[研究報告] 双生児の乳児期早期における睡眠覚醒リズムの同調性と関連する要因

本研究は乳児期早期の双生児ペアの睡眠覚醒リズムの同調性を腕時計型加速度センサー、アクチグラフ（Micro Mini，Ambulatory Monitoring Inc. USA）を用いて定量的に評価し、同調性の高低に双生児ペアのどのような要因が影響しているのかを明らかにすることを目的とし実施した。双生児の睡眠変数と睡眠覚醒リズムの同調性は、睡眠覚醒同調率と夜間同時睡眠率を算出した結果，それぞれ68.8％（SD；7.0％）と58.6％（標準偏差8.1％）であった。両者の相関は、有意水準には達しなかった（Rs＝0.383，p＝0.481）。また、睡眠覚醒同調率、夜間同時睡眠率と双生児のプロフィール、育児要因、睡眠環境との関連する要因を検討した結果、睡眠覚醒同調率では、自律授乳の励行、母親の添い寝、睡眠覚醒リズムを整える工夫を行うとの関係が示唆された。夜間同時睡眠率に関しては、関連が推測できる要因は特定できなかった。The present study was conducted to determine twin pair‒specifi c factors that may influence synchrony between sleep-wake cycles, using a wrist accelerometer Actigraph （Micro Mini, Ambulatory Monitoring Inc., USA） for quantitatively measuring the synchrony in twin pairs in early infancy. The rates of sleep-wake synchrony and nighttime synchronic sleep in twin pairs were 68.8 % （with a SD of 7.0 %） and 58.6 % （with a SD of 8.1 %），respectively. These two parameters did not significantly correlate with each other （Rs＝0.383, p＝0.481）．In addition, we investigated the relationship between the rates of sleep-wake synchrony and nighttime synchronic sleep, and various factors relating to the twin pairs’ characteristics, child-rearing, and sleep environment. We found that the rate of sleep-wake synchrony was related to strict self-demand feeding, mother-twins co-sleeping, and attempts to regulate twins’ sleep-wake cycles. We could not identify any factors that were presumably related to the rate of nighttime synchronic sleep

[資料] 小児看護に携わる看護師が新人看護師にのぞむ臨床実践能力 －入職時に修得していることをのぞむ小児看護技術－

小児看護領域で求められる小児看護技術は、新人看護職員研修で修得する臨床実践能力を基盤として、小児の特性に応じたさらに専門性・難易度が高い技術の修得が必要となる。本研究では、小児看護に携わる看護師が新人看護師の入職時までに修得していることをのぞむ小児看護技術について、総合病院の小児病棟に勤務し新人看護師教育に携わる看護師を対象とした調査を実施した。結果、新人看護師にのぞむ看護技術の多くは「知識としてわかる」レベルであった。しかし「バイタルサイン測定」「日常生活行動の援助」「成長発達の理解と発達段階に応じた関わり」「検査・処置の援助」「基本的な育児行動」「コミュニケーション能力」が入職時までにこれだけは修得してきてほしい看護技術としてあげられた。また小児看護を実践していく上で新人看護師にのぞむ姿勢として「責任感」が最も多く求められていた。The skills required in the field of pediatric nursing are based on the clinical practice abilities developed during training of new nursing staff and require the acquisition of more specialized and challenging skills appropriate to the characteristics of children. This study conducted a survey among nurses who worked in pediatric wards within general hospitals and were involved in the education of new nurses, to investigate the specific skills that nurses involved in pediatric nursing believe new nurses should acquire before the time of accession. The results showed that most of the nursing skills desired to be developed in new nurses were related to learning to a “level wherein the content could be understood as knowledge.” However, “measurement of vital signs,” “support for daily living activities,” “understanding of growth and development, and involvement appropriate to developmental stages,” “support for examinations and treatments,” “basic childcare behaviors,” and “communication ability” were listed as the minimum nursing skills needed to be learned by new nurses before the time of accession. In addition, “a sense of responsibility” was most frequently cited as the attitude to be acquired by new nurses for pediatric nursing practice

子どもとの関わりが困難な学生の実習指導のあり方

臨床実習を効果的に進めるための指導のあり方を探るために,入院2日目で症状が強く,学生を受け入れられない状況にある3歳女児と,学生との関わりを学生の実習記録と教師の指導記録から分析した。学生は患児の拒否する態度に困惑し,状況を客観的に捉えることができずに実習意欲を低下させていた。教師は,混乱している学生が客観的に現象を捉え,行動を評価できるよう心理的余裕を持たせることが必要であった。また,関わりの具体的方法を助言し,学生が実施してゆく過程をサポートし続けることで,学生が患児と関わることができた。How the association went on between a three-year-old girl who still showed strong symptoms on the second day after she was admitted to a hospital and the student nurse who was having practical training of nursing was analyzed from the student nurse\u27s records of practice and the teacher\u27s records of instruction. The student nurse was embarrassed by the sick child who refused her, and could not have an objective understanding of the situation, thus losing motivation to have practical training. The teacher had to make the confused student nurse feel relaxed enough to understand what was taking place and evaluate the behaviors objectively. The teacher also advised the student nurse about specific approaches to the child and gave support to the student nurse throughout the processes of training. As a result, the student nurse was able to associate with the sick child

