こどもの日常にケアを馴染ませる戦略：アトピー性皮膚炎をもつ幼児後期のこどもに必要なセルフケアを母親が補完する過程

Strategies to Ensure Care Becomes Part of the Child's Daily Life: Process of Mothers Complemented Self-Care for Children With Atopic Dermatitis in Late Infancy

要旨

　目的：アトピー性皮膚炎をもつ幼児後期のこどもに必要なセルフケアを養育者が補完するケアの過程を明らかにする．

　方法：乳幼児期にアトピー性皮膚炎と診断された3〜11歳のこどもの母親16名に幼児後期の状況について半構造化面接を行い，グラウンデッド・セオリー・アプローチを用いて分析した．

　結果：母親は【ありのままのこどもとの対話】を続け，『こどもの日常にケアを馴染ませる戦略』【あえての空白の創出】【補完の再調整】を繰り返し，ケアの補完を調整しこどものセルフケア能力の発達に向かう過程であった．

　結論：容易ではない幼児後期のこどものセルフケア能力発達の支援は，こどもの日常にケアが馴染むように，長期に渡り母親を支援すること，アトピー性皮膚炎の症状に留意しながら，ケアの保持と放出の調整を行う【あえての空白の創出】という新たな視点も含め，こどものセルフケア能力と母親のケア能力を拡大できる支援が必要である．

　Objective: This study aimed to clarify the process of caregiver-supplemented self-care needed for children with atopic dermatitis during late infancy.

　Method: Semi-structured interviews were conducted with 16 mothers of children who were aged 3-11 years and diagnosed with atopic dermatitis in infancy. Data were analyzed using the grounded theory approach.

　Results: Mothers continued to "dialogue with the child as he/she is," and repeated "strategies to ensure care becomes part of the child's daily life," "daring to create a void" and "readjustment of the complement," which led to the development of their children's self-care skills by adjusting the complementary care.

　Conclusion: Expanding a child's self-care abilities in late infancy is challenging and requires sustained support for mothers to integrate care into child's daily life, adopt the perspective of "creating a daring void" to adjust retention and release of care while considering atopic dermatitis symptoms. Support that can expand both child's self-care and the mother's ability to provide effective care is essential.