※一部利用できない機能があります
| 1.
図書 |
図書
|
島田啓子編著
|
||||||
| 2.
図書 |
図書
|
研究代表者 島田啓子
|
||||||
| 3.
論文 |
論文
|
太田, 良子 ; 島田, 啓子 ; 青木, 剛 ; 大畑, 欣也 ; 高松, 博幸 ; 近藤, 恭夫 ; 山﨑, 宏人 ; Ota, Yoshiko ; Shimada, Keiko ; Aoki, Go ; Ohata, Kinya ; Takamatsu, Hiroyuki ; Kondo, Yukio ; Yamazaki, Hirohito
概要:
目的造血器腫瘍は治療前に妊孕性温存の手段がとれない場合があり、その人々への支援のため、女性造血器腫瘍サバイバーが、病の中で子どもを持つことへの思いをどのように抱いているか明らかにすることを目的とする。対象と方法18 歳から 35 歳の間に造
…
血器腫瘍と診断され、抗がん剤治療または分子標的薬治療を受けて、寛解中の女性 10 名に対して半構成的面接を行い、対話構築主義に基づいたライフストーリー法で分析した。結果女性造血器腫瘍サバイバーが、結婚を視野に入れていないときは、告知時に【命の危機の前に薄らぐ将来の子どもを持つことの重要性】を感じ、寛解すると【回復した月経に伴う妊孕性への安心感と消えない不妊への不安】が生じた。結婚を考えるにつれて【念のため医師に妊娠可能かを聞く心配】が拭いきれず、不妊は家族形成の契機としての結婚の意味を失うため、【結婚前に子どもを持てないことを知る苦悩】、【病の受け入れを揺るがす子どもを持てない現実への恨み】を抱くようになった。結婚後では【子どもを持てるかより、先立つ死に向かう不安】が強かった。その後、子どもを授かるも【病の治療による胎児の障害への懸念】は続いた。結論女性の人生で “ 子どもを持つことへの思い ” が、結婚を考える時期と病の回復段階の 2 軸を中心に思いが変容していた。そのため一時的な思いではなく、女性の人生全体を考えた理解の仕方というものの重要性が示唆された。<br />PurposeFertility often cannot be preserved in patients with hematopoietic tumors. This study was performed to clarify the thoughts of female hematopoietic tumor survivor on child bearing.MethodsThe study population consisted of 10 women diagnosed with hematopoietic tumors between 18 and 35 years of age, undergoing anticancer drug treatment or molecular targeted therapy, and currently in remission. We conducted a semi-structured interview with the Life Story method based on dialogue building.ResultsWhen not considering marriage, they reported that “The importance of having a child faded compared with the crisis of life” at diagnosis, and “Relief obtained by cure of amenorrhea occurred during remission and indelible anxiety regarding infertility.” When wishing to get married, “Fear concerning infertility, asking the doctor if they can become pregnant” cannot be forgotten. Infertility results in loss of the meaning of marriage as a trigger for family formation, so the respondents reported “Anguish to know that I cannot have children before marriage” and “Resentment toward the reality of infertility that affects acceptance of disease”. After marriage, “Anxiety heading toward death, rather than whether I will have children” was strong. During pregnancy “Concerns about fetal disorders due to treatment of the disease” continued.ConclusionIn the life of a woman, thoughts of having children were transformed around two axes, i.e., the time to consider marriage and the stage of recovery from the disease. Therefore, rather than just capturing temporary thoughts, how to understand the whole life of women was suggested to be important.
続きを見る
|
||||||
| 4.
