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Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.12001/21372

 
Title :沖縄県における10代母親の現状とハイリスク者の特定
Title alternative :The Current Situation of Teenage Mothers and Measures to Identify High-Risk Individuals in Okinawa
Authors :賀数, いづみ
前田, 和子
西平, 朋子
Authors alternative :Kakazu, Izumi
Maeda, Kazuko
Nishihira, Tomoko
Issue Date :Mar-2015
Publisher :沖縄県立看護大学
Type Local :紀要論文
Type (NII) :Departmental Bulletin Paper
ISSN :1345-5133
Abstract :【目的】2010年に出産した沖縄県内の10代母親の身体的・社会経済的状態などの実態を把握するとともに、優先的に看 護支援すべきハイリスク者を特定するために参考となる指標を見つけることであった。 【方法】沖縄県内の出産を扱う産科医療機関全数34施設の産科病棟師長ら34名を対象に郵送による自記式質問紙調査を 行った。 【結果】20施設20名(回収率58.8%)の回答から2010年の10代母親185人のデータを得た。これは本県の10代母親総 数439人の約42%であった。平均出産年齢は18.0歳(土1.1)、夫・パートナーの平均年齢20.9歳(土4.1)、婚姻率50% で、「どちらかの実家に同居」48%、「核家族」34%であった。本人の65%が「無職」で、夫・パートナーの63%が 「有職」であった。本人またはパートナーが婚姻年齢に達していないカップルは18組であった。10代母親の初診は、妊 娠11週以内57%で、県内の妊娠届け出の11週以内85%に比べかなり低く、20週以降の初診も18%で遅い者が明らかに 多かった。また、妊娠中の異常は7割を超え、沖縄県の妊婦一般健康診査受診者の有所見率42%に比べ高率であり、貧 血や切迫早産、早産・低出生体重児の出生割合も高かった。新生児異常は17歳以上に比べ15・16歳の母親は有意に高 かった(X^2=10.335, Φニ1, p=O.OOl)。退院後1か月の来院者は99%であった。リスク者判別の指標は重回帰分析の結 果「夫・パートナーのクラス参加」、「本人の就業」、「夫・パートナーの就業」、「10代母親家族の受け入れ」の4変数 の組み合わせで最も高い決定係数R^2=0.487が得られた。 【結論】10代母親は成人母親と比べ、医学的有所見率が高く保健行動にも問題があることがわかった。また、彼女らの 社会経済的状況、医学的所見は多様なので出産年齢だけでは支援の必要性を判断できないこと、10代母親の否定的側 面だけでなく肯定的側面にも目を向ける必要のあること、彼らの特徴を理解し個別性を考慮した看護支援が求められ ることが示唆された。ハイリスク者の特定に有用な指標として社会経済的な4変数を特定できたが、これも含めて沖 縄県の10代母親に関する更なる調査が必要である。
Rights :沖縄県立看護大学
URI :http://hdl.handle.net/20.500.12001/21372
Comment :Objective : To establish an index that can identify high-risk individuals who preferentially need support and to improve nursing support at obstetrics facilities in Okinawa. Method: We conducted a mail-based survey of 34 head nurses who were working for maternity wards at 34 facilities in Okinawa. Result : We collected and analyzed 20 responses (response rate: 58.8%), which detailed 185 relevant cases of teenage deliveries. This represented 42% of the total of 439 teenage mothers in Okinawa. The mean age of the mothers was 18 (±1.1)years and that of their husbands/partners was 20.9 (±4.1) years. The marriage rate was 50%; 48.4% lived with their husband or with the husbands' parent(s); and nuclear families accounted for 34%. In regard to employment, 65% of mothers were not employed while 63% of their partners were employed. Eighteen couples-either one or both-had not reached the legal age for marriage. Only 57% of them received the first antenatal examination within 11 weeks of pregnancy; this was significantly lower than the average rate in Okinawa (85%). Moreover, 18% of teenage mothers received the examination after 20 weeks of pregnancy. Over 70% of them experienced an abnormal pregnancy, which is much higher than the general abnormal pregnancy rate (42%) among those who were examined in Okinawa. The results indicated that teenage mothers experience high rates of anemia, (threatened) premature delivery, and low birth weight. The neonatal abnormality rate among younger mothers with ages between 15 and 16 is significantly higher than that among 17-year-old mothers (X^2=10.335, Φ=1, p=0.001). It was noted that 99% of mothers returned to the medical facilities within 1 month of discharge. Multiple linear regression analysis revealed that the indices of high-risk individuals include "partners' participation in maternity class," "employment status of teenage mothers," "employment status of partners," and "acceptance by teenage mother's family." The combination of these four variables reached the highest coefficient of determination: R^2=0.487. Conclusion : The rate of positive medical findings among teenage mothers was higher than that of adult mothers, and their health behaviors also need to be improved. Our research suggests that mother's age is not the sole determinant of the need for support since socio-economic and medical conditions vary among teenage mothers. It is necessary to direct our attention to the positive aspects of teenage pregnancy, and to understand and provide nursing support targeting their specific circumstances. Our indices of four variables are useful in identifying highrisk individuals and provide the basis for future research in teenage pregnancy in Okinawa.
Citation :沖縄県立看護大学紀要 = Journal of Okinawa Prefectural College of Nursing no.16 p.49 -61
Appears in Collections:Journal of Okinawa Prefectural College of Nursing

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