日本赤十字秋田短期大学の小児看護学実習の実態と課題

小児との接触経験が少ないという現代学生の条件と,実習施設の制約にあわせて,本学の小児看護学実習は公立保育所10ヶ所と2つの総合病院で行っている。特性の異なる2つの病院で行うため,学生の学習経験の差がなく,効果的な学習ができるような実習計画と指導の工夫が必要である。実習前に学生のレディネス調査を行い,実習後にも学習した受持症例の種類や人数,看護技術の体験,学生の子どもとの関係の変化について調査し,分析評価した。看護学科1期生の結果では,受持患児は1～2名で,急性期疾患が多く,小児の生活の援助はほぼ経験している。学生は子どもに好意的な感情をもち,人間関係もとれている。しかし子どもとの接触経験の少ない学生は好意的関係が成立しにくいので,指導援助が必要である。Although the nurse students in this college, lack in experience of associating with children, they had to be carried out the practical training of pediatric nursing under the very condition of the pediatric in 10 public day nurseries and 2 general hospitals. For the first-term students of the nursing course looked after 1-2 children, chiefly with acute diseases, and they could bear toward the children in the nurseries and hospitals. The result obtained from the analyse of the research artcles showed that student nurses who lacked in experiences with children tend to have difficulties in dealing with children, and they need teacher\u27s instruction and support more than ever

療養型医療施設における臨地実習指導の現状と課題 : 初めて実習指導を行った臨地実習指導者と病棟管理者の面接調査より

本研究は療養型医療施設において初めて実習指導を行った臨地実習指導者の指導上の困難および病棟管理者や病棟スタッフ(看護職スタッフ・介護職スタッフ)の連携を明らかにすることを目的とし指導者8名と病棟管理者2名に面接調査を実施した。その結果、(1)指導者の指導上の困難は「指導内容や方法」「指導に対する不安」など指導者自身の問題が多かった。(2)指導者は自己の指導を振りかえり、指導方法を工夫し、学生の事故防止や緊張緩和に重点をおき実習指導を行っていた。(3)指導者と看護職スタッフとの連携では「指導への無関心」で、指導者と介護職スタッフとの連携では「情報伝達の不足」があげられており、指導者同士の連携では「連携の不足」、「指導の違い」であった。(4)病棟管理者は指導者と病棟スタッフ(看護職スタッフ・介護職スタッフ)の調整において「スタッフは協力的」「問題はなかった」と認識しており、指導者の病棟スタッフ(看護職スタッフ・介護職スタッフ)の連携に対する認識と差異があることが明らかになった。This research is aimed at indentifing difficulties experienced by clinical training staff who conducted training for the first time at medical care centers; and to make clear the cooperation between hospital ward administrators and the ward staff (nursing and care staff). To achieve this a survey was carried out by means of interviewing 8 instructors and 2 ward administrators. The results from the interviews show that, 1). Many of the difficulties in training instruction faced by the instructors were self-induced created by \u27the content and the methods of training\u27 and with the instructors feelings of \u27anxiety toward training instruction; 2). It was made clear that the instructors reflected on their own instructing skils for improvement and to carry out training instructions which focus on preventing accidents happening to the trainees while also putting them at ease; 3). There was a discrepancy in the understanding of cooperation between the staff, as ward administrators felt that in coordinating the instructors and the ward staff (nursing and care staff) \u27the staff was cooperative\u27 and \u27there were no problems\u27; 4). The main problem concerning cooperation between the instructors and the nursing staff was duetoa \u27lack of interest toward the training\u27, for the instructors and the care staff the problem was \u27a lack of information conveyance\u27, and as for the problem of cooperation between the instructors themselves it was dueto \u27insufficient cooperation\u27 and \u27differences in training methods

