出産場所選択要因に関する研究

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出産場所選択要因と出産場所の評価，ならびに出産の満足度を明らかにし，産科領域の医療者に求められることについて考察することを目的に，乳児の母親92名を対象に無記名自記式質問紙調査を行い，以下の結果を得た． 1 ．今回の出産場所選択要因として最も優先されていたものは，「経験・他者の評価」であった． 2 ．全体で 9 割以上が出産場所を肯定的に評価していた．総合病院出産群に比して産婦人科単科の病院・診療所出産群では出産場所の評価にばらつきがみられた． 3 ．出産満足度得点の平均値は助産所，産婦人科単科の病院・診療所，総合病院の順に高かった．この得点も総合病院出産群に比して産婦人科単科の病院・診療所群ではばらつきがみられた． 4 ．全体で 7 割強の者が次回も同じ施設での出産を希望していた． 5 ．次回の出産場所選択要因として最も優先されていたものは「医療者に対する評価」であった． 6 ．産科領域の医療者に対する意見・感想・要望についての自由記述回答を分析した結果，「信頼関係」「ケアの質」「医療者の姿勢」「不安の軽減・精神的ケア」「インフォームド・コンセント」「ケアシステム・体制」「産婦の主体性の尊重」「育児不安の軽減」と「設備・一般サービス改善への偏向に対する批判」「医療介入化された出産への嫌悪」の 10 サブカテゴリー，「医療者への要望」と「出産のあり方」の 2 カテゴリーに分類された．「医療者の姿勢」に関するものが最も多かった．　以上より，産科領域の医療者が施設・設備や一般サービス面の向上のみに偏向することなく，ケアの質の向上やそれを提供するシステムの構築，温かいケアの姿勢を持つ医療者の育成をも共に追及していくことの重要性が示唆された．　In order to (a) determine what factors influence womens choice of birthing institution, (b) evaluate their satisfaction with the institutions, and (c) explore what obstetric care services are required, we asked 92 mothers of infants to complete an anonymous self-administered questionnaire. We found the following:・Respondents stated that own experience and recommendations from others were the most important factors in their selection of a birthing site.・More than 90% of respondents had a positive opinion of the institution where their baby was delivered. Opinions varied more for specialized hospitals and clinics of obstetrics and gynecology than for departments of obstetrics and gynecology at general hospitals.・The mean satisfaction score was highest for birthing centers, followed by specialized hospitals and clinics of obstetrics and gynecology, and then departments of obstetrics and gynecology at general hospitals. Again, the satisfaction scores varied more for specialized institutions than for departments at general hospitals.・In total, more than 70% of respondents indicated that they would choose the same institution again if they were to have another baby. ・Respondents gave the highest priority to reputation of obstetric care providers in selecting birthing sites in the future.・Analysis of respondents responses to a free-answer question regarding their opinions on and requests to obstetric care professionals revealed two categories of factors that influence the choice of birthing site: requests to health-care professionals and maternity issues. These categories were subdivided into the following ten subcategories: reliable relationships, quality of care, attitudes of care professionals, relief of anxiety and mental health care, informed consent, care service systems, respect for the wishes of expecting mothers, relief of parenting stress and anxiety, criticism of excessive focus on improvements in facilities and non-medical services, and disgust for medicalized childbirth. The majority of opinions and requests were classified into the subcategory of attitudes of care professionals.　These results indicate that it is important for obstetric care professionals to pursue improvements in quality of care, and to establish systems for doing so, as well as encouraging caring attitudes by health care staff, without focusing excessively on improvements in facilities and non-medical services.
三重大学医学部看護学科の論文
2006-03-20

著者

杉浦絹子
三重大学医学部看護学科

出産場所選択要因に関する研究

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