論文 |
論文
|
髙山, 豊子 ; 島田, 啓子 ; Takayama, Toyoko ; Shimada, Keiko
概要:
育児支援場面において、母親と看護者の受け止め方から、双方の共感的、非共感的体験を明らかにする。対象は母親 7 名と看護者２名で、育児支援場面の参加観察及び、母親、看護者に半構成的面接を行った。分析は、逐語録から帰納的に内容の分析を行った。共
…
感的体験では母親は 2 カテゴリー、［はりつめていた心がとける］［育児をしきりなおしたい］と 6 つのサブカテゴリーに大別された。看護者は 3 カテゴリー、［母親の気持ちを察し汲み取る受け止めと関わり］［母親を支え、気持ちに応える関わり］［母親の育児の状況、母親との関わりに満足する］と 7 つのサブカテゴリーに大別された。非共感的体験では母親は２カテゴリー、［看護者と理解しあえていないが、育児への肯定感情を抱く］［支援する看護者ではない育児のよりどころ］と 6 つのサブカテゴリーに大別された。看護者は 5 カテゴリー［母親の反応を理解したい］［母親の思いを察し、夫婦の選択に委ねる］［母親自身の育児の思いが反映されない関わり］［結果、状況を優先し、判断した関わり］［助言に対する母親の反応を解釈して、満足する］と 7 つのサブカテゴリーに大別された。共感的体験の中では、母親と看護者双方の受け止め方、思いが相互理解を感じ取り、その結果母親は、前向きな解決姿勢を持たせる満足感を得ていた。そしてそのことが看護者の満足感や安堵感につながっていた。<br />This study was performed to examine the empathic and non-empathic experiences of mothers and nurses during early childcare support.Semi-structured interviews were conducted with seven mothers and two nurses engaged in childcare support.With regard to the empathic experiences, two categories ([loosening of tense feelings] and [childcare begins again on a new level]) and six sub-categories were derived from the mothers. For nurses, three categories ([relationship taking mothersʼ feelings into consideration], [relationship to support and empathize with mothers], and [accept the childcare of mothers and being satisfied with support given to mothers]) containing seven sub-categories were derived.With regard to the non-empathic experiences, we again derived two categories ([wants to take care of her baby but does not understand the nursesʼ advice] and [does not rely on nursesʼ support in childcare]) and six sub-categories for mothers. For nurses, we derived five categories ([want to understand mothersʼ responses], [infer mothersʼ feelings and respect couplesʼ choices], [relationships do not reflect mothersʼ parenting feelings], [relationships that prioritize results and situations], and [pleased to be able to interpret the mothersʼ reactions]) containing seven sub-categories.Mothersʼ and nursesʼ empathic experiences indicated that they had feelings of mutual understanding. As a result, mothers experienced satisfaction, which gave them a more positive attitude toward solving problems themselves. This led to greater satisfaction and relief among nursing staff.
続きを見る
|
||||||
| 5.
論文 |
論文
|
太田, 良子 ; 藤田, 景子 ; 鶴見, 薫 ; 島田, 啓子 ; 福井, トシ子 ; Ota, Yoshiko ; Fujita, Keiko ; Tsurumi, Kaoru ; Shimada, Keiko ; Fukui, Toshiko
概要:
院内助産システムの安全性を探ることを目的とし、医学中央雑誌を用いて、「院内助産システム」また、「院内助産」、「助産師外来」「バースセンター」のキーワードで国内文献を検索した。ヒットした 8３1 件のうち、２01２ 年から 5 年間に絞り ２
…
61 件、さらに原著論文に限定して85 件が抽出された。そのうち、運用基準、医師への移行(医療介入 )率の記載、分娩アウトカム指標の記述がある文献 11 件を分析対象とした。 助産師外来の記載があった文献は 5 件、院内助産は 10 件、助産師外来と院内助産の記載があった文献は 4 件であった。 助産師外来から非助産師外来への移行率は 4.0 〜 8.8% であり、非助産師外来のローリスクからハイリスク移行率 9.0% に比較して低率であった。また、院内助産における医師の医療介入率は9.6〜44.4％で、非院内助産における医療介入率41〜46.6%より低率であった。分娩アウトカムは児の体重と臍帯血 pH、会陰裂傷においては非院内助産と有意差がなかった。 院内助産システムの運用基準は、産婦人科診療ガイドラインを基本に、各施設で独自に選定対象基準を記載しており、助産師外来は、妊娠初期から中期まで医師が担当する協働の実態があった。助産師外来と院内助産の安全性が示唆される一方で、分娩の施設間で運用基準が異なるため、系統的なメタ分析を妨げているという課題が見えた。以上から院内助産システムの運用に関するガイドラインの検討と院内システムの標準化を進展することが早急の課題と考える。<br />This study was performed to verify the safety of midwife-managed delivery units in Japan based on a review of the domestic literature. We conducted a literature review using the Ichushi-Web (Japan Medical Abstracts Society) and searched the domestic literature with the keywords “midwife-managed delivery units system,” “midwife-managed delivery units,” “midwife-led examinations,” and “birth center.” A total of 8３1 articles were identified, of which ２61 papers were published between ２01２ and ２016, from which 85 were extracted as original articles. Eleven transcripts were analyzed by extracting the transfer rate from midwife-led examinations to obstetrician-led examinations, obstetric intervention of midwife-managed delivery units, neonatal and physiological outcomes, and safety. There were five studies with descriptions of midwife-led examinations, ten studies with descriptions of midwife-managed delivery units, and four describing both systems. The rate of transfer to obstetrician-led examinations was 4.0% – 8.8%, which was low compared to the high-risk transition rate of 9.0% for obstetric outpatients. The