NICUに入院した低出生体重児の親からみた子どもの出生から在宅移行を構成する概念—GTAを用いた質的研究

Perceptions of Parents of Low-Birth-Weight Infants Admitted to the NICU of Concepts Relevant to the Transition From Birth to Home Care: A Qualitative Study Using a Grounded Theory Approach

要旨

　目的：NICUに入院した低出生体重児の親には，子どもの出生からどのような社会的相互作用が生じ，子どもの在宅移行に至ったのか，その構成概念を明らかにする．

　方法：自宅で子どもを養育する母親21名，父親1名へ半構造化面接を行い，グラウンデッド・セオリー・アプローチよる分析を行った．

　結果：セレクティブ・コーディングの結果，低出生体重児の在宅移行は，｛医療者との折り合い｝を中核カテゴリーとする他5つの現象【生まれた子どもの状態と連動する母親の心情】【子どもの状態に合わせるかかわり】【状況に応じた柔軟な切り替え】【現実味のある情報収集】【親からありのまま伝えられた同胞の状態】と関係していた．

　結論：在宅移行における｛医療者との折り合い｝という現象では，子ども・親を中心に医療者と対等な立場で相互作用が生じ，親自身の心情や子どもときょうだいへの柔軟なかかわり，有益な情報収集につながることが示唆された．

　Objective: This study aimed to clarify the conceptual framework of social interactions that parents of low-birth-weight infants admitted to the neonatal intensive care unit (NICU) experience from childbirth and how these interactions shape their transition to their child's home care.

　Methods: Semi-structured interviews were conducted with 21 mothers and 1 father raising their children at home, and data were analyzed using a grounded theory approach.

　Results: Selective coding revealed that the transition of low-birth-weight infants to home care was associated with five other phenomena centered on the core category of "agreement with medical professionals, " including "the mother's feelings in relation to the condition of the newborn," "interaction tailored to the condition of the infant," "flexible adaptation to the situation," "realistic information gathering," and "information about the condition of siblings provided by the parents as it is."

　Conclusion: The phenomenon of "agreement with medical professionals" during the transition to home care suggests that children and parents interact with medical professionals on an equal footing, leading to parents becoming more flexible in their attitudes toward their children and siblings and supported their ability to collect useful information.