妊婦が自らに合ったつわり軽減方法を見出すセルフケア行動の向上を目指した看護援助プログラムによるセルフケア能力及びつわりへの効果検証

Evaluation of the Effects on Self-Care Agency and Nausea and Vomiting in Pregnancy by a Nursing Care Program Aimed for Pregnant Women to Improve Self-Care Behavior to Find Their Own Ways to Alleviate Nausea and Vomiting in Pregnancy

要旨

目的：効果的なつわり軽減方法は妊婦により異なる．そこで，妊婦が自らに合ったつわり軽減方法を見出すセルフケア行動の向上を目指した2週間看護援助プログラムを提供し，準実験研究によりセルフケア能力（ESCA35）やつわり（INVR）への効果を測定した．

方法：概念枠組みはOremセルフケア不足看護理論を基盤に作成した．介入群には三輪の省察的実践論を基盤としたプログラム（対面式介入3回，電話訪問2回，自己記録）を提供した．

結果：介入群45名，対照群67名を分析した．ESCA35総得点，下位尺度得点の変化量は介入群の方が有意に大きく，INVR下位尺度「空嘔吐体験，空嘔吐頻度，つわり全体苦痛」得点は介入群のみ有意に低下していた．両群間では2週間後の得点に有意差はなかった．

結論：本介入にはセルフケア能力を高め，空嘔吐やつわりの苦痛を軽減させる効果の可能性が示唆されたが，今後さらなる検討が必要である．

Purpose: Effective ways to alleviate nausea and vomiting in pregnancy (NVP) differ among pregnant women. The purpose was to evaluate the effects on self-care agency (ESCA35) and NVP (INVR) by a two-week nursing care program (NCP) aimed for pregnant women to improve selfcare behavior to find their own ways to alleviate NVP using a quasi-experimental study.

Method: The conceptual framework was based on Orem's self-care deficit nursing theory. An intervention group was given NCP based on Miwa's reflective practice, which three meeting-style interventions, two phone calls, and a self-recorded diary were included.

Result: Data analysis was performed for 45 pregnant women in an intervention group and 67 pregnant women in a control group. The variations of total score and subscale scores of ESCA35 were larger in intervention group. Three subscale scores of INVR (retching experience, retching occurrence, and total distress) were significantly improved only in intervention group. The scores after two weeks showed no significant differences in comparison between two groups.

Conclusion: NCP may improve self-care agency of pregnant women with NVP and decrease retching and the distress of NVP, but further study is needed.