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原 著 KEY WORDSchild with severe disability, sleep-wake behavior, experimental single case study Ⅰ.はじめに QOL SCN SCN Wright Accepted : October... VOL. No..

Ⅱ. 研 究 目 的 Ⅲ. 研 究 方 法 1) 研 究 デザイン 2) 研 究 対 象 3) 睡 眠 - 覚 醒 パターンのアセスメントの 枠 組 みの 開 発 4) 客 観 的 データを 用 いた 看 護 援 助 の 目 的 と 内 容 VOL. No..

/ 5)データ 収 集 方 法 / / / Knafl 6) 看 護 援 助 の 手 順 VOL. No..

/ 7) 分 析 方 法 8) 倫 理 的 配 慮 Ⅳ. 結 果 1) 対 象 の 概 要 AC 2) 個 別 分 析 の 結 果 BA GER / C (1)ケースBの 個 別 分 析 B B VOL. No..

B VOL. No..

.. (2)ケースAの 個 別 分 析 の 概 要 A (3)ケースCの 個 別 分 析 の 概 要 C VOL. No..

3) 全 体 分 析 の 結 果 AB B BCC / ABC AB C AB CA / C Ⅴ. 考 察 1 ) 重 度 の 障 害 をもつ 乳 幼 児 の 睡 眠 - 覚 醒 パターンの 問 題 の 複 雑 さと 援 助 の 意 義 2 ) 睡 眠 - 覚 醒 パターンのアセスメントの 枠 組 みの 妥 当 性 3) 客 観 的 データを 用 いた 援 助 の 有 用 性 VOL. No..

Ⅵ. 結 論 / Ⅶ.おわりに 引 用 文 献. Kohrman MH, Carney PR. Sleep-related disorders in neurologic disease during childhood. Pediatr Neurol. :,. Phillips L, Appleton RE. Systematic review of melatonin treatment in children with neurodevelopmental disabilities and sleep impairment. Dev Med Child Neurol. :,.. Rivkees SA. Developing Circadian Rhythmicity in Infants. Pediatrics. :,. Holditch-Davis D, Brandon DH, Schwartz T. Development of behaviors in preterm infants: Relation to sleeping and waking. Nursing Research. :,. Jones MW, Morgan E, Shelton JE. Primary care of the child with cerebral palsy: A review of systems part II. J Pediatr Health Care. :,.. Wright M, Tancredi A, Yundt B, Larin HM. Sleep issues in children with physical disabilities and their families. Phys Occup Ther Pediatr. :,. SINGLE-CASE RESEARCH DESIGNS D. H. M. SINGLE CASE EXPERIMENTAL DESIGNS; Strategies for Studying Behavior Change P. D. H. M. SINGLE CASE EXPERIMENTAL DESIGNS; Strategies for Studying Behavior Change. Knafl KA, Deatrick JA. Further refinement of the family management style framework. Journal of Family Nursing. :,. meta-study :. VOL. No..

USABILITY OF NURSING INTERVENTION INCORPORATING OBJECTIVE DATA FROM SLEEPWAKE BEHAVIOR ASSESSMENT IN ORDER TO IMPROVE DAILY CARE FOR INFANTS WITH SEVERE DISABILITY Maho Ichihara Chiba Rehabilitation Center KEY WORDS : child with severe disability, sleep-wake behavior, experimental single case study The purpose of this study was to evaluate the usability of an innovative nursing intervention incorporating objective data from sleep-wake behavior assessment in order to improve family membersdaily care for infants with severe disability. Using longitudinal and single case experimental designs, we analyzed infants with severe disability and sleep problems in their homes. Data were collected from video recordings, oxygen saturation recordings, sleep diaries, and semi-structured interviews with family members. Nursing intervention focusing on improving family membersdaily care was provided acording to the following three steps. First, individual sleep problems were assessed using an original sleep-wake behavior assessment tool. Second, characteristic components were extracted from objective data. Finally, nursing intervention sessions explaining the appropriate care for the childs sleep problems using the individual characteristic components were conducted by an Advanced Practice Nurse who was the researcher. Additional assessment and intervention sessions were conducted during the subsequent -month period and individual target behaviors were measured longitudinally. As a result of the intervention, all children improved their sleep-wake behavior. Each child had symptoms of central nervous system impairment that disturbed their sleep due to symptom intensification. However, the family members did not realize the actual cause of the sleep problems; therefore, the intervention was important because it gave the family members a deep understanding of the childrens needs. We conclude that promoting family awareness of the childs symptoms and distress allowed the family to provide appropriate care for the child. These results demonstrate the usability of this nursing intervention that incorporates objective data from an original sleep-wake behavior assessment. VOL. No..