産褥早期の褥婦の身体活動・休息と主観的疲労感の関係—入院形態及び授乳形態による比較

Relationships Between Physical Activity/Rest and Fatigue of Mothers in Their Early Postpartum Period: Comparison under different conditions of "hospitalization style and feeding schedule"

要旨

　産褥早期の褥婦の身体活動（歩数、活動時間、授乳回数）・休息（安静時間、睡眠時間、睡眠の満足）と主観的疲労感との関係性について、入院形態及び授乳形態の違いや産科施設の特徴に注目した分析を行うため、異なるタイプの産科施設において調査を行った。対象は、A総合病院（母児異室・規則授乳）、B産婦人科（母児同室・自律授乳）、及びC助産院（母児同室・自律授乳）にて自然経腟分娩した初産婦30名及び経産婦30名とした。測定には、生活習慣記録機ライフコーダ（スズケン）、自覚症状調査票（産業疲労研究会）及び質問紙を用い、調査期間は、産褥3日目の夕方から5日目朝とした。その結果、褥婦の疲労感は、どの施設においても身体活動とは関連せず、B産婦人科では睡眠時間、C助産院では睡眠の満足感と関連することが示された。また、入院形態や授乳形態の違いにより、活動時間、安静・睡眠時間に差は生じたものの、褥婦の疲労感に差は認められなかった。各施設とも褥婦は同様の疲労感を感じており、十分に軽減しないまま退院を迎えている現状が明らかになった。

Abstract

　The relationships between physical activity(number of steps, active hours, and times of breast-feeding), rest(rest hours, sleeping hours, and satisfaction of sleep), and the feeling of subjective fatigue of postpartum women were investigated under the different conditions of "hospitalization style and feeding schedule". Subjects were 30 primipara and 30 multipara, who had given normal spontaneous delivery, from the three different "hospitalization style and feeding schedule" facilities. The three styles were; A general hospital(the mother is separated from her child, and breast-feeds by a set schedule), B maternity clinic(the mother is in the same room with her child, and breast-feeds by a self-regulatory or self-demand schedule), and C maternity home (the mother is in the same room with her child, and breast-feeds by a self-regulatory or self-demand schedule). Data was collected from the evening of the 3rd post-partum day to the morning of the 5th postpartum day using the Life Coder(SUZUKEN)and the Fatigue Symptom Checklist(Industrial-Fatigue Study Group). The results showed that the feeling of fatigue was not correlated with physical activity, but was correlated with rest, only under the conditions used by the B maternity clinic and the C maternity home. A significant difference was found in active, rest and sleeping hours among the three different conditions of "hospitalization style and feeling schedule", while there was no difference in the feeling of fatigue. The postpartum women in each facility felt the same level of fatigue, and they were discharged before fatigue was fully reduced.