ドメスティック・バイオレンス被害女性の回復を促す周産期の助産ケア [in Japanese] Midwifery care for victims of domestic violence that encourages recovery during the perinatal period [in Japanese]
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<b>目 的</b><br> 本研究は，DV被害女性と看護者の2者の視点から周産期及び育児期におけるDV被害女性の回復を促す助産ケアの要素を明らかにすることを目的とした。<br><b>対象と方法</b><br> 質的記述的研究デザインを用いた。研究協力者は（1）妊娠前からDV被害を受けており産科を受診した経験のあるDV被害女性21名と，（1）のDV被害女性に良い変化を及ぼした看護者10名である。インタビューガイドを用いた半構成インタビューを行い，データを質的に分析した。<br><b>結 果</b><br> DV被害女性の被害に対する認識に良い変化を及ぼした看護者の関わりは〈女性と子どもの安全・安心を守る関わり〉，〈女性が自分らしさを取り戻す関わり〉，〈母親としての自己意識を促す関わり〉が抽出され，コアカテゴリーとして他者と《つながる関係の形成》が明らかになった。〈女性と子どもの安全・安心を守る関わり〉は，看護者が〔女性が安全と感じる関係を築きながらDVのアセスメントと情報提供を行う〕，〔女性と子どもの安全かつ安心の場を作る〕ことにより，女性は看護者を自分のことをわかってくれる人と感じていた。〈女性が自分らしさを取り戻す関わり〉は，看護者は女性が〔自分の存在に意識が向くように促す〕，〔ありのままの「あなた」の存在を肯定する〕，〔一人ではないと感じるつながり続ける関係を作る〕ことで，女性は自分の存在が受け入れられていると感じていた。〈母親としての自己意識を促す関わり〉は，看護者が〔女性自身が命を生み出す主体であることを感じてもらう〕，〔女性自身が子どもを「育てる」力のある存在であることを感じてもらう〕ことで，女性が家を出る力となっていた。<br><b>結 論</b><br> パートナーから暴力を受け孤立していたDV被害女性は，看護者との《つながる関係の形成》の過程で，大切にされる自分の存在を知覚し他者への信頼を取り戻すことで回復に向かっていったと考えられる。よって上記のケアはDV被害からの回復を促す助産ケアの重要な要素であることが示唆された。
<b>Objective</b><br> The purpose of this study is to clarify the elements of midwifery care to encourage the recovery of domestic violence victims during their perinatal and child rearing period from the perspectives of both victims and nurses.<br><b>Method</b><br> The study used both qualitative and descriptive research designs. Those who participated in the study were: (1) 21 victims of domestic violence who had been suffering from their partners' violence even before pregnancy and had seen obstetricians during pregnancy, and (2) 10 nurses who victims in the first group credited with recognizing the abuse and helping them with their emotions and outlook. We asked those victims of domestic violence about the moment they were able to realize that their recognition toward suffering from DV had changed through their communication and involvement with the nurses while they were visiting medical institutions. We asked the nurses how they tried to assist domestic violence victims based on interview results of those victims. Interviews were conducted in a semi-structured manner with the reference of an interview guide. After conducting the interviews, the researchers conducted a qualitative analysis of the data.<br><b>Result</b><br> Nursing interaction that led to positive changes in IPC recognition were classified into three categories; Interaction that created a sense of reassurance and safety for these women and children, Interaction that helped women regain a sense of themselves, Interaction that stimulated maternal self awareness. The core category emerged as "building relationships" with other people. In the first category, nurses "conducted IPV assessment and provided information while creating a relationship in which the women felt safe". They felt the nurses understood them and were safe to talk to. In the second category, nurses "encouraged women to be more aware of their own existence" and accept themselves as they are. The women then felt accepted and not alone. In category three, nurses "made women recognize their own identity as bearers of life'. The women then recognized their role as a protector and nurturer of their child, which led them to leave the home for the child's sake. The nurses also gave them the strength to follow through with their decision.<br><b>Conclusion</b><br> It can be considered that those victims of domestic violence, who were suffering from violence by their trusted partners and isolated, perceived their existence that is valued by others on the way of "forming ties in relationship", experienced an opportunity to believe others and recovered trust in others and headed for their own recovery. With those findings, it was indicated that the above described care is an important element of midwifery care encouraging victims of domestic violence to recover.
- Journal of Japan Academy of Midwifery
Journal of Japan Academy of Midwifery 27(2), 247-256, 2013
Japan Academy of Midwifery