新生児に対する母親の応答過程促進に向けた看護介入プログラムの効果(50周年記念論文)  [in Japanese] Effects of an early intervention program in promoting maternal response process toward the infant in Japan(50th Anniversary Article)  [in Japanese]

本研究の目的は,新生児に対する母親の応答過程促進に向けた看護介入プログラムを初産の母子(対照群12組,介入群12組)に導入し,その効果について,(1)授乳場面における母子の行動評価,(2)母親の認知評価(3)母親の応答過程の評価の3つの方法論的トライアンギュレーションを用いて検討することである。母子行動については,介入前後におけるAMIS修正版得点の変化量を比較すると,母親項目(U=31.0,p<0.05),児項目(U=33.0,p<0.05),二者関係項目(U=34.0,p<0.05)ともに,介入群が対照群より有意に高かった。さらに,二者関係項目は,出産後1ヵ月においても,介入群は対照群よりも促進への変化量が有意に高かった(U=28.0,p<0.05)。以上のことから,本介入プログラム導入により母親が早期に応答スキルを獲得することで,母子行動に影響を及ぼし,母子関係が促進されることが検証された。

Purpose: An early intervention program for the promotion of maternal response processes to the infant is conducted, and its effects are evaluated using a methodological triangulation: 1) Assessment of mother-infant interactions during feeding by behavioral observation, 2) assessment of the mother's perception concerning their mental well-being and childcare, and 3) assessment of the mother's response processes to their infant by case analyses. Method: Twenty-four first-time Japanese mothers and their newborn infants participated in the study (the intervention groups n=12, and the control groups n=12). In the intervention group, each mother received an early intervention program at 2 days postpartum. At 1 day, 4 days and 1 month postpartum, observational data and self-report instruments were collected. Result: The intervention group showed a greater change than the control group on the AMIS Scale revised version. Furthermore at 1 month postpartum, the intervention group showed a greater amount on change of dyadic items than the control group (U=28.0, P<0.05). There were not significant differences found between the 2 groups regarding mother's anxiety, self-esteem, or postnatal depression. The 4 levels of maternal response processes became linked and began to function after intervention in all mother-infant pairs.