Misc - KONNO Miki

小児科外来患児の母親・家族の喫煙状況―家庭内受動喫煙防止にむけた看護援助の為の予備調査―

今野美紀, 丸光恵, 宇加江進

日本小児保健学会講演集   50th   272 - 273  2003.10

J-GLOBAL

在宅療養中の子どもをもつ家族へのボランティア活動によるレスパイトケア

木原キヨ子, 丸山知子, 今野美紀, 杉山厚子, 石塚百合子, 吉田安子

札幌医科大学保健医療学部紀要 ( Sapporo Medical University )  ( 6 ) 79 - 86  2003.03

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本研究は、慢性疾患で在宅療養を要する子どもをもつ家族支援体制を組織することを目的に行った。支援体制の組織化には、レスパイトケアモデルの概念を基に検討し、有資格の看護職者によるボランティア活動が有効と考えた。その考えに基づきボランティア育成プログラムを作成し、学習会を開催した。この学習会の内容は、在宅療養中の子どもの日常生活の援助、医療的ケアを提供する直接的支援について特に、養育者である母親の利益につながるレスパイトケアの意義を強調した。そして、学習プログラムの一環としてボランティア活動を実践した。ボランティア利用ケースの反応は、ボランティアが看護師なので子どもの症状の把握と対応は安心してまかせられる、今後も利用を希望するという肯定的な意見が多かった。ボランティア体験後の看護師は、専門性が求められる重要な活動であると認識できた等、ボランティアの試行によりレスパイトケアの意義と継続の必要性が示唆された。今後、本研究のボランティア活動は、子育て支援グループや他のボランティア活動とのネットワークづくりを行うことによって発展させてゆきたいと考える。This study was conducted to organize a support system for the family with a child who needed home care due to his/her chronic disease. We studied the possibility of applying the concept of a respite care model for organizing the support system and considered that volunteer activity by qualified nurses might be effective. Based upon the idea, we prepared a volunteer development program and held a seminar. The seminar focused upon support to the activities of daily living and direct support in which medical care would be provided to a child who was cared at home. Particularly, it emphasized the significance of respite care that would be to the benefit of his/her mother who was the primary care provider. As part of the studying program, its participants practiced volunteer activity. Responses from people who used the service of volunteer activity were mostly positive. That is, they wanted to receive the service because they felt that they were able to leave their children in the care of the volunteer with a sense of security in that the volunteer was a nurse who understood the child's symptoms and could provide proper care. The nurse, after having experienced the volunteer activity, mentioned that she/he recognized that the activity, which required professional knowledge and skills, was indeed important. Thus, this trial indicated the significance and necessity of respite care. We intend to develop the volunteer activity tried in this study in the future through buildinga network with childcare support groups and other volunteer activities.

DOI CiNii J-GLOBAL

慢性疾患患児への喫煙に関する教育的介入の試み

今野美紀, 丸光恵, 綿谷靖彦

日本小児保健学会講演集   49th   528 - 529  2002.10

J-GLOBAL

1型糖尿病の年少児・発症後間もない児と家族を対象としたファミリーキャンプの活動と看護師の役割

中村伸枝, 兼松百合子, 出野慶子, 徳田友, 内田雅代, 今野美紀, 谷洋江, 宮本茂樹

日本糖尿病教育・看護学会誌   6 ( 2 ) 141 - 146  2002.09

DOI J-GLOBAL

BODY FATNESS AND INFLUENCE FACTORS OF TYPE1 DIABETES MELLITUS IN CHILDREN AND ADOLESCENT, AND SELF AWARENESS OF THEIR BODY WEIGHT

中村 伸枝, 出野 慶子, 徳田 友, 今野 美紀, 兼松 百合子, Nakamura Nobue, Ideno Keiko, Tokuda Tomo, Konnno Miki, Kanematsu Yuriko, ナカムラ ノブエ, イデノ ケイコ, トクダ トモ, コンノ ミキ, カネマツ ユリコ

