Development of "assessment tool" for visiting nurses to identify abuse of children with severe physical and mental disabilities at home

Research Project

Project/Area Number	18K10651
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 58080:Gerontological nursing and community health nursing-related
Research Institution	Teikyo Heisei University
Principal Investigator	Nishi Rubiko 帝京平成大学, ヒューマンケア学部, 准教授 (20526131)
Co-Investigator(Kenkyū-buntansha)	益田育子帝京平成大学, ヒューマンケア学部, 教授 (60464781) 荒木田美香子川崎市立看護短期大学, その他部局等, 教授 (50303558)
Project Period (FY)	2018-04-01 – 2021-03-31
Project Status	Completed (Fiscal Year 2020)
Budget Amount *help	¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000) Fiscal Year 2020: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000) Fiscal Year 2019: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000) Fiscal Year 2018: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
Keywords	在宅重症心身障害児 / 被虐待 / 訪問看護師 / 指標 / 重症心身障害児 / 被虐待の指標 / 在宅 / アセスメントツール
Outline of Final Research Achievements	We have developed an "index of awareness of abuse" for visiting nurses to recognize the abuse of children with severe physical and mental disabilities at home. We confirmed its validity and reliability. The index consisted of 38 scenes of abuse in short sentences. To determine its validity, we conducted a Delphi survey of visiting nurses who had experience in dealing with abuse nationwide. As a result, more than 70% agreed on the validity of all index items. The reliability was investigated in two groups, 9 experienced visiting nurses and 9 inexperienced visiting nurses. I had them watch the abuse video (self-made). At that time, we used indicators to confirm the awareness of abuse, the presence or absence of cognition, and the degree of cognition, and examined the concordance rate. The concordance rate for awareness and cognition was 100-82.2%. It was confirmed that even inexperienced visiting nurses can recognize abuse by using the indicators.
Academic Significance and Societal Importance of the Research Achievements	本研究の協力者は、被虐待対応経験のある全国の訪問看護師で、1人が約1.8人の被虐待児の対応を経験していた。在宅重症児の「被虐待気づきの指標」は、これらの経験豊富な訪問看護師の意見を集約し、妥当性が検討され完成に至った。この指標は、被虐待対応の経験の有無にかかわらず、被虐待場面への気づき・認知の一致率も確認した。被虐待場面は、模擬被虐待児家庭（DVD）を作成した。今後は、実際の訪問において「被虐待気づきの指標」を活用することにより、被虐待の早期発見及び在宅重症児と母親等の満たされない欲求や苦しみに対する早期対応につながることが期待される。