Takayo Sakiyama

The purpose of this study is to clarify the situation and problems of Infertility Counseling Centers in local governments. Participants in the study consisted of counselors at 87 centers. The participants were asked to complete an unsigned self-administered questionnaire, consisting of items relating to their jobs and systems of counseling, realization of difficulty regarding counseling, etc. As a result, approximately half of the centers had established selection criteria for counselors, and 60 percents of the centers provided support through counselors of two or more types of profession. 40 percents of the centers answered that they had systems of cooperation with other institutions, but only 10 percents of the centers engaged in cooperative counseling with other institutions. Also, it was observed that 20 percents of the centers-although only having one type of counselor- did not have any kind of cooperative system, and difficulties handling problems outside of the range of the counselors' professional fields were expressed. Furthermore, approximately half of the centers carried out events such as lectures for health care providers. Also, some centers evaluated their duties through the holding of conferences, but there were also centers which did not conduct evaluations. From these results, we feel that it is necessary for centers to conduct evaluations according to problems in counseling systems and actual counseling, and for the centers to evaluate the entirety of their operations including counseling according to the needs of women suffering from infertility and problems in the region, and to make modifications to their methods according to the actual situation of their respective regions.

不妊治療後に妊娠した女性が妊娠期間中に「母親としての自己」を認知していく過程を明らかにすることを目的に,人工授精または体外受精を受けて妊娠した初産婦12名(26〜36歳,平均年齢31.7歳)を対象に半構成的面接を実施した.その結果,妊娠への現実的な知覚や対処機制の特徴に基づく以下の5つの過程が抽出された.1)防衛機制をはたらかせることなく,妊娠の危機を乗り越えて母親になっていく過程.2)胎児喪失に関連した防衛機制をはたらかせていたが,現実的な知覚により最終的には妊娠の危機を乗り越えて母親になっていく過程.3)新たな防衛機制の出現により不妊体験への否定的感情が再燃し,悲嘆作業も停滞したまま母親になっていく過程.4)胎児喪失に関連した防衛機制は消失し,妊娠の危機は乗り越えたように見えるが,「母親としての自己」に否定的感情をもちつつ潜在する防衛機制を残したまま母親になっていく過程.5)胎児喪失に関連した防衛機制をはたらかせたまま妊娠の危機が長期化し,母親としての否定的感情をもちつつ潜在する防衛機制を残したまま母親になっていく過程

開設後1年を経過した三重県不妊専門相談センターにおける,不妊看護相談の実態と看護者の役割を検討した.相談件数は201件で,相談内容は「納得して治療を受ける決定を下すための相談」と「治療前からの心理的問題を抱える者や不妊治療中のストレスが重篤化した者の相談」に大別された.また,看護者の役割として,1)看護実践者としての役割,2)対象のニーズの見極めにともなう調整者としての役割,3)現場の医療に携わる医療職に対する情報提供者としての役割,が挙げられた