千葉看護学会会誌 ( 千葉看護学会 )  7 ( 1 ) 1 - 6  2001.06

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本研究の目的は,(1)小児糖尿病患者の肥満度と,体脂肪,年齢,性別,血糖コントロール,インスリン量,療養行動の関連について明らかにする,(2)小児糖尿病患者自身の体重についてのとらえ方を明らかにすることである。小児糖尿病外来を受診中の10歳以上の1型小児糖尿病患者のうち,承諾が得られた10〜24才の53名(男子22名,女子31名)を対象に,療養行動質問紙,理想体重,体重が気になるか,体重測定頻度についての自記式質問紙調査と,面接調査,身長・体重・体脂肪測定を行った。その結果,肥満度の平均は4.9±12.1%であり,肥満度10〜20%未満は9名(17.0%),肥満度20%以上は5名(9.4%)であった。肥満度と体脂肪には相関がみられ,肥満度の低い者は,運動をよく行い,身体活動に合わせて間食の時間を決めていた。血糖コントロールを3群に分けて比較した結果,血糖コントロールが不良(HbA1c9.0%以上)の者は,平均肥満度が高く,体重あたりのインスリン量が多かった。女子は男子より血糖コントロールが同じ群でも肥満度の高い傾向がみられた。女子は男子より体重が気になる者が多く,現在の体重より平均5.6kgやせたいと回答した。男子は,筋肉をつけ体型を維持したいと考える者がいる一方で,体重に関心がうすい者も多かった。自分の体重が増加する原因を,生活と結びつけてとらえ整えている者は,血糖コントロールが良好で体重も適正であった。患者の体重についてのとらえ方を把握した上で,性差,年齢差を考慮し,インスリン不足になることなく徐々に理想体重に導く看護援助の方向性が示唆された。This study examined the relationship between body fatness and body fat, age, sex, blood glucose control, insulin dose, and self-care behavior behavior in type 1 diabetes mellitus in children and adolescents, and also investigated the patient's self awareness of their own body weight. Informed consent was obtained from 53 diabetic patients (22 boys and 31 girls, 10～24 years old) who were being followed in the pediatric diabetic clinic. The subjects completed a diabetic self-care behaviors questionnaire, and participated in an interview involving self awareness of their own body weight, and then their height, body weight and body fat were measured. The results were as follows. The average body fatness was 4.9±12.1%, and 9 patients had a body fatness level of 10～20%. In 5 patients, the body fatness level exceeded 20%. A correlation was observed between body fatness and body fat. Patients in whom body fatness was low often had decided a time for exercise and between-meal snacks with respect to physical activities. Poor control patients had high average body fatness, and the insulin dose was high in relation to body weight. Girls tended to exhibit higher body fatness than boys, even under equal blood glucose control conditions. Girls and boys thought quite differently about body weight, and girls wanted to become an average of 5.6kg thinner compared to their present body weight. Boys, on the other hand, thought that body weight added muscle and wanted to maintain their physique. Some boys had almost no awareness or interest in body weight. Patients who understood that body weight was linked with life style, and arranged their life style accordingly, showed good blood glucose control and proper body weight. Nursing intervention is therefore needed to help patients understand their role in body weight control, considering differences in sex and age, and to gradually lead patients to a proper body weight without them experiencing insulin insufficiency.

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Discussion held within the Department of Nursing, School of Health Sciences, Sapporo Medical University, regarding guidelines for technical terms and learning objectives for a course in "nursing process".

