Departmental Bulletin Paper 脳性麻痺をもつ児の母親の産科医療補償制度に対する認識

森田, 真理子  ,  佐々木, 規子  ,  坪田, 幸子  ,  宮原, 春美

30pp.47 - 52 , 2017-07 , 長崎大学大学院医歯薬学総合研究科保健学専攻
ISSN:18814441
Description
目的: 我が国では2009年に産科医療補償制度が開始となった.しかし,現在,制度への申請数は,想定より少ないという現状がある.そこで,本研究では,脳性麻痺をもつ児の母親を対象に産科医療補償制度に対する認知と現状に対する考えを聞き,今後の助産師としての課題について検討した.方法: 研究協力者は,A市内の障害児デイサービスを利用する脳性麻痺をもつ児の母親とその母親らからのス ノーボールサンプリングにて承諾の得られた母親 9 名である.半構成的インタビューを実施し,その内容を質的帰納的に分析した.結果: 分析の結果,産科医療補償制度の申請が少ない現状に対する考えとして,情報不足による困難,障害受容の問題による困難,申請期限による困難,申請条件による申請困難という 4 つのカテゴリーが抽出された.また,社会資源全体を通して母親たちは専門職者からの情報提供不足を感じていることが明らかとなった. 結論: 助産師自身が制度に関心をもち,対象者へ利用を促していくこと,育児期のインフォメーションの充実,障害受容への支援が必要であることが明らかとなった.また,申請期間や申請対象,掛金など制度そのものの見直しも検討されるべきであると示唆された.
Objectives: The Japan Obstetric Compensation System for Cerebral Palsy was launched in 2009. However, the current number of application for this system remains less than assumed. The aim of this study is to identify issues of concern that midwives need to address through interviews with mothers of children with cerebral palsy on their awareness and thoughts on the present situation of The Japan Obstetric Compensation System for Cerebral Palsy. Methods: The study participants consisted of 9 mothers of children with cerebral palsy who are users of day service for disabled children provided by City A, or who were recruited by snowball sampling and provided their consent to participate in this study. A semi-structured interview was performed and the data obtained were analyzed qualitatively and inductively. Results: Analysis showed that the mothers' views of the present situation of The Japan Obstetric Compensation System for Cerebral Palsy could be categorized into four groups. These were “Difficult to apply due to lack of information”, ”Difficult to apply due to disability acceptance issues”, “Difficult to apply due to application deadlines” and “Difficult to apply due to application conditions”. In addition, mothers felt the overall lack of information on social resources from professionals. Conclusion: Findings suggest that midwives need to be more aware of the Japan Obstetric Compensation System for Cerebral Palsy and actively encourage mothers to make use of the system, and that information on child care and support on disability acceptance should be more available to these mothers. The framework of the system itself may also need to be reconsidered such as its application period, eligibility and installment.
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http://naosite.lb.nagasaki-u.ac.jp/dspace/bitstream/10069/37713/1/hokenn30_47.pdf

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