was to get mothers be more "confident" and to support those mothers. Since the midwives always show their concern for the mothers, by both highly valuing them and accepting them unconditionally, the mothers consequently have benefited from such constant care. It is believed that this triggered the involvement of futher "watching over mothers at all times", and such involvement made the midwives care even more about the mothers and pay close attention to them, thus creating a self-sustaining mutual relationship. It has been considered that such basis of involvement with mothers has stimulated the specific involvement of the midwives. Therefore, mothers got more confident, and also could promote proactive behavior.