Horiguchi Masami, Konno Miki, Kiguchi Sachiko

Bulletin of School of Health Sciences, Sapporo Medical University ( Sapporo Medical University )  ( 4 ) 113 - 119  2001.03

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平成12年度カリキュラム改正に際し、本学看護学科において看護過程の概念、各看護専門領域に共通する用語のガイドライン、および学年別学習目標の検討を行った。カリキュラム改正１年目ということから、看護過程を教授することのねらい、看護過程の定義と構成要素、各看護専門領域で共通する用語を中心に検討した経緯をまとめた。看護実践能力を育成するための看護教育カリキュラムにおいて、看護過程はその中心的要素のひとつである。このため看護過程の教授のねらいを、学生が看護活動の場において「看護過程」を活用できるようにするために論理的思考を育成し、対象の健康状態の理解および看護技術を提供するときに「看護過程」を活用できるようにすることとした。そして「看護過程」を論理的思考を活用しながら、看護ケアを系統的に行う方法であると定義し、その構成要素にはアセスメント、健康課題の特定、目標の設定、計画、実施、評価の６側面があるとした。また、看護過程についての用語のガイドラインを作成し、学年別学習目標を検討した。今後は実際の学習内容と比較し、今回の検討内容の妥当性を検討することが課題である。Working group on "nursing process" in the Department of Nursing, School of Health Sciences, Sapporo Medical University We held a discussion regarding guidelines for technical terms and learning objectives for a course in "nursing process" with colleagues within the Department of Nursing, School of Health Sciences, Sapporo Medical University. Topics coverd included concepts, guidelines for technical terms, and learning objectives for a course in "nursing process". The goals of teaching "nursing process" are the development of logic and critical thinking, and their practical application by nursing students. We defined "nursing process" as a systematic approach to providing care based on logic and critical thinking. The "nursing process" consists of six phases: assessment, identification of health-related tasks, the determination of objectives, planning, intervention and evaluation. It was clarified that we will need to compare this activity report with actual courses in "nursing process" going forward.

DOI CiNii

小児の生活習慣病 そのケアと指導の実際 入院時におけるケア 看護アセスメントと看護計画の立て方

今野美紀

小児看護   23 ( 3 ) 332 - 334  2000.03

J-GLOBAL

小児の生活習慣病 そのケアと指導の実際 入院時におけるケア 看護援助のすすめ方

今野美紀

小児看護   23 ( 3 ) 335 - 337  2000.03

J-GLOBAL

The rotation of insulin injection sites and lipohypertrophy at injeciton sites

NAKAMURA Nobue, IDENO Keiko, TOKUDA Tomo, KANEMATSU Yuriko, KONNO Miki

Journal of School of Nursing, Chiba University ( Chiba University )  22   63 - 67  2000.03

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本研究の目的は,(1)部位別の注射頻度と,注射部位を変えられない理由,(2)注射部位の選択と関連する要因,(3)注射部位の硬結の有無と関連する要因を調べることである.インスリン注射を行っている4才から23才の小児糖尿病患者44名を対象に,外来の待ち時間にインスリン注射の部位別の注射頻度を4段階で回答を求め,注射を打たない部位がある場合にはその理由を尋ねた.また,年齢,罹病期間,注射部位のずらし方と,注射部位の硬結の有無,硬結部位,使用中のインスリン製剤の種類と1日の注射回数,インスリン量,キャンプ経験の有無を調べた.その結果,最も注射を打つ頻度が高かったのは大腿であり,臀部は打ったことがない者が約65%を占めた.同一部位に注射することが多い理由は,やりやすさや痛くないことであった.上腕に注射を打つ頻度が高い患児は,注射部位を毎回ずらしている者が多く,腹部に打つ頻度が高い患児は,注射回数が多かった.男子より女子の方が,また,キャンプ経験者の方が,全ての部位で注射を打つ頻度が高かった.注射部位の硬結は,過去の経験を加えると,半数以上の者が経験していた.硬結の経験がある者は,中期型インスリンの量が有意に多く,硬結部位は,臀部に少なく上腕に多い傾向を示した.キャンプなどで継続的に注射部位の拡大を含む技術の見直しを行うこと,中間型インスリンや上腕への注射の指導は,注射部位のずらし方や手技などをより丁寧に行う必要があると考えられた.

