産婦人科病院・診療所の助産師が「気になる親子」を他機関への情報提供ケースとして確定するプロセス:─ 子ども虐待の発生予防を目指して(第1報) ─  [in Japanese] The Processes by Which Midwives at Maternity Clinics Recognized “Parents and Children of Concern” and Decide Pass on This Information to Other Institutions::with an Aim to Preventing Child Abuse (Report 1)  [in Japanese]

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Abstract

<p>目的:産婦人科病院・診療所の助産師がどのように「気になる親子」に気づき,情報提供ケースとして確定していくのか,そのプロセスを明らかにする。<br>方法:助産師8人を対象としたインタビューで得られたデータを,M-GTAの手法で分析した。<br>結果:産婦人科病院・診療所の助産師が「気になる親子」を情報提供ケースとして確定するプロセスは,助産師が子ども虐待の観察の視点をもったうえで,【援助のなかでリスクを探る】ことで,【気になるサインに気づく】。助産師・師長という【担当者が中心となり確認・判断・対応を担う】ことにより,【長期的な子育てを見据え判断する】。【院長という権限者の方針】に沿い結論を出し,本人・家族の【同意のハードルを越える】ことであった。<br>結論:担当者が中心となり対応し,窓口の一本化ができていた。院長という権限者の影響が大きい,リスクの探索や確認の困難な環境があるという特徴があった。</p>

<p>Purpose: This study aimed to elucidate the process by which midwives at maternity clinics recognized “parents and children of concern” and decide to pass on the information on these case to prevent child abuse. <br>Methods: Data obtained from interviews of eight midwives were analyzed using the Modified Grounded Theory Approach (M-GTA). <br>Results: From the perspective that midwives are able to recognize potential child abuse, the processes by which midwives at maternity clinics identify parents and children of concern and decide to pass on this information involve “looking for risks during care” and “noticing signs for concern”. Then, “the anticipated long-term child rearing is determined” based on the “verifications, judgments, and support primarily by the individuals in charge”, i.e., midwife and head nurse. Decisions were made in accordance with “the guidance from the authority, i.e., the medical director”, and the next stage will be “overcoming the hurdle of gaining agreement from the mother and family”. <br>Conclusions: Individuals in charge provided support for “parents and children of concern” at maternity clinics; hence, a centralized service was established for cooperation with other institutions. We found that the medical director, who held an authoritative position, had great influence on our decision-making. This study also recognized environmental characteristics of maternity clinics, where detecting risks and confirming situations were difficult.</p>

Journal

  • Journal of Japan Society of Nursing Research

    Journal of Japan Society of Nursing Research 42(1), 1_75-1_85, 2019

    Japan Society of Nursing Research

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