持続皮下インスリン注入療法（CSII）を行っている1型糖尿病の学童期の子どもにセルフケアを移行するプロセスにおける親の関わりの様相

Parental Involvement in the Transition to Self-Care for School-Aged Children With Type 1 Diabetes Using Continuous Subcutaneous Insulin Infusion

要旨

　目的：1型糖尿病の学童期の子どもにセルフケアを移行するプロセスにおける親の関わりの様相を明らかにする．

　方法：9歳以下で1型糖尿病を発症した，現在小学生以上の子どもの親10名を対象に半構造化面接を実施し，質的帰納的に分析した．

　結果：研究参加者は全員が母親であり，子どもは全員持続皮下インスリン注入療法（CSII）を行っていた．分析の結果，【子ども自身で遂行することが難しい糖尿病管理を補う】【子どもとともに糖尿病管理を実施できるように働きかける】【親の責任のもとに段階的に糖尿病管理を子ども主体で進める】【学校関係者と協働して子どもの糖尿病管理を行う】【安心・安全な子どもの環境を整える】【子どもの主体性を促すために対応の仕方を工夫する】の6カテゴリーが抽出された．

　結論：子どもにセルフケアを移行するプロセスにおける親の関わりは，子どもが主体的に糖尿病管理を行い，1型糖尿病と共に生きていくことにつながると示唆された．

　Objectives: This study aimed to clarify parental involvement in the transition to self-care for school-aged children with type 1 diabetes.

　Methods: We conducted semistructured interviews with 10 parents of children of school age or older, who were diagnosed with type 1 diabetes before the age of 9 years. The interview data were analyzed using qualitative inductive methods.

　Results: All study participants were mothers, and all children were using continuous subcutaneous insulin infusion. Based on the analysis, six categories were extracted: "Complementing diabetes management that is difficult for the child to manage by themself," "Managing diabetes with the child," "Gradually promoting the child's self-management of diabetes under parental supervision," "Collaborating with school staff to manage diabetes in school," "Establishing a safe and secure environment for children," and "Devising ways to encourage the child's independence".

　Conclusion: Parental involvement in the transition to self-care helps children will take the intiative in managing diabetes and live with type 1 diabetes.