J. Jpn. Acad. Midwif., Vol. 6, No., -, 0 資 料 産後 3 4 か月の母親の母親役割獲得と妊娠中における 産後の身体的変化へのイメージや 産後の生活 育児に対する夫婦間調整との関連性 Acquisition of maternal roles by mothers three to four months after childbirth, their antenatal assumptions regarding their postpartum physical changes, and relationship between these factors and adjustment with their husbands regarding postpartum life and child rearing Akemi NAKAGAKI Asako CHIBA 抄 録 目的 34 方法 346 3434 996 33.50 結果 3.0SD4.0.030.0 p=.049, p=.06p=.035 p=.036p=.00 p=.06, Aichi Medical University College of Nursing Mie Chuo School of Nursing, National Mie Chuo Hospital 090 J. Jpn. Acad. Midwif., Vol. 6, No., 0
結論 キーワード :34 Abstract Purpose Based on a questionnaire survey to mothers three to four months after childbirth, we examined how mothers acquire maternal roles, perceive a gap between their antenatal assumptions regarding their postpartum life, physical changes and child rearing and their actual postpartum conditions, and we identified other related factors, considering the measures to be introduced during pregnancy to support acquisition of maternal roles. Methods The study was conducted on mothers three to four months after childbirth, timing when mothers are considered increasingly eager to acquire maternal roles, and to gradually become relieved of the postpartum anxieties. A questionnaire sheet requesting anonymous, handwritten responses, was sent to 34 mothers, who had participated in checkups for infants aged three to four months, which were conducted at six health facilities in two cities. The responses were collected by post from 3 mothers (collection rate: 3.5%). After excluding invalid responses, the responses from 0 mothers were analyzed in this research. Results The mean age of enrolled respondents was 3.0 years (SD: 4.0), and those mothers comprised primiparous women (.0%) and 30 multiparous women (.0%). The primiparous women had no clear assumptions about the postpartum wound pains and breast pains. Even if they had any assumptions, they perceived that the actual postpartum pains were greater than their antenatal assumptions. Positive correlations were found between afterpains greater than antenatal assumptions and negative acceptance of the maternal roles, between anal prolapse milder than antenatal assumptions and positive acceptance, and between severe fatigues and/or afterpains and heavy perceived loads of child rearing. Adjustment with husbands regarding child rearing positively correlated with positive acceptance. Adjustment in other aspects of life did not correlate with acquisition of maternal roles. Positive correlations were found between positive acceptance of maternal roles and satisfaction with childbirth, and between negative acceptance and heavy loads of housework and child rearing. Conclusion We clarified that the difficulties in acceptance of maternal roles correlated with a gap between the antenatal assumptions of the mothers regarding their postpartum physical changes and their actual postpartum conditions, particularly when the actual pains and loads were greater than their antenatal assumptions. A positive correlation was found between adjustment with husbands during pregnancy regarding child rearing and acceptance of maternal roles. These findings suggested the necessity for introducing supporting measures during pregnancy, such as filling the gaps in the mothers' assumptions. Key words: Maternal roles, antenatal education, checkups for infants aged three to four months, satisfaction with childbirth, support to pregnant women Ⅰ. 緒言 Rubin, 94/99, p.46-6 003George 005 6 0