[その他] 統合実習研修会「教員と指導者の連携強化をめざして －実習指導の実態と課題から－」の報告

本学における統合実習指導の実態や課題を解決に導くために研修会を企画・運営したので報告する。研修会では統合実習開始当初からこれまでの指導体制に関する課題と各実習施設の工夫や取り組みについてグループワークをし、情報共有することができた。研修会を終えて、グループ毎のまとめをもとに、研修会担当者らで検討した結果、統合実習の指導体制、臨地実習PBL展開、夜間実習計画・指導、の３点が課題として集約できた。また大学と実習施設の連携強化のために必要な内容として、初めての実習施設で学生が力を発揮できるための学習環境の整備、臨地実習指導者と教員間の実習目標・指導方法・評価方法の共有、学生の心身両面のサポートも含めて教員と指導者の役割の明確化など、指導体制の連携強化の重要点が示唆された。Abstract：Planning workshops to guide in solving challenges and the realities of practice teaching methods at a university were conducted. Since leadership is challenging and the sharing of initiatives and information is important, there was a need to devise a training and work method for each practice of the integration exercise.The results of each group, based on consultation, training of personnel, training, integrated training in the education system, along with clinical practice PBL deployment, night-time practice planning and guidance, were summarized into three points. These key points were: strengthening leadership, such as clarification of the role of teachers and leaders; including support for shared training goals which can aid students at practice facilities for the fi rst time at a university for practical training necessary to foster a cohesive learning environment; and aiding clinical instructors and teachers, including teaching methods for evaluation of the student’s mental condition

予防接種対象となっている小児期感染症に関するA県の看護教育機関に在学する1年生のとらえ方

A県内の看護教育機関に在学する1年生114名を対象に予防接種対象となっている小児期感染症に関する調査を行い以下の結果がえられた。1.小児期感染症の罹患歴が「わからない」とする学生は風疹が24%、麻疹が19%、ムンプス14%、水痘9%であった。また、予防接種歴が「わからない」とする学生は水痘43%、風疹が41%、ムンプス38%、麻疹28%であった。2.罹患歴、予防接種歴の情報源は家族から聞いたとする人が多く、母子手帳で知ったとする人は少なかった。3.小児期感染症の抗体価の検査は、「受けたことがある」19.3%、「受けたことがない」23.7%、「わからない」57.0%であった。4.予防接種で成人期の小児期感染症の発症を防ぐことについて、「できると思う」50.9%、「できないと思う」22.8%、「わからない」26.3%であった。小児期感染症の罹患歴や予防接種歴が「わからない」とする人や抗体価の検査を受けたことがある人が少なかったことから、感染予防や予防接種に関する指導の必要性が示唆された。I conducted a survey on the attitude related to pediatric infectious disease requiring vaccination among 114 freshmen students who are studying at educational institutions of nursing science within A Prefecture, and obtained the following results. 1. Among the students who do not know their own history of pediatric infectious disease, rubella accounted for 24%, measles 19%, mumps 14%, and chickenpox 9% in respect to the vaccinations they received. Students who do not know their own history of vaccination had 43% of chickenpox, 41% of rubella, 38% of mumps and 28% of measles in terms of vaccinations they received. 2. Most of the students obtained the information of their diseases and vaccination history from family, and a few students knew it from their mothers maternity passbook records. 3. Students who had the Serum Antibody Titer Test of pediatric infectious disease occupied 19.3%, those who did not take the test accounted for 23.7% and those who do not know if they took the test or not accounted for 57%. 4. Students believing to be able to prevent the development of pediatric infectious disease in adulthood by way of vaccination occupied 50.9%, those believing it is not possible to prevent it accounted for 22.8%, and those who are not sure if it is possible or not accounted for 26.3%. As preventive measures for pediatric infectious diseases hereafter, it is advised to implement the Serum Antibody Titer Test along with positive health education related to vaccination for freshmen students

ロウネン カンゴガク ジッシュウ ニオイテ ガクセイ ノ インショウ ニ ノコッタ バメン デノ カンジョウ ブンセキ ノ イチコウサツ

本研究は、老年看護学実習において学生の印象に残った場面での感情を焦点化し、実習指導の方法について考察することを目的とし、老年看護学実習Iを終了した81名の学生を対象に無記名の質問紙調査を実施した。64名から回答が得られ以下の内容が明らかになった。1.快の感情である『喜び』『受容』『期待』は全体の6割を占めており、不快の感情である『驚き』『悲しみ』『嫌悪』は3割を占めていた。2.快の感情は、患者へ積極的に関わるための動機づけとなっていた。3.学生自身がどのような現象に注目し、どのように捉え受け止めたのかに気づき、感情を抱くまでのプロセスを理解し関わることが必要である。This study focused on feelings in a situation that left impressions on students in practical training of nursing care for the aged people, and aimed to examine the method of instruction in the practical training. This study was done by conducting a survey by anonymous questionnaire of 81 students who finished the Practical Training of Nursing Care for the Aged People I. 64 students answered the survey and the following observations were clarified. 1. Comfortable emotions, such as "pleasure", "acceptance" and "expectation" occupied 60 % of all students, and uncomfortable emotions, such as "surprise", "sorrow" and "dislike" accounted for 30 %. 2. The comfortable emotions motivated them to positively relate to patients. 3. It is necessary to notice what situations the students focused on and how they took and understood them and relate to the process of feeling involved

