成田 伸

In Japan, the incidences of pregnancy and sexually transmitted infections (STIs) are increasing among young people. To address these issues, we initiated the following steps: 1) processes supporting contraception and prevention of STIs were created for counseling and construction of an algorithm for that process; 2) a system was developed using a website to support the program for training counselors, and provide practical support during and after the training; and 3) a program for the counselor was developed and is being evaluated. The counseling process was visualized by an algorithm notion method developed by Tsuru et al. Participants registered on the website, enabling them to confirm the lecture contents, record their self studies and submit issues. In order to evaluate this program, a preliminary survey and short tests after the lectures were completed. Participants were nurse-midwives who graduated at a nursing university. 27 participants were expected to complete the program. The answer ratios in the short tests were significantly improved compared to them in the preliminary survey. All participants submitted issues via the website. Further development of the system is planned so that the website can provide practical support by trained counselors and build on the accumulated practical results. Further refinement of the developed algorithm is required so that trained counselors can use it regularly via the website.

産褥早期の母乳育児支援において助産師が対応を決定するうえで考慮する要因を明らかにすることを目的に,事例(産褥4日目の初産婦が乳房緊満による苦痛と疲労を訴え,児を新生児室に預けて寝たいと言っている場面)を提示してのアンケート調査を実施し,33施設の526名(22〜55歳,平均年齢31.7歳)より回答を得た.提示した事例に対し,母乳および母児同室を継続するか否かの対応を5つの選択肢から求めた結果,「児を預かるが,児が泣いたら連れていくので夜間の授乳は中止しないように促す」を選択した者が378名(71.9%)で最も多かった.また,助産師が対応の決定において考慮した要因として,<身体的疲労><精神的疲労><乳房の状態><母乳栄養確立><母子関係><児の状態><母親の意思><退院後の育児><母親の性格><母乳の利点><児の権利><事故防止>の12のカテゴリーが明らかになった