虐待予防のために母子の継続支援を行う助産師と保健師の連携システムの記述的研究

Descriptive Study on Continuous Mother-Child Care for the Prevention of Child Abuse: Collaboration between Midwives and Public Health Nurses in Japan

要旨

　本研究は，虐待予防のために母子の継続支援を行う助産師と保健師の連携システムの構造を記述することを目的とした質的記述的研究である．結果，連携の目的は，妊娠期から育児期を通して【母子へ継続した安心を提供する】ことであった．方法は，個別対応の【助産師と保健師の双方が母親と信頼関係をつくる】，組織内・外の【関係職種が支援の必要な母子を漏らさない網目をつくる】二重の支援であり，媒体となるのは【日常的な口頭のやりとりで情報を生かす】ことであった．連携の条件は，助産師と保健師が【虐待予防のために協力する意識を高める】，【互いを信じて支え合う】ことであった．虐待予防には，母親と専門職の関係を継続させることや文書だけではない情報の交換が重要であり，助産師と保健師の信頼関係があることで実践できていた．このことから虐待予防システムに関わる専門職の信頼関係を構築する必要性が示唆された．

Abstract

　Aims: This paper describes a collaborative system between the midwives and public health nurses who provide continuing care to mothers and children to prevent child abuse.

　Methods: Qualitative descriptive study.

　Results: The midwives and public health nurses collaborated to provide continuing relief to mothers and children from the prenatal to the postnatal period. There were duple supporting methods, “midwives and public health nurses collaborating to build trust relationships with mothers” as personal support and “the creation of a safety net by professionals to prevent mothers and children who need assistance from falling through the cracks of the care system” as organizational support. The intermediary method that “exchange information on daily communication and utilize the information for the support.” The collaboration between the midwives and public health nurses necessitated their “increased awareness of the need for collaboration to prevent abuse” and “their mutual trust and support in the process of assisting the mothers and children.”

　Conclusions: In order to prevent abuse, it is important to sustain the relationship between mothers and specialists and to enable the exchange of information that cannot be fully communicated by documents. This can be realized through a trusting relationship between the midwives and public health nurses. This finding indicates the necessity of building trusting relationships among the specialists involved in child abuse prevention systems.