中板 育美

AIM: This study assessed the validity and reliability of the Secondary Traumatic Stress Scale-Japanese Version. METHODS: The original Secondary Traumatic Stress Scale was translated into Japanese, and Japanese items were back-translated to English to confirm the accuracy of the translation. A total of 870 public health nurses from the Tohoku region in Japan completed the Secondary Traumatic Stress Scale-Japanese Version. An exploratory factor analysis was conducted to identify the number of components. Moreover, 351 public health nurses from the Saitama prefecture in Japan also completed the scale. A confirmatory factor analysis was performed with the factor structure identified in the exploratory factor analysis. RESULTS: The exploratory factor analysis identified two components: one associated with client-related distress and the other with trauma-related distress. The confirmatory factor analysis confirmed the two-factor structure. The two-factor structure model was better than the three-factor model presented in the original validation study for the English version of the scale. The two-factor model had good internal consistency for the overall product and the subscales. Pearson correlations showed that this model had good convergent validity against the Maslach Burnout Inventory, a psychological measure similar to the Secondary Traumatic Stress Scale. Finally, the two-factor model had good discriminant validity against the Maslach Burnout Inventory. CONCLUSION: This study identified two components of the Secondary Traumatic Stress Scale-Japanese Version that differ from the three components found in the original English version. The differences in the factor structure might indicate that the factor structure was culturally influenced.

我が子を虐待する母親15例の精神療法過程を検討した。11例が児童相談所、児童家庭相談センター、保健所、保健センターからの紹介で、4例が自主的受診であった。診断は、統合失調症1例、知的障害1例、神経症圏病態が13例であった。神経症圏患者の中では、人格障害傾向を併存する者が7例あった。治療開始後に親子分離を導入した症例が8例あり、そのうち4例は強制的な分離導入であった。分離措置後に治療状況が動揺し、中断した症例が5例あったが、最終的に治療途絶となったものは2例のみであった。以上から、治療関係が十分深まっている場合には、子ども保護システムに属する関係スタッフと精神科医療との連携が治療状況を悪化させる可能性は少なく、親子分離が育児負担の軽減のみならず母親の葛藤状況を緩和させ、内省的精神療法を促進させる契機となるうることが示唆された。