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インスリン注射部位のずらし方と注射部位の硬結について

中村伸枝, 出野慶子, 徳田友, 兼松百合子, 今野美紀

千葉大学看護学部紀要   ( 22 ) 63 - 67  2000.03

J-GLOBAL

NURSING INTERVENTION TO DIABETIC CHILDREN AND THEIR PARENTS FROM THE EARLY ONSET OF IDDM

今野 美紀

千葉看護学会会誌 ( 千葉看護学会 )  5 ( 2 ) 19 - 24  1999.12

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The purposes of this study were to investigate how perceptions and feelings about diabetes self-care activities motivate actual activities among diabetic children and their parents during the first 2 years after diagnosis of Insulin Dependent Diabetes Mellitus (IDDM), and identify effective nursing interventions through the author's nursing experiences with patients and parents. The studied subjects were three child/parent pairs. The patients required hospitalization from the onset of IDDM. The results were as follows: 1. When patients had few or no negative feelings and perceived high self-efficacy about diabetes self-care activities, their actual activities were appropriate. During the early onset period parental dependent diabetes self-care activities were fairly appropriate even when parents were feeling anxious about the future and were resistant to the activities. Concerning insulin therapy, the parents found it more difficult to accept than the patients did. On the other hand, concerning diet, parents could directly assist the patients; parents accepted the value of diet before accepting insulin therapy. 2. Nursing interventions could contribute to quickly getting a good assessment of the patients' and parents' problem solving, empathizing with their perceptions and feelings, and trying to think with them about better self-care activities while paying attention to their usual coping patterns. Nursing interventions were effective in helping patients and parents to undertake effective self-care decision making.本研究の目的は,小児糖尿病患者と親の療養行動に関連する認識と感情が,患児の療養行動に及ぼす影響,及び親の関わりに及ぼす影響を縦断的に明らかにすること,患児の診断後早期から行った看護援助の有効性を検討することであった。対象は,インスリン依存型糖尿病の診断で入院した患児とその親3組であった。研究者は入院時からの記録を分析した結果,以下のことが明らかとなった。1.診断後いずれの時期においても,療養行動において患児が「自分でできる」と認識し,否定的感情がないことは,適切な実施に影響していた。診断後早期の親は,患児の発病に罪悪感をもち,患児の将来を案じ,患児をかわいそうに思うことがあったが,関わり方は概ね適切であった。親の認識や感情に肯定的変化を生じさせたのは,親が繰り返し療養行動に関わること,患児が適切に実施している様子であった。療養行動の中でもインスリン療法は,患児が自己管理することが多く,親の関わりは少ない為,親の受容は患児よりも遅れた。一方,食事療法は,親の関わりが多く,親はインスリン療法よりも早期に受容でき,各々が責任をもって実施するものには,その行動の受容が進んだ。2.診断後早期から行った看護援助は,患児と親に問題となる変化が生じた時には,問題解決へのアセスメントの視点が素早くもて,患児と親の認識や感情に共感でき,患児と親が行っている対処の仕方を尊重した上でより適切な方法を共に考えることができた。これは患児と親自身が適切な行動を選択するのに有効な看護援助であった。

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Health Habits and Self-Care Behaviors of Children with Insulin-Dependent Diabetes Mellitus in relation to Lifestyle of their Parents.

