入院中の小児に対する看護婦の言動に関する研究（混合病棟において）―人格の発達を支えるという視点から

Daily Nursing Behavior for Children in Hospital（Especialy in an “Adult-child Mixed Ward”）：To Help Children's Personal Development

要旨

　入院中の児の人格の発達を支える日常の看護婦の言動のあり方について研究を行った．成人小児混合病棟では，小児の人格の発達を援助する特別にとりくみを行うことが難しく，工夫を必要としている．本研究では，ある成人小児混合病棟に於いて調査を行った．質問紙による6つの仮定場面に対する看護婦の言動の調査から以下の知見を得た．治療上の制限を看児が破った疑いがある場面・破ったところを見つけた場面では評価的な言動が多く，受容的な言動が少なくない傾向があり，看児が欲求不満を表出している場面では，すぐに気をそらす言動が採られており，児の欲求の表出や自覚が妨げられ，自律と積極性の発達が妨げられていた可能性が考えられた．看護婦の意識と実際の言動との間にはギャップがあることが明らかになった．看児が持つイメージの調査では，看護婦は親しみの薄い存在である可能性が示唆された．

　以上より，評価的言動を避けて，児の気持ちに耳を傾け受容しようとすることと，科学的な看護過程の遂行と患者の気持ちの受容を統合する教育が必要と考えられる．

Abstract

　It has been discussed how daily nursing behavior can support personal development of a child. In an adult-child mixed ward, it is not easy to provide specific attention to a child, however, a general guideline on nursing behavior helps personal developments. Investigations have been made on an adult-child mixed ward to obtain the following results. Using questionnaires about two supposed cases, nurses' behavior has been analyzed for the following three situations. (1) A child is suspected to have broken a medical restriction. (2) A child is found to have broken a medical restriction. (3) A child is frustrated by a medicalrestriction. For (1) and (2), nurses' behavior tended to evaluational, while they rarely tried to understand children's mind with sympathy. For (3), nurses tried to distract children's attention. These reactions have risks of preventing developments of autonomy and positiveness. A gap was observed between nurses consciousness and their behavior. An aural examination has been also made for children to find that they were not sufficiently familiar with nurse.

　The following points have been suggested. Nurses are advised to try to understand children's mind with sympathy, and should avoid evaluational behaviors. Nursing education should care to make a better connection between scientific nursing processes and accepting patient's mind.