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発達障害のリスクを持つ乳児と母親に対するブラゼルトン新生児行動評価を用いた早期介入


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Title: 発達障害のリスクを持つ乳児と母親に対するブラゼルトン新生児行動評価を用いた早期介入
Other Titles: Neurobehavioral Assessment Scale-based Intervention for Infants with Developmental Disabilities
Authors: 大城, 昌平 / 儀間, 裕貴 / Loo, KekKhee / 穐山, 富太郎
Authors (alternative): Ohgi, Shohei / Gima, Hirotaka / Lookekkhee / Akiyama, Tomitaro
Issue Date: 20-Aug-2005
Publisher: 社団法人日本理学療法士協会
Citation: 理学療法学. 32(5), p.326-332: 2005
Abstract: 発達障害のリスクを持つ乳児と母親を対象として, ブラゼルトン新生児行動評価(NBAS)を基にした介入(以下, NBAS-based intervention)の新生児行動の発達, および母子相互作用に対する影響を検討した。研究デザインは, それぞれ2週間の観察期間と介入期間の前後比較研究である。対象は長崎大学医学部歯学部附属病院未熟児室で加療した発達障害のリスクを持つ新生児・乳児とその母親13組であった。NBASを用いた介入方法は, NBASのデモンストレーションを母親と一緒に行いながら, 児の行動能力を示し, ハンドリング指導や生活指導などの育児支援を行なう母子介入の方法である。帰結評価には, 1) NBASによる新生児行動の発達評価, 2) NCATS (Nursing Child Assessment Teaching Scale)による母子相互作用の観察評価, 3) 母親の児の取り扱いに対する自信スケール(Lack of Confidence in Caregiving; LCC)の3つの評価尺度を用いた。その結果, NBAS-based interventionは, 母親の児の行動に対する感受性と育児技術を向上させ, 母子の相互作用, 母親の育児の自信と児の行動発達を促進する結果であった。以上の結果から, NBAS-based interventionは発達障害のリスクを持つ児と母親の関わり方や母子の相互作用を促し, 相乗的に児の行動発達も促進する可能性があると思われた。 / Early intervention planning for infants with disabilities has conventionally been centered on the infants' disabilities, rather than the family's adjustment. There have been no prior studies designed to evaluate the effects of early intervention, based on the principles of the Brazelton Neonatal Behavioral Assessment Scale (NBAS), on infants with disabilities and their mothers. The objective of this study is to investigate the effectiveness of an NBAS-based intervention for infants with disabilities, in enhancing infant neurobehavioral organization, maternal self-efficacy, and mother-infant interaction. This trial consisted of a time series design two-week observation (base-line) and intervention periods to analyze the efficacy of the NBAS-based intervention on infants' neurobehavior, maternal self-efficacy and mother-infant interaction. Subjects were 13 infants with disabilities (6 cystic periventricular leukomalacia, 3 chromosomal anomaly, 1 birth asphyxia, 1 holoprosencephaly, 1 congenital multiple arthrogryposis, 1 Russell-Silver syndrome) and their mothers receiving care in the NICU at Nagasaki University Hospital. The Brazelton NBAS, Lack of Confidence in Caregiving (LCC) items of the Mother and Baby Scale, and the Nursing Child Assessment Teaching Scale (NCATS), were used to assess neonatal neurobehaviors, maternal self-efficacy, and the quality of mother-infant interaction respectively, at 3 time points : at intake, pre-intervention, and postintervention. The NBAS-based intervention consisted of parental observation of the NBAS exam conducted by the infant specialist, followed by discussion of infants behavioral characteristics and demonstration of intervention strategies to attune mothers to their infants behaviors. Intervention sessions were performed 6-8 times, 30 minutes per session, during intervention period. The NBAS orientation and State Regulation cluster scores, the LCC score, and the NCATS Caregiver Total and Subscale scores (Sensitivity to cues and Social-Emotional Growth Fostering) were significantly improved post-intervention. The NBAS-based intervention has beneficial effects on neonatal neurobehavioral organization and the quality of mother-infant interaction skills and maternal self-efficacy, in infants with developmental disabilities. Attunement of mothers to their infants' behaviors early on in life may promote a positive cycle of interaction between parents and infants.
Keywords: ブラゼルトン新生児行動評価を基にした介入(NBAS-based intervention) / 新生児行動発達 / 母子相互作用 / 育児の自信
URI: http://hdl.handle.net/10069/21237
ISSN: 02893770
Relational Links: http://ci.nii.ac.jp/naid/110004042739/
Rights: 社団法人日本理学療法士協会 / 本文データは学協会の許諾に基づきCiNiiから複製したものである
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/21237

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