NAKAMURA NOBUE, KANEMATSU YURIKO, TAKEDA JUNKO, MARU MITSUE, MATSUOKA MARI, UCHIDA MASAYO, NINOMIYA KEIKO, KONNO MIKI, TANI HIROE

日本看護科学会誌   19 ( 3 ) 74 - 82  1999.11

DOI J-GLOBAL

インスリン依存型糖尿病幼児と親への診断後早期からの看護援助に関する研究

今野美紀, 中村伸枝

日本看護科学学会学術集会講演集   19th   112 - 113  1999.11

J-GLOBAL

Health Habits and Self-Care Behaviors of Children with Insulin-Dependent Diabetes Mellitus in relation to Lifestyle of their Parents

NAKAMURA Nobue, KANEMATSU Yuriko, TAKEDA Junko, MARU Mitsue, MATSUOKA Mari, UCHIDA Masayo, NINOMIYA Keiko, KONNO Miki, TANI Hiroe

Journal of Japan Academy of Nursing Science ( 日本看護科学学会 )  19 ( 3 ) 74 - 82  1999.11

DOI CiNii

<Articles>Nursing Intervention to Develop Autonomy in Self-care Activities of Children/Adolescents with Diabetes at a Summer Camp

NINOMIYA Keiko, KONNO Miki, TANI Hiroe, NAKAMURA Nobue, KANEMATSU Yuriko

Bulletin of Kobe City College of Nursing ( Kobe City College of Nursing )  3   47 - 57  1999.03

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The aims of our diabetes summer camp are to provide opportunities : to make friends and have good time with both children and adolescents with IDDM and the camp staff members, to learn that they can do the same social activities as normal children/adolescents if they can manage their diabetes adequately and to gain positive attitude and motivation for diabetes self-management. The diabetes summer camp of 8 days in 1996 was held in August with 49 IDDMs from first grade to twelfth grade and 76 camp staff members per day including 4 pediatricians, 9 nurses, 3 dieticians, 2 educational counsellors and 58 student volunteers. Our intervention to develop autonomy was promoting decision-making on diabetes self-care activities with good understanding. It included three methods : 1) self-recordings using 2 types of cards, 2) encouragement and support, 3) group lessons. Children/adolescents were encouraged to discuss with nurses to make decisions at insulin reactions and all other occasions. Our intervention were evaluated by two types of cards used in the camp, and the checklists for children/adolescents' autonomous behaviors in the camp, which were written by nurses and student nurses after the camp. The following results were obtained : 1) The younger children enjoyed card recordings. In contrast, the older children showed less interests in recordings. 2) 11 out of 49 children under 4th grade and first-time campers could expand injection and blood sampling sites. 3) From nurses' and student nurses' observation, development of autonomy was found in : (1) Preventing and coping with hypoglycemia by taking appropriate kind and amount of snacks. (2) Exercise to decrease blood sugar level. (3) Adjusting insulin dose according to blood sugar level. (4) None of them could develop autonomy in adjustment of diet. These findings suggest that new interventions other than self-recordings using cards will be needed for older children, and developing autonomy in terms of adjusting kind and amount of served food according to blood sugar level will be needed.

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The relationship between perceptions of diabetes and self-care behaviors, and self-esteem or social support in early-onset NIDDM patients

NAKAMURA Nobue, KANEMATSU Yuriko, KONNO Miki, NINOMIYA Keiko, UCHIDA Masayo, TAKEDA Junko

Journal of School of Nursing, Chiba University ( Chiba University )  21   17 - 24  1999.03

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The purposes of this study were 1) to compare perceptions of diabetes and se1-care behaviors in early-onset NIDDM patients with those in IDDM patients, 2)to investigate the relationship between perception of diabetes and self-care behaviors, and self-esteem or social support. The subjects were 20pair of early-onset NIDDM patients and IDDM patients who matched age and sex. The findings of this study were following, 1) NIDDM patients perceived almost same effect of diabetes on daily life as IDDM patients. But IDDM patients perceived more positive effect of diabetes. 2) Perceptions of importance on follow-up clinic visit, stress management, no smoking and weightcontrol were significantly lower in NIDDM patients than in IDDM patients. 3)The meaning of follow-up clinic visit were to know conditions of glycemic control and health. Additionally, IDDM patients were supported by diabetic friends in follow-up clinic visit, and reviewed self-care behavior from last clinic visit. 4) The motivation to enhance adherence to self-care behaviors were follow-up clinic visit, increase of weight and the appearance of diabetic complications. 5) The higher self-esteem were related with the better glycemic control. NIDDM patients who perceived more importance about diet management and weight-control were good in self-care behavior. NIDDM patients who received lower social support tended to have problem of self-care behavior and poor glycemic control.

