日本新生児成育医学会雑誌　第30巻　第1号　91～98頁（2018年）

日本新生児成育医学会雑誌　30(1)：91-98；2018　

受付日：平成29．08．17

受理日：平成29．12．07

NICU における多職種・他機関連携の実際と課題―全国調査の結果から―

Present Status and Issues with the Cooperation between NICU Staff Members from Different Occupations and Collaborations between NICUs and other Organizations ―From Results of the Nationwide Survey

名古屋大学　心の発達支援研究実践センター

Psychological Support & Research Center for Human Development, Nagoya University

永田雅子

Masako NAGATA

Key Words：NICU，team approach，multi-organizational network

　本研究の目的は，NICU でのチーム医療の充実に向けた検討を行うことである。全国のNICU 施設責任者を対象に調査を行った。NICU スタッフとして，理学・作業療法士（PT/OT），医療ソーシャルワーカー（MSW），心理専門職は70％以上の施設で活動していた。一方で，NICU 専属の割合は少なく，保育士，心理職で20％前後であった。心理職の33％は，妊娠中からフォローアップまで一貫して関わっており，所属科にかかわらずカンファレンスに参加していたが，コミュニケーションを取る時間があると回答した施設は半数にとどまっていた。
　地域の他機関との連携では，保健センター，訪問看護，児童相談所とは，書面だけではなくNICU 訪問やカンファレンスの開催など顔の見える連携が1/3 で行われていたが，一部の機関とは書面での連携にとどまっていた。今後，多職種および他機関との連携体制の整備が課題となってくると考えられた。

　The aim of this study was to identify areas for improvement regarding the collaborative approach of NICUs in Japan. A questionnaire survey was sent to managers in charge of NICUs in Japan. The findings were that any one of physical therapists（ PT）, occupational therapists（ OT）, medical social workers（ MSW） or psychologists worked with NICU staff members in 70％ or more of NICUs that responded to the questionnaires；however, the number of specialists working exclusively in NICUs was low as a whole. The number of childcare workers and psychologists working exclusively in NICUs was relatively higher；however, the ratios were only approximately 20％ of all childcare workers and psychologists working in NICUs. Although 33％ of psychologists working in NICUs were consistently involved in cases from patient pregnancies up to the follow-up outpatient visits for these patients, these psychologists joined conferences regardless of the department they belonged to while half of the managers answered that they did not have enough time to communicate with other NICU staff members. The process of how to collaborate with other NICU staff members is an area that needs work in the future.
　With respect to the collaboration between NICUs and other organizations, the cooperation of local organizations such as healthcare centers, home-visit nurses and children’s welfare centers was found common in one-third of NICUs and these organizations not only exchanged letters but also communicated face-to-face, such as through NICU visits and conferences. In comparison, the collaboration between NICUs and some other organizations was found to involve no more than the exchange of letters. In light of this finding, it will be an important issue to improve the collaborative structure with other organizations.