採血を受ける子どもを支援する親への看護介入の効果：親の支援効力感向上と親子のストレス緩和のために

Effects of Nursing Interventions on Parents of Children Who Had Blood Drawn: Enhancing Parents' Sense of Efficacy of Support and Reducing Stress in Parents and Children

要旨

　目的：本研究の目的は、採血を受ける子どもの親に対する支援効力感を高める看護介入を開発することである。

　方法：子どもが採血を受ける前に、親に支援内容を具体的に示した自作のDVDを視聴してもらった。そして、介入群と非介入群（4から5歳の子どもとその親、それぞれ21組）に対して、採血前後、10分後の生理学的および心理学的指標によりその効果を検討した。

　結果：介入群のみ、親の支援効力感は採血前から10分後に有意に上昇し、親の状態不安の不安存在項目（P項目）は採血前から10分後に有意に低下した。また、介入群のみ、唾液中アミラーゼ値を指標にした親のストレスは、採血前から直後、採血前から10分後にそれぞれ有意に低下した。一方、子どものストレスは、非介入群は採血前から直後に有意に上昇したが、介入群では有意な上昇は認められなかった。採血10分後の子どもの痛みは、介入群のほうが有意に低かった。

　結論：親の支援効力感を高め、親子のストレスを軽減する看護介入の意義が示唆された。

ABSTRACT

　Aim: The aim of this study to develop and test a nursing intervention designed to enhance parents' efficacy in supporting their children who had blood drawn.

　Methods: The intervention involved our showing parents a self-produced DVD demonstrating how to support their children. Participants were 21 parent-child pairs in each of two groups, an intervention group and a control group, with all children aged 4-5. The effects of intervention were examined with physiological and psychological indicators before, immediately after, and 10 minutes after drawing blood.

　Results: Parents' sense of efficacy of support increased significantly from the time before to 10 minutes after drawing blood and that scores for state anxiety of anxiety-present items(P items)in parents decreased significantly from the time before to 10 minutes after drawing blood in the intervention group only. Similarly, only in the intervention group did stress levels in the parents, as indicated by salivary amylase activity, decrease significantly from the time before to immediately afterwards, as well as from the time before to 10 minutes after drawing blood. Stress levels in children, on the other hand, increased significantly from the time before to immediately after drawing blood in the control group, while no such significant increase was observed in the intervention group. Levels of pain felt by the children 10 minutes after drawing blood were also significantly lower in the intervention group.

　Conclusions: Nursing intervention has been demonstrated to enhance the efficacy of parents' support to children and reduce stress in both parents and children.