産科混合病棟で勤務する助産師が認識する特有のケア経験と自己のケア能力

Unique Care Experiences and Skills Perceived by Midwives Working in Mixed Obstetrics Wards

要旨

　目的：産科混合病棟で勤務する助産師が認識する，産科混合病棟特有のケア経験とその経験から培った自己のケア能力について明らかにする．

　方法：産科混合病棟の経験が4〜5年以上の助産師8名に，半構造化面接にてデータ収集し，質的記述的に分析した．

　結果：助産師は，産科混合病棟特有のケア経験と自己のケア能力は，【助産師1人の重責を感じる勤務経験に基づく，産科領域の的確な判断と調整能力】，【他科患者へのケア経験に基づく，広い視野を持ったアセスメントと調整能力】，【他科患者の人生に触れた経験に基づく，長期的な視点で退院後の生活や育児を考える能力】，【看護師と働くことに基づく，看護職チームの中で助産師の専門性をケアに活かす能力】であると認識していた．

　結論：助産師1人体制での勤務や他科患者との関わりなど，産科混合病棟特有のケア経験から助産師として必要なケア能力を培えるよう，教育体制を検討する必要性が示唆された．

　Purpose: This study clarifies the care experience specific to a mixed obstetrics ward as perceived by midwives working there. Furthermore, it identifies the care capabilities drawn from that experience.

　Method: Eight midwives with more than four to five years of experience in a mixed obstetrics ward were interviewed using a semi-structured interview and the responses were analyzed qualitatively and descriptively.

　Results: Midwives recognized that their experience of care unique to mixed maternity wards and their own care ability were [Accurate judgment and adjustment ability in the field of obstetrics based on the experience of working as a single midwife who feels a heavy responsibility], [Assessment and adjustment ability of subjects with a broad perspective based on experience in caring for patients from other departments], [The ability to think about post-discharge life and childcare from a long-term perspective based on the experience of touching the lives of patients from other departments], [The ability to utilize the midwife's expertise in care within the nursing team based on working with nurses].

　Conclusions: The experience of care unique to mixed obstetrics wards, such as the working system of one midwife and care for patients from other departments, suggests the need to consider the educational system so as to cultivate the necessary care skills as a midwife.