新生児訪問指導の実態—早期訪問の効果

Current Status and Effectiveness of Early Home Visit Guidance for Infants

要約

　本研究の目的は、訪問指導の実態を調査し、訪問時期による育児姿勢への影響を明らかにすることである。新生児訪問指導を受ける350名の褥婦を対象とし、質問紙調査を依頼した。257名より有効回答を得た（有効回答率73.4％）。

　今回の結果から以下のことが明らかになった。

　1．新生児訪問指導は退院後1週間以内から9週目の時期に実施されており、早期訪問（退院後2週間以内）は約20％、退院後3週間以内（新生児期内）の訪問は約40％であった。

　2．訪問の時期と訪問指導の満足度に有意な差はみられなかった。

　3．育児に関する不安の出現時期は退院後1〜2週目の時期が約7割と最も多かった。

　4．訪問指導に満足した褥婦、また、早期に訪問を受けた褥婦ほど、有意にその後の育児に臨む姿勢に前向きな変化がでていた。

　訪問が適切な時期に実施されているとは言い難い。初産・経産婦ともに新生児訪問指導の必要性を感じていることより、今後は訪問対象と訪問時期の検討の必要性が示唆された。

Abstract

　The purposes of this study are to investigate the current status and effectiveness of home visit guidance for infants.

　Methods; The study was conducted from June 2000 until December 2000. The sample consisted of 257 women who were one week to nine weeks postpartum. Data were collected by structured questionnaires. Participants were asked about their satisfaction with home visits, ideal visitation times and attitude changes related to child-rearing.

　Results; The response rate was 73.4％. The main results are as follows;

　1. Home visits were conducted on one week to nine weeks postpartum. About 20％ of home visits were made within two weeks postpartum and about 60％ were made within four weeks postpartum.

　2. There was no significant difference women's satisfaction with home visits according to time of visit.

　3. About 70％ of women were anxious regarding infant care in 1-2 weeks after discharge.

　4. The more satisfied that a mother was with the home visit, and the earlier that a visit made the more significant was the positive attitude change toward child-rearing after visit.

　Home visits can not be conducted at an appropriate time for all postpartum women and infants. The findings of this study suggest that home visits should be made at an early stage in the postpartum period. Mothers who have retuned to their homes need support from midwives and community health nurses with professional skills related to child-rearing. Further research is needed about subjects and timing of home visit guidance after discharge.