医療的ケアを継続しながら在宅療養へ移行した先天異常のある子どもの母親のレジリエンス

Maternal Resilience of Children with Congenital Abnormality Discharged from Hospital to Home Medical Care

要旨

目的：医療的ケアを継続しながら在宅療養へ移行した先天異常のある子どもの母親の経験や思いから，母親のレジリエンスの一端を明らかにする．

方法：在宅療養中の先天異常のある子どもの母親7人に感情浮沈図を用いて半構造化面接を行った．

データは内容分析の手法を用いて分析し，母親のレジリエンスについてカテゴリー化した．

結果：母親のレジリエンスとして【退院への意志】【ネガティブ感情に負けない力】【夫の存在】【信頼できる医療者の存在】【子どもの生命力】【家族の存在】【妊娠と出産のポジティブな思い】【同じ境遇の母親の存在】【母親としてのプライド】【ソーシャルサポート】が抽出された．

結論：医療的ケアを継続しながら在宅療養へ移行した先天異常のある子どもの母親のレジリエンスは，退院への意志，母親の性格，周囲の人々との信頼関係や支援，子どもの生命力，子どもとの相互作用によって培われた母親としての思いであった．出産前からの計画的な支援，母親と子どもの相互作用に着目した支援，在宅療養への段階的な支援が重要であることが示唆された．

Purpose: To describe part of maternal resilience of children with congenital abnormality discharged from hospital to home medical care.

Methods: Semi-structured interviews using diagrams of emotional vicissitudes were performed with seven mothers of children with congenital abnormality discharged from hospital to home medical care, and results were categorized into maternal resilience using content analysis.

Results: Ten categories of maternal resilience were extracted: “motivation for discharge,” “ability to rise above negative feelings,” “presence of the husband,” “presence of trusted medical staff,” “the child's life force,” “presence of the family,” “positive feelings about pregnancy and childbirth,” “presence of the mother in the same situation,” “maternal pride,” and “social support.”

Conclusion: The categories of maternal resilience of children with congenital abnormality discharged from hospital to home medical care included characteristics specific to mothers, relationships of trust with and support from those around them, the child's life force, thoughts and feelings as a mother cultivated through interaction with their child, and the desire for the child to be discharged home. Planned support before delivery and later; support focusing on the interaction between the mother and child; and systematic support for receiving home medical care are essential to promote maternal resilience.