Departmental Bulletin Paper 単胎初産婦の産後1か月までの育児不安

飯田, 恵子

【目的】近年日本は、子育てに関する不安やストレスを抱えている母親の増加や、子どもに対する虐待の増加1, 2, 3)が問題となっている。現在子育て中の世代は、児への接し方がわからないといった児とのコミュニケーション上の困難が育児不安の要因となっている。そこで単胎初産婦の産後1か月までの育児不安を明らかにし、ケアの方向性の示唆を得ることとした。【方法】産後1か月の単胎初産婦に、無記名自記式質問紙を行った。調査では、育児に対する自己効力感尺度(PSES)とともに、分娩経過・方法、新生児の経過、単胎初産婦の産褥早期の状態、産後2週間健診の受診の有無、産後2週間、産後1か月の育児不安、を尋ねた。統計処理は、有意水準を両側5%未満、両側5~10%未満を有意傾向とした。本研究は、奈良県立医科大学の医の倫理委員会の承認を受けた。【結果】研究対象者数は202名、有効回答数は137名(67.8%)であった。平均PSES得点は、50.03±6.77点であった。産後2週間の育児不安は114名の対象者のうち91名(77.2%)、産後1か月の育児不安は137名の対象者のうち111名(81.0%)において認めた。育児不安の認めた項目は産後2週間、産後1か月とも、「母乳」、「皮膚トラブル」、「啼泣」であった。2週間健診受診群は、PSES得点において有意に高い傾向を認めた(p=0.06)。2週間健診受診による育児不安の改善を認められた内容は「母乳分泌」、「オムツかぶれ」、「授乳直後の啼泣」であった。【考察】産後1か月までに2週間健診や母乳外来、育児相談、電話相談等個別相談による成功体験の承認による言語的説得によって、単胎初産婦の育児に対する遂行行動の達成の見込みがつきやすくなり、育児に対する自己効力感が高まる可能性が示唆された。
【Purpose】In recent years, Japan has become a problem with an increase in mothers with anxiety about parenting and stress, and an increase in abuse to children1, 2, 3). Difficulties in communication such as people not understanding how to engage in children are causing factors of childcare anxiety. Therefore, it was decided to clarify childcare anxiety up to one month after childbirth of the first baby and to obtain suggestion of the direction of care.【Methods】I performed anonymous self-descriptive questionnaire on the first birth single gestation after childbirth. In the survey, together with Parenting Self-efficacy(PSES), it was decided whether or not the childbirth method, the course of the newborn, the early postpartum state of the first baby’s woman, the presence or absence of consultation for 2 weeks postpartum, 2 weeks after birth, I asked about monthly childcare anxiety. In the statistical treatment, the significance tendency was a level of significance less than 5% on both sides and less than 5 to 10% on both sides. This research was approved by the medical ethics committee of Nara Medical University.【Results】The number of subjects to be studied was 202 and the number of valid responses was 137(67.8%). The average PSES score was 50.03 ± 6.77 points. 91 parents(77.2%)out of 114 subjects were found to be anxious about parenting for 2 weeks after childbirth, and parenting anxiety for 1 month after childbirth was accepted in 111 subjects(81.0%)of 137 subjects. Breastfeeding anxiety items were “breast human-milk”, “skin trouble”, and “weeping” for 2 weeks after birth and 1 month after birth. The 2week health checkup group showed a significantly higher tendency in PSES scores(p = 0.06). The contents that were found to improve child-care anxiety by medical examination for 2 weeks were “breast milk secretion”, “diaper rash”, “weeping immediately after breast feeding”.【Discussion】By prospect of linguistic persuasion by approval of a successful experience by health checkup, breastfeeding outpatient, child care counseling, telephone consultation etc. by 1 month after childbirth, the prospect of achieving performance of child rearing for the first birth woman It became easier to attach, suggesting the possibility that Parenting self-efficacy will increase.

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