Departmental Bulletin Paper 長期入院した双子の母親の産後の経験と思い

坪田, 幸子  ,  佐々木, 規子  ,  赤星, 衣美  ,  宮原, 春美

29pp.17 - 25 , 2017-01 , 長崎大学大学院医歯薬学総合研究科保健学専攻
目的  長期入院を経験した双子の母親の産後の経験や思いを知り,必要な支援について検討する. 方法  対象:妊娠期にA病院に入院し,双子を出産した女性5名.  方法:産後 3 ヵ月後に半構成的インタビューを行い,質的帰納的に分析した. 結果  双子の母親の産後の経験や思いでは【自身の身体の不調】【育児準備性の不足】【産後の家族機能】【母子の適応】【支援に対する思い】【管理入院の肯定的評価】【管理入院の否定的評価】の 7 つのカテゴリーが抽出された.産後早期はイメージとのギャップや長期入院による筋力低下などの身体の不調などから困惑やストレスを抱えていたが,産後 3 ヵ月頃になると育児の慣れや余裕を感じ,母子の適応という過程を経験しており,管理入院への肯定的・否定的な思いが聞かれた.産後の社会資源への期待は高く,利用できる 社会資源の紹介や入院中と同様に産後の医療者の介入といったサポートを求めていた. 結論  双子の母親は産後3ヵ月頃になると母子の適応という過程を経験していた.退院後も継続的に母児に関わることができる場作りが必要であり,医療者は妊娠中から利用できる社会資源の紹介や情報提供といった対応の重要性が明らかになった.
Purpose  The present study aimed to understand the reflections and postpartum experiences of mother of twins who underwent long-term hospital stay, and to discuss necessary care for such women. Subjects and Methods 1 ) Subjects: The study subjects were five women who were hospitalized during pregnancy and delivered twins at Hospital A. 2 ) Methods: We conducted semi-structured interviews at three months postpartum, and used the Modified Grounded Theory Approach for analysis. Results  The following seven categories of postpartum experiences and reflections of mother of twins were extracted: own poor physical condition, insufficient readiness to raise a child, postpartum family function, adaption to mother-child relationship, reflections toward care, positive evaluations of hospital care, and negative evaluations of hospital care. Mothers experienced confusion and stress in the early postpartum period due to factors such as a gap between expected postpartum life and actual postpartum life, and poor physical condition such as decreased muscle strength associatied with long-term hospitalization, but by the time at three months postpartum, they had become used to child rearing and felt more relaxed. They had experienced the adaption of the mother-child relationship and we had their positive and negative opinions about managed care during hospitalization. There was a high degree of expectation concerning postpartum social resources, and there was a need for an introduction of available social resources and postpartum interventional support by health care workers in the same way provided during the hospitalization period. Conclusion  Mothers of twins experienced and felt confusion and stress during the early postpartum period, but by three months postpartum, the mothers had gone through the mother-child adapting process. The results of the present study revealed the need to create opportunities for continuous involvement with mothers and children after discharge, and the importance of introducing and providing information during pregnancy concerning social resources that can be used by mothers.

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