obstetric intervention rate in midwife-managed delivery units was 9.6% – 44.4%, which was lower than the obstetric intervention rate of 41% – 46.6% in deliveries managed by physicians. The neonatal and physiological outcomes were not significantly different according to the weight of the child, umbilical cord arterial blood pH, or perineal lacerations in the physician control group. The operation criteria of midwife-led examinations and midwife-managed delivery units are based on the Obstetrics and Gynecology Clinical Practice Guidelines, and many facilities have established their own criteria. In outpatient midwifery clinics, the doctor was in charge from early pregnancy to mid-term. This study suggested that midwife-led examinations and midwife-managed delivery units have good levels of safety. On the other hand, there were differences in operation standards among the facilities, which prevented more reliable meta-analysis of midwife-managed delivery units. To further disseminate midwife-managed delivery units, it is necessary to evaluate not only the outcome items but also operational criteria, and establish standards according to the environment, facilities, and personnel of each facility.
続きを見る
|
||||||
| 6.
論文 |
論文
|
岩谷, 久美子 ; 島田, 啓子
概要:
Purpose: This study was performed to develop an educational model of safety management in midwifery clinical practice fo
…
r midwifery students and to examine the content validity and utility of this model. Methods: A provisional four-step educational model was developed for teaching safety management skills in birth assistance. First, semi-structured interviews were conducted with birth assistance educators, and elements that they deemed necessary for safety management education were extracted (Step 1). Following Bloomʼs theory of education, Step 2 served to develop an education model proposal based on the findings obtained in Step 1. In Step 3, 102 birth assistance educators completed a paper survey to evaluate the proposed modelʼs content validity based on a four-point Likert scale to evaluate how well they understood the proposed model. Finally, in Step 4, the proposed model was revised to develop educational model version 1 based on the suggested revisions from survey responses. The content validity and utility of this educational model version 1 were examined by 10 educators, including five new birth assistance educators who replaced five of the originally surveyed educators. Results: The proposed educational model was composed of six extracted categories. Four categories, “Objectives of safety management education,” “Midwife ethics,” “Appropriate reporting, communication, and consultation,” and “Infection prevention,” were set as course outcomes, while the remaining two categories, “Experiences of birth assistance” and “Safety knowledge and techniques,” were expressed on a horizontal axis representing five stages of learning and a vertical axis representing the level of growth, respectively. Of the 102 participants that provided valid responses, 88 (86%) “Agreed (including partial revisions)” with the proposed model. Safety management education abilities were clearly defined with reference to opinions on the need for more concrete descriptions of safety management abilities in the proposed model. Furthermore, in response to requests for description of the relationship of safety management with experiences of birth assistance and the sequence of learning in experiences of birth assistance, six stages were added to the axis ranging from understanding of labor and delivery to autonomy. Educational model version 1 was presented with the level of growth on the vertical axis designated as the level of achievement of safety management abilities and representing the interaction of the three domains in Bloomʼs taxonomy of educational objectives, and the four course outcomes shown as a curve on the axis. All 10 respondents agreed that model version 1 had content validity and was “applicable” in practice. Conclusion: The results suggested the validity of the content and utility of the proposed safety management education model for birth assistance in midwifery clinical practice.