34 003 4 Mercer, 95 maternal role attainment Becoming a Mother Mercer, 004 005a, b 006 00 3 004a 004b 000 3 006 00 00 34 Ⅱ. 研究方法. 調査対象 634 343 3.50 6. 研究方法, 研究期間 3 3. 用語の定義 Mercer, 95 4. 調査項目 996 6 6 4 J. Jpn. Acad. Midwif., Vol. 6, No., 0 3
005 4005003 00 3 00 3 3 00 00 4 00 00 003 003004 0033 005 5. 分析方法 SPSS Statistics ver.0 for Windows IBM 表 Fisher Kruskal Wallis tspearman 5p 6. 倫理的配慮 6 Ⅲ. 結果. 対象者の属性 3.0SD4.0.0 3.3SD4.0 30.0 33.9SD3.4 99. 9.60.0 p=.00 対象の属性 項 目 人数 % n= n=30 30 96 9 3 6 36 35 3.0.0 9..4.9 9. 60.0.3. 6.5 4.3 33. 3.. 6.5 =.00 Fisherp.05p 4 6 0
34.3 36 33.64.3 353. 439.. 役割獲得の状況 Cronbachα.0.6 9.3SD3.0.0SD.5.4SD.9.SD3.0 3. 産後の身体的変化のイメージの有無と実際 p=.006p=.03 p=.00 5..5.4 9. 4. 関連要因の状況..6.SD.0 4.0SD3.04.SD.9 3.5SD.4.SD.4 p=.00 p=.00p=.00p=.00 p=.044p=.04p=.034 p=.005p=.09 p=.033p=.03 50 64.9963.3 3.43.3 9.4. 3.0SD.5.SD. p=.009 p=.045 5. 産後の身体的イメージと役割受容および関連要因 3 p=.04 表 初経別の産後の身体的変化のイメージの有無と実際イメージの有無 イメージしなかった イメージした ) 実際は検定なかった イメージした場合の実際の状況 イメージより軽い イメージと同じ イメージより辛い 人数 % 人数 % 人数 % 人数 % 人数 % 人数 % 0 9 0 46 3 3 6.3 3.4 40..6.6. 66. 60. 5. 4.9 5.4.4 54 4 50 6 3 34 6 36 3.0 96.6 59..4.4 9.9 33.3 39.3 4. 5. 4.6.6 Fisher: not significant p=.0 p=.033 p=.0 0 4 9 6 4.9 0.0 6. 4. 4. 5.4 39...6 6.3.4 9. 3 5 5 0 3 4 6 9 34.0 46.4 35. 3. 4.5 3.5 3.0 36.4 3.5 3.5 5. 36.4 5 0 9 4 0.6.6.9 3. 4.3 3.5 4.3. 6.5 50.0.4 45.5 4 9 3 4.5 5.0 33.3 33.3 5.. 39..3 3.4 6.3 5.4 9. J. Jpn. Acad. Midwif., Vol. 6, No., 0 5
図 初経別における妊娠中の相談者の回答割合の比較 ( 複数回答 ) Fisherp.05 図 初経別における現在の相談者の回答割合の比較 ( 複数回答 ) Fisherp.05 図 3 初経別の乳児の心配ごとの回答割合の比較 ( 複数回答 ) Fisherp.05 6 6 0
34 表 3 産後の身体的変化のイメージと役割受容の関連 役割受容 身体的変化 イメージの有無 ( 実際の状況 a ) 肯定的受容 否定的受容 n 平均 SD 検定 n 平均 SD 検定 9 0..6 0 0.9.3 5 9. 3. 5..9 34.. 33.4 3. 3 9.0. 3 0.. 43 0. 3.0 45.3. p=.06 9 9.0 3.. 3.3 5 9. 3.5 5.4 3. 45 9.6. 4.5 3.0 34 9.5 3.0 33.. 55 9. 3. 56..9 34 0.6.9 p=.049 34.3.9 5.5. 5 3. 3.0 43 9.6 3.0 44.0 3. 45 9. 3. 45.0.9 6 9.9 3. 6.4. 43 9.6 3.0 44.0 3. 45 9. 3. 45.0.9 6 9.9 3. 6.4. a Kruskal-Wallisnot significantsd p=.06 6. 妊娠中の家事 育児の調整と役割受容および関連要因 4 t0=.6, p=.035t0=.6, p=.036t 0=.633, p=.003 t0=., p=0.. 役割受容と出産満足度, 家事 育児の負担感, 心配ごと等の相関 5 r=0.50 r=-0.35 r=0.45 r=0.4 r=0.4 r=0.66 p=.0p=.00p=.033 p=.033 p=.06 Ⅳ. 考察 34 00 J. Jpn. Acad. Midwif., Vol. 6, No., 0
表 4 妊娠中の家事 育児の調整の有無と役割受容の関連 役割受容 生活育児項目 調整の有無 肯定的受容 否定的受容 n 平均 SD 検定 n 平均 SD 検定 4 9.. 49..5 56 9.3 3.3 56. 3.3 56 9.9. 56.5.9 4 9.0 3. 49.4 3.0 60 9.5 3. 60.0 3.0 44 9.5.9 45 0.. p=.0 49 9. 3. 50. 3.0 55 9.3.9 55.4.9 50 9.9.9 5.3. 54 9. 3. 54.6 3. 49 0.. 49.4. 55.9 3. p=.035 56.6 3. 49 0..9 4.. 55.9 3.0 p=.036 5. 3. 5 0.. 56..9 4. 3. p=.00 49. 3.0 49 0. 3.0 49.0. 55 9.0 3.0 56.0 3. SDnot significant 表 5 役割受容とその他の要因との関連性 肯定的受容否的的受容出産満足度家事負担育児負担児の心配数 妊娠期の相談者数 現在の相談者数.459.50.5.33.5.4.006.35.45.46.69..0.4.6..09.05.4.6.009.004.6.04..055.0.4.66 Spearmanp.0p.05 Rubin 94/99, p.4-44 George005 Rubin94/99, p. 6 0
J. Jpn. Acad. Midwif., Vol. 6, No., 0 34 9 004b 006 009 4 00 00 9. 003 00
本研究の限界と今後の課題 6 Ⅴ. 結論 謝辞 文献 00 69(6)49-55. 00 4(6)44-455. 003 6-4. George. L (005). Lack of Preparedness Experience of First-Time Mother, The American Journal of Maternal/ Child Nursing. 30(4)5-55. 0054 ()5-5. 00 4()40-5. 003 9-30. 00 4(4)49-4. 003 5-6. 003-5. 00 Grounded Theory Approach 5-6. Rubin. R (94)99 46-64- 44. 005a 5()3-3. 005b 5()3-45. 006 4()43-5. 006 4() 4-4. Mercer, R.T. (95). The process of maternal role attainment over the first year. Nursing Reserch, 34, 9-04. Mercer, R.T. (004). Becoming a Mother Versus Maternal Role Attainment. Journal of Nursing Scholarship, 36(3), 6-3. 004a 9-. 0 6 0
34 004bReve Rubin 3-3. 00.5 355-0. 00 33(5)45-53. 996 3-34. 000 6()4-3. 006 () 50-5. 003 0 6(4)56-60. 00 4(4)5-59. 0094 3() 5-60. 00335 300-. 005 69-. 0056 3 64(6)5-59. 00 4()934-93. J. Jpn. Acad. Midwif., Vol. 6, No., 0