日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
〒162-0801東京都新宿区山吹町358-5アカデミーセンター Japanese Society of Pediatric Cardiology and Cardiac Surgery Academy Center, 358-5 Yamabuki-cho, Shinju-ku, Tokyo 162-0801, Japan
Pediatric Cardiology and Cardiac Surgery 31(1-2): 52-60 (2015)
doi:10.9794/jspccs.31.52

原著Original

小,中学生の先天性心疾患患児の疾患理解患児の「年齢」と疾患の「重症度」による疾患理解の比較―Disease Understanding in Primary and Junior High School-Aged Children with Congenital Heart Disease according to Age and Severity

1東京学芸大学大学院連合学校教育学研究科The United Graduate School of Education, Tokyo Gakugei University ◇ 〒184-8501 東京都小金井市貫井北町4-1-14-1-1 Nukuikita-machi, Koganei-shi, Tokyo 184-8501, Japan

2千葉県こども病院循環器科Department of Cardiology, Chiba Children’s Hospital ◇ 〒266-0007 千葉県千葉市緑区辺田町579-1579-1 Heta-cho, Midori-ku, Chiba-shi, Chiba 266-0007, Japan

3千葉大学教育学部Faculty of Education, Chiba University ◇ 〒263-8522 千葉県千葉市稲毛区弥生町1-331-33 Yayoi-cho, Inage-ku, Chiba-shi, Chiba 263-8522, Japan

受付日:2014年10月20日Received: October 20, 2014
受理日:2015年2月11日Accepted: February 11, 2015
発行日:2015年3月1日Published: March 1, 2015
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背景:成人科への移行に向けて,幼い頃から患児本人が疾患を理解することは重要であるが,患児の疾患理解についてはよく検討されていない.患児の「年齢」や疾患の「重症度」による疾患理解の特徴を比較した.

方法:A県内の小児専門病院循環器科に通院中の小学1年生から中学3年生の先天性心疾患患児28名を対象に,半構造化面接を行った.

結果:運動制限,薬の頻度・効果,感染性心内膜炎の予防の理解は,患児の「年齢」や疾患の「重症度」による差が見られなかった.しかし,病名,薬の名称,受診の理由,次回の受診日の理解では,患児の「年齢」による差が見られ,年齢が上がると共に,理解している患児が増加し,薬の管理の主体は「親」から「患児」へと移行していた.心臓の欠陥の理解では,疾患の「重症度」による差が見られ,軽度の患児の方が具体的に理解していた.

結論:医療者は,患児に疾患説明を行う際,認知的な発達段階や疾患の構造の複雑さを考慮して説明を行うことが重要である.

Background: For the transition to adult health care, it is important that children with congenital heart disease (CHD) understand their disease. However, disease understanding in children has not been well documented. This study evaluated the ability of children with CHD to understand their disease according to patient age and disease severity.

Methods: A total of 28 children in grades 1–9 who received treatment at a pediatric cardiology department participated in semi-structured interviews.

Results: No differences according to age or severity were observed in children’s knowledge of “limitation of exercise,” “medication frequency,” “medication effect,” and “prevention of infective endocarditis.” However, understanding of “disease name,” “medication name,” “reason for consultation,” “next consultation date,” and “self-management of medication” increased with age. “Cardiac defect” was specifically understood best by patients with mild symptoms.

Conclusion: The results suggest that care providers should explain the disease to children with CHD while considering cognitive development and disease complexity.

Key words: cognitive development; disease understanding; transition preparation

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This page was last modified on 2015-03-23T22:33:59.339+09:00


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