特別支援学校における医療的ケアへの対応からみた教職員の施設整備要望

医療的ケアを必要とする児童生徒に対する特別支援学校の施設整備課題　その１

抄録

 Japan is one of the countries with the lowest neonatal and infant mortality rate in the world. The main factors behind this are said to be the progress of medical science and the prevalence of advanced medical technology and treatments. However, some children need medical care in their daily life. In fact, the total number of children in kindergarten, primary, and secondary schools who need daily medical care has increased from 5,901 in 2006 to 8,143 in 2015.
 Despite the increase in educational needs for students receiving daily medical care in schools for special needs education, the facilities improvement guideline provided by the Ministry of Education, Culture, Sports, Science, and Technology notes quite a few issues about medical care. Architectural research studies on them in Japan are also lagging.
 This paper shows the subjects of school facilities development for students receiving medical care in schools for special needs education. In Part 1 of the research, we attempted to grasp the problems and teachers' requirements for improving school facilities from the perspective of medical care. We used a nationwide questionnaire, which was conducted in 2015, targeting all schools (281) for students with physical disabilities. We obtained responses from 160 schools (56.9%).
 In the questionnaire, we established the following sections for dividing the problems based on their features such as priority, facilities improvement, or teachers' creativity: 1) problems solved through repair or renovation, 2) problems remaining despite repair or renovation, 3) problems that teachers cannot solve by themselves, 4) considerable problems in school planning despite teachers' capacity to manage them, and 5) problems solved through teachers' creative use of space and human resources.
 The main targets of the analysis were answers regarding the problems, reasons for them, and ways to solve or adapt to them. The data was analyzed using KH coder developed by Higuchi (2001) as text mining software. A total of 688 problems were obtained from the questionnaires. We drew the co-occurrence network by using the software in each section; through this method, commonality could be cleared from the various problems.
 In Part 1, the analysis results of section 1)-4) were showed. One of the main problems solved through repair or renovation was the establishment of a medical care room. The problems that teachers could not solve by themselves were mainly four: a) the lack of lunch room space for students who need tube feeding, b) the difficulty of controlling the constant temperature and humidity in each room including corridors, c) the difficulty of emergency care because of the layout of the school facilities, and d) classrooms or medical care rooms without any hot water supply. The considerable problems were regarding e) the lack of outlets, f) inconvenient or uncomfortable restrooms, g) anxiety regarding dust on classroom floors and also hot water supply. These could be considered as the requirements for improving school facilities.
 We also obtained the characteristics of each kind of medical care. It was clear that the considerable issues in school planning were regarding the lunch space being adequate for tube feeding, an efficient restroom for catheterization, clean floors in classrooms so students with tracheotomy or weak respirators can avoid dust, and sufficient outlets for suctions or artificial respirators.
 In Part 2, we will attempt to analyze section 5) and perform a cross-sectional study of 1)-5). This analysis will show what to plan when adapting school facilities to provide medical care and how to allow teachers to make decisions regarding creative use of space.