Development of a nursing support model to foster socialization and autonomy in children with medical complexity and its effectiveness

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K24176
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund
• Review Section: 0908:Society medicine, nursing, and related fields
• Research Institution: Tokyo Medical University
• Principal Investigator: Suzuki Seigo 東京医科大学, 医学部, 助教 (10847825)
• Project Period (FY): 2019-08-30 – 2023-03-31
• Keywords: 医療的ケア / 健康関連QOL / レスパイトケア / 小児看護 / 家族看護 / 在宅ケア

Outline of Final Research Achievements

A survey of parents through medical child development support facilities nationwide was conducted using a health-related quality of life scale for children. The results showed that for preschool-aged children with medical complexity, being able to go to daycare centers and child development support and other daycare facilities without a guardian's escort was associated with improvements in the overall health-related quality of life and the sub-domain on friendships for children with medical complexity.
In addition, a nursing support program was developed for school-aged children with medical complexity receive medical care from nurses in general education schools and to attend school without a parental chaperone. When piloted in one general education high school, the program showed a trend toward higher health-related quality of life scores on peer relationships for children with medical complexity.

Free Research Field

小児看護学

Academic Significance and Societal Importance of the Research Achievements

就学前の医療的ケア児にとって、保育所や通所施設といった日中の居場所において、看護師からケアを受けながら通所できることが医療的ケア児の健康関連QOL、特にこども同士の関係性に影響することを定量的に示した。これは保育所や通所施設での看護師配置を促進する行政施策の必要性を裏付ける根拠になり得る。
また、常勤看護師のいない通常の高等学校に導入した看護師によるケアが、医療的ケア児の仲間関係に関する健康関連QOLへ影響することが示唆された。医療的ケア支援体制が比較的整いつつある特別支援学校だけでなく、通常の学校においても、保護者の付き添いではなく看護師によるケアによって通学できる体制を整備する意義を示した。