終末期がん患者と家族間における看護師の対話支援の実践状況とその関連要因

Practice and Factors Influencing Nurses' Support for Dialogue Between Terminally Ill Cancer Patients and Their Families

要旨

　目的：終末期がん患者と家族間における看護師の対話支援の実践状況とその関連要因を明らかにする．

　方法：臨床経験2年目以上の看護師839名を対象にオンライン調査を実施した．対話支援の実践状況として看護師の終末期がん患者と家族間の対話支援自己評価尺度と対話支援の機会を尋ねた．個人属性，学習経験，関心，家族支援の取り組み，職場からのサポートを調査し，対話支援自己評価尺度改訂版得点を従属変数とした重回帰分析により関連要因を検討した．

　結果：有効回答296件のうち68.9％が対話支援の機会を有していた．対話支援の実践状況との関連要因は，対話支援に関わる機会があること，カンファレンスで自分の症例を報告すること，専門書や関係する雑誌を読むことであった．

　結論：対話支援実践頻度の上昇に向けて，カンファレンスで気づきを語りやすい職場風土の醸成，専門書や関係する雑誌の紹介等の組織的な教育機会の整備が必要と示唆された．

　Purpose: The purpose of this study was to determine the practice of nurses' support for dialogue between terminally ill cancer patients and their families and the factors that influence this support.

　Methods: The subjects were 839 nurses with at least 2 years of clinical experience working at hospitals, and who were involved in the care of terminally ill cancer patients. The survey included a self-assessment scale for nurses to enhance dialogue support between terminally ill cancer patients and their families, opportunities for dialogue support, personal attributes, learning experiences, interest, what they are doing to improve their ability to support family members, and support from the workplace. Multiple regression analysis was conducted with the revised version of the scale score as the dependent variable, personal attributes, learning experiences, interest, what they are doing to improve their ability to support family members, support from the workplace, and opportunities for dialogue support as the independent variables.

　Results: There were 296 valid responses, 68.9% had opportunities for dialogue support. Multiple regression analysis showed that having opportunities to be involved in dialogue support, making an effort to report their own cases at conferences and reading technical books and related journals were associated with the practice of dialogue support.

　Conclusions: This study highlights the importance of encouraging nurses to practice more dialogue support, fostering a workplace culture that makes it easier for nurses to talk about their findings at conferences and developing of organized educational opportunities such as introduction to specialized books and relevant journals.