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The relationship between perceptions of diabetes and self-care behaviours, and self-esteem or social support in early-onset NIDDM patients.

NAKAMURA NOBUE, KANEMATSU YURIKO, KONNO MIKI, NINOMIYA KEIKO, UCHIDA MASAYO, TAKEDA JUNKO

千葉大学看護学部紀要 ( Chiba University )  21 ( 21 ) 17 - 24  1999.03

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The purposes of this study were 1) to compare perceptions of diabetes and se1-care behaviors in early-onset NIDDM patients with those in IDDM patients, 2)to investigate the relationship between perception of diabetes and self-care behaviors, and self-esteem or social support. The subjects were 20pair of early-onset NIDDM patients and IDDM patients who matched age and sex. The findings of this study were following, 1) NIDDM patients perceived almost same effect of diabetes on daily life as IDDM patients. But IDDM patients perceived more positive effect of diabetes. 2) Perceptions of importance on follow-up clinic visit, stress management, no smoking and weightcontrol were significantly lower in NIDDM patients than in IDDM patients. 3)The meaning of follow-up clinic visit were to know conditions of glycemic control and health. Additionally, IDDM patients were supported by diabetic friends in follow-up clinic visit, and reviewed self-care behavior from last clinic visit. 4) The motivation to enhance adherence to self-care behaviors were follow-up clinic visit, increase of weight and the appearance of diabetic complications. 5) The higher self-esteem were related with the better glycemic control. NIDDM patients who perceived more importance about diet management and weight-control were good in self-care behavior. NIDDM patients who received lower social support tended to have problem of self-care behavior and poor glycemic control.

CiNii J-GLOBAL

小児糖尿病患者の日常生活習慣、療養行動と親のライフスタイル

中村 伸枝, 兼松 百合子, 武田 淳子, 丸光 惠, 二宮 啓子, 内田 雅代, 今野 美紀

日本看護科学会誌   17 ( 3 ) 154 - 155  1997.12

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Daily life habits and curing action of infant diabetic patients and life style of parents.

NAKAMURA NOBUE, KANEMATSU YURIKO, TAKEDA JUNKO, MARUMITSU MEGUMI, NIMIYA KEIKO, UCHIDA MASAYO, KONNO MIKI

日本看護科学会誌   17 ( 3 ) 154 - 155  1997.12

DOI J-GLOBAL

Lifestyle of Diabetic Children and Their Parents and DM Self-Care Behaviors

NAKAMURA Nobue, KANEMATSU Yuriko, NINOMIYA Keiko, KONNO Miki, TANI Hiroe

Journal of School of Nursing, Chiba University ( Chiba University )  19   61 - 69  1997.03

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The purposes of this study are 1) to examine whether diabetic children's daily life behaviors associate with their parents' daily life behaviors, and 2) to examine whether diabetic children's and their parent's daily life behaviors associate with self-care behaviors of diabetes mellitus. And 3) to examine whether changes of family's daily life behaviors because of children's diagnosis. The subjects were 49 pairs of diabetic children and their parents who visited the pediatric diabetic follow-up clinic in Chiba city. The results of this study were 1) The parents' daily life practices were correlated with their children's daily life behaviors. 2) Both parents' and children's daily life practices were significantly correlated with children's selfcare behaviors. Especially regularity of life time and hygienic behaviors were correlated with diabetic selfcare behaviors. 3) Most parents described good changes of family's daily life behaviors because of children's diagnosis. The nursing interventions to improve lifestyle of diabetic children and their families, especially wake up time, regularity of meal time and hygienic behaviors, are necessary.

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