幼児期にある先天性難聴の子どもと母親に対する看護師の意識やケアの変化

Changes in Attitudes and Care of Nurses Towards Mothers and Their Children With Congenital Hearing Loss in Early Childhood

要旨

　目的：先天性難聴の子ども（以下子ども）と母親に対する看護師の意識やケアの変化を明らかにする．

　方法：アクションリサーチを用いた．研究参加者は看護師10名であり，データは参加観察法および半構成的面接法，会での看護師の語り等を用いて質的記述的に分析した．

　結果：看護師の意識の変化は，子どもに対して「近づけないが近づきたい」「できなかった手話をやってみたい」，母親では「話しかけにくいが話しかけたい」「思いは聞きにくいが知りたい」が導き出された．ケアの変化は，子どもでは「話し言葉ではなく見せ方や触れ方を工夫する」「痛みを聞けなかったが手話を使って聞く」が，母親は「話しかけられずにいたが話しかける」「聞きにくかった思いを聞く」が見出された．

　結論：看護師は語ることで時間の流れを止め内省し，意識が変化した．また，語り合うことで発想が柔軟となり，新たなケアを創出することが示唆された．

　Objective: To determine changes in nurses' attitudes toward, and care of, children with congenital hearing loss (hereafter referred to as "children") and their mothers.

　Methods: Action research was applied to conduct the study. Study participants included 10 nurses. Data were analyzed qualitatively and descriptively through participant observation, semiconstructive interviews, and nurses' narratives at meetings.

　Results: The changes in the nurses' attitudes were as follows: regarding the children, the nurses said, "I cannot approach but want to approach" and "I want to try sign language, which I could not do," and for the mothers, they said, "I want to talk to them although it is difficult to talk to them" and "I want to know their thoughts although it is difficult to hear their thoughts." The changes in care were "to show and touch the child instead of using spoken words" and "to listen using sign language although I could not ask about the pain" for the children, and "to talk to the child although I could not talk to him" and "to listen to his thoughts although it was difficult for me to ask" for the mothers.

　Conclusions: By talking to the children and their mothers, the nurses were able to reflect and change their perceptions. In addition, it was suggested that talking with each other made them flexible in their thinking and devise new methods of care.