精神疾患が疑われる高校生に対する養護教諭の支援の工夫

The Ways and Means for Support by Yogo Teachers for High School Students with Suspected Mental Disorders

要旨

　目的：精神疾患が疑われる高校生への養護教諭による支援の工夫を明らかにする．

　方法：高等学校養護教諭8名を対象に半構造化面接を行った．

　結果：養護教諭は，［本人と家族が安心し苦しさを表出できるように支える］［本人と家族が専門機関への相談を決断できるように支える］［本人と家族が専門職に相談しやすくなるように調整する］の『直接的な支援の工夫』と，それらの支援を効果的にすすめるために，［中学校時代の情報や普段の様子を把握し支援に活用する］［教職員と情報や支援方針を共有しチームで支援をすすめる］［専門多職種からのコンサルテーションを支援に活かす］の『間接的な支援の工夫』を行っていた．

　結論：家族の思いに寄り添い続け，関係性を構築することで本人を支えること，専門機関と事前に情報を共有し，本人や家族のタイミングに合わせつつ陰で支えること，保健室での支援を教職員に伝えて他の生徒への支援につなげるとともに，関係性に配慮しながら支援チームをマネジメントすることの必要性が示唆された．

　Purpose: This study aimed to identify the ways and means for support by Yogo teachers for high school students with suspected mental disorders. Yogo teachers are special licensed educators who support children's growth and development through health education and health services on the basis of principles of health promotion in all areas of educational activities in school.

　Methods: Semi-structured interviews were conducted with 8 Yogo teachers working at high schools in Japan.

　Results: The Yogo teachers provided three “direct support”: (1) support of students and their families to be able to provide peace of mind when expressing suffering, (2) support of students and their families to be able to decide on consultation with health care professionals, and (3) adjust arrangements so that students and their families can easily consult professionals. In order to effectively promote these three elements, there are three ways of “indirect support”: (1) collect information about the time in junior high school and the usual situation and use these in the support, (2) share information and support policies with teachers and encourage teams to engage in the support, and (3) seek consultation with professionals and make use of any advice in the support.

　Conclusions: It is suggested that the necessity of (1) supporting of students by staying close to the thoughts of their families and building relationships, (2) sharing information with health care professionals in advance and supporting of students and their families behind the scenes at their convenience, and (3) playing the role of managing the support team in the school with considerations for relationships as well as telling teachers about the support in the school health room and to use that to support other students.