思春期の1型糖尿病患児と両親の認識の相違に焦点を当てた看護援助の効果

The Effectiveness of the Nursing Intervention Focused on Difference of Perception on Self-Care Behavior between Adolescents with Type 1 Diabetes and Their Parents

　本研究は，認知的不協和理論に基づき，親子の不協和を低減させるために療養生活に対する親子の認識の相違に焦点を当てた看護援助を2組の1型糖尿病をもつ中学生女子とその両親に行い，その効果として，疾患管理行動に対する患児と両親の認識・行動および血糖コントロールの変化を明らかにすることを目的とした．調査は二次元イメージ拡散法，患児の独立意識と親の養育態度に関する質問紙を用いた調査および療養生活に関する面接調査を行った．また，調査は2回行い，1回目の調査結果に基づき，翌月に親子の認識の相違に焦点を当て親子の相互理解を促すように看護援助を行い，その3か月後に2回目の調査を行った．その結果，2組とも親子間における疾患管理行動の大切さの認識の相違が減少し，著明な疾患管理行動・血糖コントロールの改善がみられた．また，疾患管理行動に対する認識の相違は親子の間だけでなく，父親と母親の間にもみられた．

　The purpose of this study was to clarify the changes of metabolic control, illness-management behavior and perception of 2 pairs of junior high school girls with Type 1 Diabetes and their parents (mothers and fathers) as the effectiveness of the nursing intervention focused on differences of perception on self-care behavior between adolescents and their parents using a theory of cognitive dissonance. The 2-dimensional image diffusion method was used to measure the perceptions of adolescents and their parents. The adolescents' awareness of independence scale and the child-rearing attitude scale were administered, and semi-structured interviews were conducted to obtain information about adolescents' self-care behavior. These measures and interviews were administered to subjects pre and post nursing intervention. The nursing intervention focused on differences of perception between adolescents and their parents gained from the first measures and interviews for promoting that adolescents and their parents understand each other were administered. Results were as follows: 1) The differences of perception of“importance”on illness -management behavior between adolescents and their parents on both pairs were reduced, and their illness-management behavior and metabolic control were improved significantly by the nursing intervention. 2) There were differences of perception on illness-management behavior not only between adolescents with Type 1 Diabetes and their parents, but also between mothers and fathers.