@article{oai:niigata-u.repo.nii.ac.jp:02000505,
 author = {石澤, 尚子 and Ishizawa, Naoko},
 issue = {1},
 journal = {新潟歯学会雑誌},
 month = {Jun},
 note = {To improve treatment success, the present study aimed to identify ideal treatment for cleft lip and palate from the perspective of patients and their families by investigating maternal feelings and the treatment decision-making process. Semi-structured interviews were conducted on 8 mothers (age range, 33-43 years) of children with cleft lip and palate who had completed first-line surgical treatment at Niigata University Medical & Dental Hospital. Verbatim transcripts were created, and then the data were coded for each context and categorized by repeated comparison and integration to derive the main concepts. The following concepts were extracted regarding maternal feelings and treatment decision-making from the time of the child's birth: 'shock and confusion'; 'feelings of self-condemnation as a mother'; 'uncertainty about treatment and the future'; 'the possibility of surgery and the feeling of overcoming treatment'; 'a positive attitude toward treatment'; 'parent-child conflict and respect for the child's wishes'; 'help through information and support from medical professionals'; 'help through information and support from families with children with the same condition'; 'help through support from family members'; and 'trust toward medical professionals'. The following two structures were then identified based on these categories: 'a cycle of uncertainty toward treatment', and 'changes in maternal feelings coming to grips with treatment'. The present findings demonstrate that, to provide high quality treatment incorporating the perspective of patients and their families, comprehensive and continuous support based on informed consent and an understanding of the structure of maternal feelings and treatment decision-making are needed., 口唇口蓋裂治療を成功に導くために，患者および家族の立場に立った治療のあり方を見いだすことを目的として，母親の心情と治療に対する意思決定過程を調査した。対象は新潟大学医歯学総合病院で外科一次治療を終了した口唇口蓋裂児の母親8名(年齢:33～43歳)とした。半構造化面接を行い，録音した逐語録をデータとした。データは文脈ごとにラベルをつけ，比較と統合を繰り返すことでカテゴリー化を行い，主要概念を導いた。その結果，母親の心情と治療の意思決定に関わる概念として，口唇口蓋裂児の出生に始まり，〈ショックと戸惑い〉〈母親としての自責感〉〈治療と将来への不安〉〈手術の可能性と治療を乗りこえた実感〉〈治療への前向きな姿勢〉〈親子の対立と子どもの意思の尊重〉〈医療者からの情報とサポートの救い〉〈同病者の家族からの情報とサポートの救い〉〈家族からのサポートの救い〉〈医療者に対する信頼〉が抽出された。また，抽出されたカテゴリーから，治療に対する不安のサイクルと，治療に取り組む母親の心情の変化という2つの構造が見いだされた。患者および家族の視点を取り入れた質の高い治療を実践するためには，母親の心情と治療に対する意思決定の構造を理解したうえで，インフォームドコンセントを基盤とした包括的で継続的な支援の必要性が示された。},
 pages = {19--26},
 title = {口唇口蓋裂児の母親の心情と治療に対する意思決定過程},
 volume = {44},
 year = {2014}
}