思春期の糖尿病患児とその親の療養生活に対する認識の変化が療養生活・血糖コントロールに及ぼす影響に関する研究 : 二次元イメージ拡散法を用いた看護援助の検討
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本研究は,思春期の糖尿病患児とその親の療養生活に対する認識の変化が療養生活・血糖コントロールに及ぼす影響について明らかにすること,患児とその親の療養生活に対する認識の相違に焦点を当てた看護援助の有効性を検討することを目的に行った。12歳から18歳までの糖尿病患児とその親30組を対象に二次元イメージ拡散法,患児の独立意識と親の養育態度に関する質問紙を用いた調査及び療養生活に関する面接調査を行った。また,調査は2回行い,1回目の調査結果に基づき,翌月に親子の認識の相違に焦点を当てた看護援助を行い,その3カ月後に2回目の調査を行った。その結果,患児の療養生活・血糖コントロールの変化は疾患管理行動に対する親子の認識の相違の変化に連動していた。また,親子の認識の相違に焦点を当てた看護援助は,患児の食事の計量・親の忠告の大切さの認識と親の低血糖の補食の大切さ・実施の認識を変化させ,疾患管理行動に対する親子の大切さの認識の相違を小さくし,療養生活・血糖コントロールの維持・改善に有効であった。The purposes of this study were to clear the changes of perceptions of diabetic adolescents and their parents on self-care behaviors and their influence on metabolic control and to investigate nursing intervention using the 2-dimensional image diffusion method. The subjects were 30 pairs of adolescents, aged from 12 to 18 years who had diabetes and their parents. The 2-dimensional image diffusion method was used to measure the perceptions of adolescents and their parents. The adolescents' awareness of independence scale and the child-rearing attitude scale were administered, and semi-structured interview were conducted to obtain information on adolescents' self-care behaviors. These measures and interview were administered to all subjects pre and post nursing intervention. The nursing intervention focused on differences of perceptions between diabetic adolescents and their parents gained from the first measures and interview were administered. The results were as follows: 1) The gearing linkage relation between the differences of perceptions on self-care between adolescents and their parents, and self-care behaviors and metabolic control was found. 2) The nursing intervention focused on the differences of perceptions between adolescents and their parents was changed the adolescents' perceptions of "importance" on diet management and parents' advice, and the parents' perceptions of "importance" and "practice" on snacks in hypoglycemia, and also effective to reduce the differences of perceptions of "importance" on self-care between adolescents and their parents and to improve self-care behaviors and metabolic control.
- 1998-06-30
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