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訪問教育における医療的ケア児の実態と教育支援の課題に関する研究

家访教育中儿童就医实际情况及教育支持问题研究

基本信息

批准号：
20K03044
负责人：
菊池紀彦
金额：
$ 1.41万
依托单位：
Mie University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2020
资助国家：
日本
起止时间：
2020-04-01 至 2024-03-31
项目状态：
已结题

项目摘要

コロナ禍の中でも実践研究であったため、対象児童生徒の体調を考慮しつつ取組を行った。今年度は、訪問教育の小学部児童1名と中学部生徒1名を対象とした。2名の対象者とも、人工呼吸器を装着し、経管栄養等を必要とする超重症児である。小学部、中学部の担任とともに、それぞれの児童生徒宅を訪問した。小学部の児童については、自宅と特別支援学校とをGoogle Classroomを用いてオンラインで繋ぎ、タブレットPCを通して児童生徒同士の合同学習の場を設定した。合同学習の場は5回設定した。合同学習の期間は、2022年9月から同年12月までであった。特に、秋の文化祭に向けた同時双方型の授業が展開された。文化祭ではスクーリングが予定されていたため、離床し、抗重力姿勢を一定時間保持した。教室の児童や教師の音声が聞こえると、あたかもその音源を探るかのように眼球の動きが認められた。その際、安静時よりもHR変動の上昇が認められるとともに、持続的心拍数変動を解析すると、安静時と授業中では、授業中のHRV値が有意に高かった。中学部の生徒にも通学する生徒との同時双方型の合同学習を設定しようと試みたものの、対象生徒の体調変化等により困難であった。そのため、今回は同時双方型の授業を見送り、担任の教師とともに授業を行った。働きかけに対する応答が殆ど認められないため、全身をくまなく観察し、不随意的な微小運動が発現する箇所に身体接触を伴うフィードバックを行った。授業終了後に持続的心拍数変動を解析すると、安静時と授業中では、授業中のHRV値が有意に高いことが認められた。医療的ケアを濃厚に必要とする超重症児の場合、生命活動が極めて脆弱であるため、自宅に居ながらにしても体調の維持・管理が困難である。2名の児童生徒を対象としたかかわりから、同時双方型学習を行うことも時として困難であることが明らかとなった。

In the study of the practice of the students, the students, like the students of the child, took part in the study of the students' bodies. This year, there is one child in the primary school section and one student apprentice in the secondary school department. Two patients with elephant disease, artificial respirator, tube, and so on, were found to be extremely critical. The primary school department and the secondary school department are responsible for the teaching of children and students. In the primary school department, there is a special support for school students, Google Classroom students, PC students, student students, contract apprentices, and school students. There are 5 settings in the contract learning program. During the contract period, it will be held in September 2022 and in December of the same year. The special and autumn festival cultural sacrifices will be held at the same time for both types of training programs. Cultural festivals are scheduled to be held for a certain period of time, such as train, bed, and anti-gravity posture. In the classroom, the children teach the sound and sound source to explore the sound source and eyeball movement. In the international and quiet time, monitor the HR activity to monitor the number of heart beats, analyze the number of beats in the operation, and intentionally monitor the HRV activity in the course of operation. At the same time, the student apprenticeship and apprenticeship programs of the secondary school department have been set up for both sides of the contract program, such as student apprentice training, student apprenticeship training, and so on. At the same time, both parties will be responsible for the delivery of both types of employment, and will be responsible for the teaching and learning of both parties. We should pay attention to all kinds of health care, full-body inspection, and non-random micro-movement to show that you are in contact with each other. After the operation has been completed, the number of heart beats that have been maintained will be analyzed, the HRV will be monitored during quiet time, and it is intended to be monitored during the operation. It is necessary to pay attention to the health care of medical staff, such as the combination of ultra-severe diseases, active life activities, and the maintenance of health care and management difficulties. The two child apprentices were in the same class as the two-year-old student, while the students of both types of students were in the same period of time, while the students of both types of students were in need of help.