続きを見る
|
||||||
| 7.
論文 |
論文
|
米田, 昌代 ; 吉田, 和枝 ; 曽山, 小織 ; 島田, 啓子
概要:
Women that have lost a child during the perinatal period are more likely to continue suffering from deep loneliness and g
…
rief after discharge. Here, a survey was performed among perinatal medical centers, health centers, municipal centers, and self-help groups throughout Japan to clarify the current state and issues regarding post-discharge grief care and regional cooperation, and to design a tentative regional cooperation system model for perinatal grief care. A total of 475 facilities provided effective responses to our self-completed questionnaire. These data were subjected to descriptive and qualitative content analyses, which revealed that sufficient grief care was not provided for post-discharge women and their families. In addition, a tentative regional cooperation model was designed based on the current state and issues regarding regional cooperation. This cooperation model included “assignment of those in charge of post-discharge grief care in medical centers”,“development of a system to report pediatric deaths from medical centers to administrative bodies”,“assignment of clinical psychologists within medical centers or dispatch of such psychologists from administrative bodies to medical centers”,“support groups led mainly by medical centers and administrative bodies”,“cooperation with psychology professionals”,“specialistsʼ participation in and support for self-help groups”,“administrative bodiesʼ financial support and consulting services for self-help groups”,“opportunities provided by relevant organizations to learn about grief care and to discuss difficult cases”, and “information management by administrative bodies”. It is necessary to determine whether our tentative model is useful in the community.
続きを見る
|
||||||
| 8.
論文 |
論文
|
藤田, 景子 ; 島田, 啓子
概要:
The present study was performed to examine the challenges to nursing practices and skills related to the support of dome
…
stic violence victims in medical settings. A questionnaire survey was performed using a descriptive exploratory study design. The subjects were nurses and midwives who participated in a meeting regarding domestic violence （DV） between March and December 2012. A content analysis approach was applied to the comments. Ninety-five of the 126 participants in the DV meeting completed the questionnaire （response rate: 75.4%）. Three categories were extracted regarding nursing practice tasks: “Building a Relationship between DV Victim and Nurses,” “Nursing Practices that Promote the Recovery of DV Victims,” and “Developing a Support System for DV Victims in Medical Settings.” Three categories that nurses required were extracted relating to nursing skills to support DV victims in medical settings: “ Appropriate DV-related Knowledge,” “Nursing Intervention Techniques to Help DV Victims,” and “Behaviors when Nurses Care for DV Victims.” At healthcare sites, the assignments and skills required by nurses have become apparent based on the viewpoint of nurses that have previously encountered DV victims. As DV victims tend not to talk about their suffering with others, their issues seldom come to the surface and this may seriously affect their health. Therefore, it is necessary for nurses to obtain nursing skills to support these victims and find and intervene in DV cases at an early stage. Based on the results of this survey, the authors intent to review the contents of nursing education to effectively deal with DV issues.
続きを見る
|
||||||
| 9.
論文 |
論文
|
岩谷, 久美子 ; 島田, 啓子 ; 福村, 友香
|
||||||
| 10.
論文 |
論文
|
内, 織恵 ; 島田, 啓子 ; 田淵, 紀子
|
