産後の子宮触診技術に活用できる「装着型産褥子宮モデル」の開発

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  • Development of a “Wearable Model of the Puerperal Uterus” for Palpating Uterus after Delivery

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本研究の目的は,産後の子宮触診時に褥婦への対応が可能な「装着型産褥子宮モデル」(以下,装着モデル)の開発である.研究方法は,平成26 年4 月~平成27 年3 月に,1 )自作モデルを基に,株式会社高研の協力を得て装着モデルを試作(以下,試作品),2 )試作過程において看護系大学および医療機関での試作品の形状や触感等に関する質問( 5 段階評価)と自由記載の質問紙調査, 3 )試作品を装着した模擬患者に対する面接調査, 4 )装着モデルの完成である.倫理的配慮は,研究者の所属施設の倫理委員会の承認後に実施した(No.1432-1).質問紙調査は50 名の協力を得,質問項目の「恥骨の位置がわかりやすい」は平均2.5±1.2(SD)であった.自由記載では,恥骨結合の触れにくさ(22 名:44.0%)を感じており改善が必要と回答した.面接調査の協力者は4 名を得,全員が装着のしやすさ,学生との対話のしやすさを感じる一方,試作品が重いと指摘した.以上から恥骨結合の触診感覚,重量を改善し,装着モデルを完成させた.子宮は,下腹部という日常生活では他者が触れない部位である.そのため,対象者の羞恥心に配慮し,反応を観察しながら触診する必要がある.装着モデルは,助産師の触診感覚と装着者の意見を重視したモデルとして評価できる.今後は演習時に活用し,その効果を検討する.

The objective of this study is to develop a “wearable model of the puerperal uterus”(wearable model) , which is interactive for puerperal woman on practical uterus palpation. The study was conducted from April, 2014 to March, 2015 as follows: 1) manufacturing a wearable model ( prototype ) in collaboration with Koken, Co., Ltd. based on midwivesmanufactured model, 2 ) a questionnaire administered at nursing colleges and medical institutions: five scale questions and free descriptive questions for the shape and texture of the prototype, 3) interview with “pretend” patients after wearing the prototype, and 4) completion of the wearable model. This study was conducted with the approval of the ethical committee of the institution the researchers belonged to ( No. 1432-1 ). With the aids of targeting 50 participants, the score for one of the questions “Is it easy to feel the location of the pubic bone?” was 2.5 (mean) ± 1.2 (SD). In the descriptive questions, 22 participants (44. 0%) noted difficulty to touch the pubic symphysis, which required improvement. All of 4 interviewed participants found it easy to wear the prototype and to communicate with students, but indicated heaviness of the prototype. Thus, we improved the prototype to easily palpate the symphysis and itʼs weight. Palpation of the constricting uterus in puerperal period needs to be conducted considering “sense of shame” of patients and observing responses of the patients, because the lower abdomen is not usually touched by others. The wearable model is valuable as it reflects both palpation feeling of midwives and comments of the participants wearing the model.

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