日本赤十字秋田短期大学看護学科卒業生の動向調査(第2報) : 社会人経験の有無と学業に対する取り組み、学生生活に対する満足度の関係

本研究は卒業生の動向把握と在学中の教育や学生生活について卒業生がどのように評価しているかを明らかにすることを目的に本学看護学科卒業生を対象に無記名の質問紙調査を行った。158名の回答から以下の結果が得られた。1.社会人経験のあった卒業生は入学時に看護師になりたい意欲が低い傾向にあったが、在学中は意欲的に勉学に取り組んだとする人が多く、看護師になることや学業を諦めようと思った人は少なかった。社会人経験のなかった卒業生は入学時には看護師になりたい意欲が高い傾向にあったが、在学中は意欲的に勉学に取り組んだとする人は半数であった。また、社会人経験のなかった卒業生の約30%は看護師になることや学業の継続を諦めようと思った経験をもっていた。その理由は学業面での困難や看護への魅力や意欲の低下であった。2.卒業生の学生生活に対する満足度は、社会人経験の有無にかかわらず、「学習環境」、「同級生との交流」、「自己の成長」、「チューターとの交流」、「臨地実習」の項目が高く、「クラスアドバイザーとの交流」、「他学科学生との交流」、「看護学科の先輩・後輩との交流」、「部活動やサークル活動」、「ゆとりある学校生活」の項目が低い傾向にあった。This study was conducted by an anonymous questionnaire given to the graduates of the Department of Nursing Science of this school, to evaluate the careers of these graduates and to clarify how the graduates evaluated the education and school life of this school. 158 graduates responded as follows: 1. Graduates with experience, being an active members of society, were likely to have less incentives to become a nurse at school entry, but most studied enthusiastically while in school and few thought about quitting or not completing the academic work. Graduates without experience of, being active members of society, were likely to have more incentive to become a nurse at school entry, but only half studied enthusiastically in school. 30% of the graduates without experience thought about quitting or not completing academic work. The reasons included difficulties faced in academic work and a decreased attraction or motivation for the nursing profession. 2. Irregardless of experiences of being active members of society, graduates had high satisfaction levels for school life in terms of learning environment, interaction level with classmates, personal development, communication with tutors, and opportunities for on-site training. They had low satisfaction levels for school life in terms of communication with class advisors, interaction with students of other departments and with senior and junior members of the Department of Nursing Science, also involvement in club and circle activities

日本赤十字秋田短期大学看護学科卒業生の動向調査(第1報) : 卒業生の就業・進学状況と卒後の資格取得の実態

本研究では、本学看護学科卒業生の動向把握と卒業生から本学の教育に対する評価を得ることを目的に1期生から7期生までの卒業生を対象に質問紙調査を行い、163名から回答が得られた。本報では、卒業生の就業や進学、資格取得状況について報告する。1.卒業生の92.0%が就業しており、職種は看護師が95.0%を占めていた。就職先は93.4%が病院で、そのうち300床以上の病院への就職者は71.4%であった。また、勤務先は赤十字病院が40.0%であった。2.卒後の進学率は12.3%で、資格取得率は10.4%であった。資格の種類は保健師・助産師が多く、取得時期は卒後2年以内であった。3.卒業生の35.0%が卒業時点で進路を見つけることができたと答え、そのうち具体的な看護領域を挙げた者が60.0%以上であった。進路決定に影響したことは臨地実習が最も多かった。本学卒業生の進学率、資格取得率は低かったことから、看護職に期待される専門性について教授し、学生の進路の選択肢を拡げていく必要がある。In this study, we administered a survey to all graduates of the first through seventh classes of the Department of Nursing Science. The survey was in the form of a questionnaire which evaluated our education program and trends of our graduates. 163 responses were received. This report presents the status of employment and higher education of the graduates and the status of completion of qualification after graduation. 1. 92.0% of the graduates were employed wirh the occupation of nurse accounted for 95.0%. Hospitals accounted for 93.4% as place of employment and 71.4% of the graduates worked for hospitals with 300 beds or more. Red Cross Hospitals employed 40.0% of the graduates employed at hospitals. 2. The advancement rate was 12.3% and the rate of completion of qualification was 10.4%. Public health nurses and obstetric nurses accounted for the majority of qualifications completed. The time to complete qualification was within two years of graduating. 3. 35.0% of the graduates responded that they had found a career at the time of graduation. 60.0% or more of the graduates responded that they chose their area of nursing. On-site practice affected the determination of most careers. The advancement and completion of qualification rates of our school are low. Based on these results, we need to instruct students in the expertise expected for the nursing occupation and expand alternatives for their careers