Japanese

Title	小児病棟における付き添い入院中の虐待リスクと対応 - 産後うつおよび心理的負担への対応
Subtitle	投稿論文 研修医報告
Authors	阿久津朱伽1), 中村俊一郎2), 西田光宏1)
Authors (kana)
Organization	1)静岡市立清水病院小児科, 2)慶應義塾大学病院小児科
Journal	子どもの心とからだ 日本小児心身医学会雑誌
Volume	34
Number	3
Page	413-419
Year/Month	2025 / 11
Article	報告
Publisher	日本小児心身医学会
Abstract	【要旨】近年, 児童虐待の増加に伴い, 救急外来における虐待対応は標準化が進んでいる. 一方, 小児病棟, とくに付き添い入院における虐待リスクは十分に認識されておらず, 体系的な取り組みは不足している. 本研究では, 母親の付き添い入院中に発生した3か月乳児に対する虐待事例を通じ, 母親の産後うつ, 感染症による患児の機嫌の悪さ, 付き添い入院に伴う心理的負担などの背景要因と病棟スタッフの対応を検討した. 病棟スタッフは夜間で人員が限られており, 虐待対応に不慣れな中で迅速に患児を保護した. しかし, 小児病棟で虐待が発生することを誰も予見できておらず, 緊急対応マニュアルも未整備だったため, 母親の安全確保や心理的配慮は行えなかった. これを踏まえ, 産科・小児科間の情報共有, 付き添い入院中の負担軽減策を講じた. また緊急時対応マニュアルを作成し, 院内に展開した. 本研究は全ての小児病棟における虐待対応の質向上に寄与する可能性がある.
Practice	臨床医学：内科系
Keywords	小児虐待, 産後うつ, 小児病棟, 付き添い入院, 院内マニュアル, child abuse, postpartum depression, pediatric ward, accompanying hospitalization, hospital protocol

English

Title	Abuse risks and response during parental accompaniment in pediatric wards - addressing postpartum depression and psychological burden
Subtitle	Resident Report
Authors	Ayaka Akutsu1), Shunichiro Nakamura2), Mitsuhiro Nishida1)
Authors (kana)
Organization	1)Department of Pediatrics, Shizuoka City Shimizu Hospital, 2)Department of Pediatrics, Keio University Hospital
Journal	Journal of Japanese Society of Psychosomatic Pediatrics
Volume	34
Number	3
Page	413-419
Year/Month	2025 / 11
Article	Report
Publisher	Japanese Society of Psychosomatic Pediatrics
Abstract	[ABSTRACT] In recent years, as child abuse has increased, standardized abuse response protocols have been developed in emergency departments. However, the risk of abuse in pediatric wards, particularly during accompanying hospitalization, has not been sufficiently recognized, and systematic efforts are lacking. This study examines a case of abuse involving a 3-month-old infant during the mother's accompanying hospitalization, focusing on background factors such as the mother's postpartum depression, the infant's irritability due to infection, and the psychological burden associated with accompanying hospitalization. The hospital staff acted swiftly to protect the infant, despite a shortage of personnel during the night and inexperience with abuse response. However, no one anticipated the occurrence of abuse in the pediatric ward, and there was no emergency response manual in place. As a result, the safety and psychological care of the mother were not adequately addressed. In response to these findings, the study emphasizes the need for improved information sharing between obstetrics and pediatrics, as well as measures to reduce the burden on mothers during accompanying hospitalization. Additionally, an emergency response manual was created and distributed throughout the hospital. This research has the potential to contribute to improving the quality of abuse response in pediatric wards across all hospitals.
Practice	Clinical internal medicine
Keywords	child abuse, postpartum depression, pediatric ward, accompanying hospitalization, hospital protocol

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