Maruyama Yuki, Takada Satoshi
Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Hyogo.
No To Hattatsu. 2010 Sep;42(5):346-51.
The nurse-teachers have important roles in health care of the students in Japanese schools. Usually one nurse-teacher works in each regular primary and junior high school in order to manage health care of the students. We surveyed the medical care of the students who had a history of convulsions by the questionnaires to 319 nurse-teachers. One hundred thirty nine nurse-teachers (93%) of 150 responders replied that they were taking care of at least one student with a history of convulsion. In 26 (17.4%) of the schools surveyed, more than one convulsion occurred between the first of April 2006 and the 31st of March 2007. More than 65% of nurse-teachers had witnessed convulsions at school. Results of the present study show 59 nurse-teachers were asked by parents to keep the rectal diazepam to administer to their children in the event of a convulsion. However, only 16 nurse-teachers received the instructions from a doctor on the indication of rectal diazepam. Sixty eight per cent of nurse-teachers felt that they had no or little support from doctors. Although most of the nurse-teachers felt reluctant to administer rectal diazepam at school, they considered the administration was unavoidable for student's safety and comfort. Clear instructions and detailed consultation by the doctors and prompt response in case of emergency were desired by the nurse-teachers. The establishment of the support system for the students with a history of convulsions is required to maintain safe and comfortable school life.
在日本学校中，护士教师在学生的医疗保健方面发挥着重要作用。通常，每所普通小学和初中都会配备一名护士教师，负责管理学生的医疗保健工作。我们通过问卷调查的方式，对319名护士教师进行了调查，了解有惊厥病史学生的医疗护理情况。在150名回复问卷的护士教师中，有139名（93%）表示他们至少照顾过一名有惊厥病史的学生。在接受调查的学校中，有26所（17.4%）在2006年4月1日至2007年3月31日期间发生了不止一次惊厥事件。超过65%的护士教师曾在学校目睹过惊厥发作。本研究结果显示，有59名护士教师被家长要求保留直肠用安定，以便在孩子惊厥时给药。然而，只有16名护士教师从医生那里得到了关于直肠用安定适应症的指导。68%的护士教师认为他们从医生那里得到的支持很少或没有。尽管大多数护士教师不愿意在学校使用直肠用安定，但他们认为为了学生的安全和舒适，给药是不可避免的。护士教师希望医生能给出明确的指导和详细的咨询，并在紧急情况下迅速做出回应。为了维持安全舒适的学校生活，需要建立针对有惊厥病史学生的支持系统。
