小児の入院と母親の付き添いがきょうだいに及ぼす影響―母親の認識を通した，きょうだいの肯定的な変化

Influence on Siblings as a Result of Children's Hospitalization and Mother's Rooming-in: Focus on Siblings' Positive Change

要旨

　小児の入院と母親の付き添いによるきょうだいの肯定的な変化について，母親（N＝201）の認識を通して調査し，その内容を明らかにすることを目的に自由記述回答形式の質問紙調査を行った．分析には，Krippendorff（2004）の内容分析の手法を用いた．その結果，きょうだいの肯定的な変化についての記述201件から抽出された368記録単位は93コードに分類され，そこから26サブカテゴリーに類型化され，最終的に【現状の把握】【情動の変化・成長】【肯定的な行動の変化・増進】【情動のコントロール・抑制の増進】【自立的行動の増進】の5テーマが形成された．きょうだいは，小児の入院という家族にとっての逆境の中において，辛い気持ちや寂しい気持ち，不安といった否定的な感情を抱きながらも，入院児や家族のために頑張ろうと肯定的な変化もしている．きょうだいの肯定的な変化に注目し，その姿を認めねぎらっていき，きょうだいの否定的な変化の緩和に繋げたい．

Abstract

　The purpose of this study was to identify the positive behavioral and emotional of siblings', through the perception of their mother's（N＝201）, during the child's hospitalization and mother were rooming-in. Free-descriptions with a questionnaire survey concerning positive changes in siblings were analyzed according to the technique of the content analysis of Krippendorff（2004）. The age of the siblings was 6.5±3.7（M±SD） with a range of 0 to 19, the male and female ratio was approximately 6：4, the age of mothers was 34.6±4.7, that of hospitalized children was 3.9±3.4, and duration of hospitalization was 26.6±56.3, 6.0, 1.341（M±SD, Mdn, Range）. There were 368 textual units extracted from 201 descriptions concerning siblings' positive change were abstracted into 93 codes, and then the codes are sorted into 26 sub-categories. Finally, from the underlying meanings of the sub-categories, 5 themes,［grasp of the present］,［emotional change and maturity］,［change and increase in positive behavior］,［ increase control and restraint in emotion］ and［ increase in independent behavior］ were formulated from siblings' positive change. The formal test produced reliability coefficients of 87.3% and 86.3% in percent agreement and .84 in Krippendorff's alpha from the researcher and two pediatric nursing scholars. Tough negative feelings like feeling hard, loneliness or anxiety, siblings are also acquired positive changes through the adversity of children's hospitalization and mother's rooming-in. It is important to accept and appreciate the states, through noticing those of siblings' positive change. Paying attention to appearance with siblings' positive changes will make possible to improve self-efficacy, and relieve any negative change of the siblings'.