Study on medical care for children at the general schools

Research Project

Project/Area Number	17K12548
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Community health nursing
Research Institution	Tokai University
Principal Investigator	ISHIHARA Takako 東海大学, 医学部, 講師 (70580851)
Co-Investigator(Kenkyū-buntansha)	岡部明子東海大学, 医学部, 准教授 (90287053)
Project Period (FY)	2017-04-01 – 2020-03-31
Project Status	Completed (Fiscal Year 2019)
Budget Amount *help	¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000) Fiscal Year 2019: ¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000) Fiscal Year 2018: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000) Fiscal Year 2017: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Keywords	医療的ケア児 / 通常学校 / 就学判断 / 看護師配置 / 教育医療連携 / 医療的ケア / 看護職 / 教育関係者 / 保護者 / 訪問看護 / 在宅療養児 / ノーマライゼーション
Outline of Final Research Achievements	When a medical care child enters a regular school, the Board of Education decided that the main decision to enter a school was based on the condition of the child, the strong desires of parents, and the understanding of the applicable elementary school principal. The principal accepted with equal opportunity for learning, separation of mother and child, and support for independence. The homeroom teacher worked closely with the surroundings and prepared a learning environment like other children, but also had concerns about medical practices and anxiety about safety. Although it is desirable to assign nurses, problems such as difficulty in securing human resources, unstable working environment, difficulty in cooperation, and one-person system were also found. The placement of nurses freed parents from attending and continued their work. It was confirmed that the children with medical care could promote age-appropriate development by interacting with the teacher and other children.
Academic Significance and Societal Importance of the Research Achievements	日常的に医療的ケアを要する状態で在宅療養を継続する児童も、地域の他の児童と同様に、その地域の通常学校に通学することが可能となった。障害があるからといって一律に訪問教育や特別支援学校就学を決定するのではなく、教育的視点を主眼に置いて当該児童や保護者に向き合っている教育者の認識・判断・行動が明らかになった。学校で医療的ケアを担当する看護師もケアだけ行っているのではなく、教育的な配慮を重視していることも明らかとなり、教育現場における医療のあり方を示唆している。障害を持った子どもが親と離れ、自立に向けた成長発達をすることも浮かび上がり、親もまた、就労継続や自身の人生を歩むことにつながっている。