産後0〜4か月の母子を対象とした助産師の家庭訪問支援の構造

Structure of Midwife Home Visit Support for Mothers and Infants Aged 0-4 Months Postpartum

要旨

　目的：産後0〜4か月の母子を対象に自治体で行っている助産師による家庭訪問活動の経験から支援の構造を明らかにする．

　方法：対象者はA県で産後0〜4か月の母子に対して家庭訪問支援を実践する助産師10名とし，半構造化面接を行い質的統合法（KJ法）にて分析した．

　結果：助産師が行う家庭訪問の専門的支援は，【心身の負担を減らす支援】を手がかりとし，【分娩体験の振り返り支援】と【母の育児実践に向けた支援】の2つの実践を助産ケアの核として通底していた．しかし，経験を通して対象の多様性にあわせた【多面的な支援の必要性】に気づき，【地域に根差した継続的支援】や【保健師との協働】を課題と捉えていた．

　結論：家庭訪問を行う助産師の支援の構造が明らかとなり，今後は育児に揺れる母を深く理解することや，母子への継続的支援の時期を見極めること，多職種が互いの専門性に理解を深め協働することが重要である．

　Objective: This study aimed to clarify The Structure of Support based on the experiences of midwife home visit activities that municipalities conducted for mothers and infants aged 0-4 months postpartum.

　Methods: Semi-structured interviews were conducted with 10 midwives who practiced home visit support for mothers and infants aged 0-4 months in Prefecture A. Interview data were collected and assessed using the qualitative synthesis method (KJ method).

　Results: The professional support that midwives offered during home visits was underpinned by efforts to decrease physical and psychological burdens and consistently characterized by two core practices of midwifery care: helping in the reflection on childbirth experiences and supporting mothers in their caregiving practices. However, through their experiences, the midwives recognized the requirement for multifaceted support tailored to the diversity of mothers and infants. Additionally, they identified challenges such as "sustainable community-based support" and "collaboration with public health nurses."

　Conclusion: The structure of midwives' support during home visits was clarified. Therefore, deeply understanding mothers struggling with childcare, determining the appropriate timing for ongoing support for mothers and infants, and fostering collaboration among multidisciplinary teams with a deeper understanding of each other's expertise are crucial.