産後1か月の初産婦が育児より感じる助産師へのケアニーズ

Care needs for midwives that primiparas one month after delivery feel about childcare

要旨

目的

　産後1か月の初産婦の育児観や育児行動より、対象への産後のサポートを充実させる支援策を具体化するために必要な、助産師へのケアニーズの示唆を得る。

対象と方法

　単胎児を出産し経過が良好で母子ともに重篤な異常がない初産婦10名とした。半構造化面接法であり、語りの内容を、Berelson Bの内容分析の手法を用いた。大学倫理委員会の承認を得て行った。

結果

　対象者10名より、1,165の記録単位数、28のサブカテゴリー、10のカテゴリー、3のコアカテゴリーが抽出された。コアカテゴリーは、1）育児適応困難と心身の苦痛の重複時期、2）家族からの支援は必須、3）継続支援を望むであった。

1）育児適応困難と心身の苦痛の重複時期は、〖児の世話やペースに合わせる困難さ〗、〖産後の心身の苦痛がある〗、〖授乳技術獲得過程にある〗、〖肯定否定の混在した気持ち〗より構成された。

2）家族からの支援は必須では、〖家族の支援は必須〗、〖夫への感謝と望み〗より構成された。

3）継続支援を望むは、〖信頼する助産師の継続支援を受けたい〗、〖予期的不安〗、〖インターネット情報による不安の助長〗、〖育児経験者の支援は役に立つ〗より構成された。母親は出産した施設の助産師への厚い信頼を持ち、継続支援を望むなどのニーズが語られた。

結論

　助産師へのケアニーズは、信頼する施設助産師による継続支援であった。授乳や母乳に関すること、身体及び精神さらに育児へのきめ細やかな支援と、家族単位への育児環境の整備が望まれた。実母が就労している場合が多く、里帰り先より充分な支援が得られない母親も多く見受けられた。本研究により産後1か月の初産婦の育児より得られた助産師へのケアニーズは妊娠、出産、産後を通して予期的で継続した支援であることが示唆された。

Purpose

The purpose of this study was to obtain suggestions for the care needs of midwives, based on the actual conditions felt by primiparas one month after delivery, in order to concretize support measures to enhance postpartum support for the target population.

Subject and methods

The subjects were 10 primiparas who had single birth and had a good course without serious abnormalities in both mother and child.

The survey was conducted using the semi-structured interview method, and the content analysis method of Berelson B was utilized to analyze the content of the narrative. This study was conducted with the approval of the University Ethics Committee.

Result

From the 10 subjects, 1,165 units of record, 28 subcategories, 10 categories and 3 core categories were extracted. The core categories included 1) [A period which is difficult to adjust for childcare and physical and mental distress coexist.], 2) [Support from family is essential], and 3) [Continuous support is needed].

1) The core category of [A period which is difficult to adjust for childcare and physical and mental distress coexist.] consisted of 4 categories; [Difficulties in caring for the child and keeping pace with the child], [Post-partum physical and mental pain], [In the process of acquiring breastfeeding skills] and [Feelings mixed with positive and negative].

2) The core category of [Support from family is essential] consisted of 2 categories; [Family support is essential] and [Appreciation and continued support by the husband].

3) The core category of [Continued support is needed] consisted of categories of [I want to receive continuous support from a trusted midwife], [Anticipatory anxiety], [anxiety with Internet information] and [Support from people who have raised children is helpful.]

These mothers had a strong trust in the midwife at the facility where they gave birth and was told that they needed continuous support.

Conclusions

The mother's care needs for midwives were continued support by a trusted institution midwife. Mothers wanted to provide detailed support for breastfeeding and breastfeeding, physical and mental health, and childcare, and to improve the childcare environment for each family. The mother's mother was working in many cases, and there were many mothers who could not obtain sufficient support from their parents.

This study suggested that the care needs by midwives for child-rearing among primiparas of one month birth are expected and continued throughout pregnancy, childbirth and postpartum.