Respiratory Conditions in Children Undergoing Home Oxygen Therapy : Usefulness of Measuring Oxygen Saturation for Nursing Care in Daily Life Settings

本研究の目的は,HOTを実施する子どもの,日常の生活場面における呼吸機能の状態を明らかにすること,および看護援助における酸素飽和度測定の有用性を明らかにすることであった.対象は,極低出生体重児として出生し,出生後NICUに入院し,慢性肺疾患のためにNICU退院時にHOTを開始した3名の子どもと母親であった.データ収集は家庭訪問にて退院後約1年まで縦断的に実施し,睡眠中・食事中・哺乳中の場面についての,パルスオキシメーターを用いての酸素飽和度および脈拍数の測定,睡眠中の呼吸数の測定,呼吸窮迫症状の観察を行った.また,同時に実施した子どもの病状についての母親へのインタビューや,訪問時の観察から,SpO2の測定に対する母親の反応を捉えた.得られた結論は次のとおりであった.1)HOTを実施する子どもの日常の生活場面における呼吸機能の状態は,HOTの実施処方が減り,処方薬が少なくなってゆく経過の中でも,安定し,好転する傾向にあった.2)HOTを実施する子どもの看護援助において,呼吸機能の状態を説明し,母親の病状の捉え方および対応を促進するのに,酸素飽和度測定を用いることは有用であると考えられた.The purposes of this study were to clarify respiratory conditions in children undergoing home oxygen therapy in daily life settings, and to clarify usefulness of measuring oxygen saturation (SpO2) for nursing care. Subjects were three child/mother pairs in which the children were below fifteen hundred grams at birth and entered a NICU after birth, and were on home oxygen therapy upon discharge for neonatal chronic lung disease. The data was collected longitudinally by home visits until one year after discharge. Data collection included SpO2 and pulse rate, using a pulse oximeter during sleep and feeding, the child's respiratory rate during sleep, and observed respiratory conditions. The mothers' perceptions of measuring SpO2 were examined from interview data about their children's respiratory conditions and mothers' sayings and doings. The results were as follows : 1. The children's respiratory conditions improved even when oxygen flow and medication were decreased. 2. It was considered that using a pulse oximeter was useful to promote mothers' perceptions of their children's respiratory conditions, and to promote mothers' skill to care for children