我が国の緩和ケア病棟に勤務する中堅看護師の能力指標（competency inventory）の開発

The Development of Competency Inventory for Mid-Career Nurses in Palliative Care Units

要旨

　目的：緩和ケア病棟の中堅看護師に求められる能力指標を開発する．

　方法：デルファイ法により緩和ケア病棟配属3〜5年目の専門資格や役職のない中堅看護師に必要な能力を特定した．文献レビュー，エキスパートナースインタビュー，フォーカスグループインタビューから草案を作成し，デルファイラウンドのパネリスト15名に対し，2017年7〜8月に郵送法にて，各項目の必要性，適切な難易度について各9段階，3段階で評価を得た．

　結果：草案（294項目）は能力指標の枠組みとして2ドメイン『専門的緩和ケア看護実践』（36項目）『中堅看護師の役割』（16項目）計8カテゴリー52項目となった．デルファイラウンドは合意基準に基づき，2ラウンドでほぼ全項目合意された．

　結論：具体的な内容の指標により，今まで曖昧だった中堅看護師の個々の目標設定が可能となり，サポーティブな教育プログラムの構築に寄与する可能性がある．

　Aims: This study aims to develop a competency inventory for mid-career nurses in palliative care units(PCUs).

　Methods: We conducted a Delphi study to develop the competency inventory of mid-career nurses with 3-5 years of experience in PCUs who do not possess a Certified Nurse Specialist and/or Certified Nurse license and do not hold a managerial post. The initial drafts were prepared from literature reviews, insights from interviews with expert nurses in palliative care, and feedback from focus group interviews. Subsequently, Delphi-round questionnaires were distributed to panelists via mail from July to August 2017. Panelists were tasked with evaluating each item using a nine-point scale. Additionally, they were required to indicate the perceived level of difficulty, classified into three categories.

　Results: We conducted a process of unification and revision, successfully reducing the number of items from the initial 294 drafts to a refined set of 52. A two-domain, eight-category, 52-item inventory was developed. Domain I was called "specialized palliative care nursing practice"(36 items), and Domain II was called "mid-career nurse's role"(16 items). During the two Delphi rounds, consensus was achieved among the 15 panelists on nearly all items, meeting the established agreement.

　Conclusions: The competency inventory is detailed, and it may be helpful for individual nurses in setting clear goals. Educational programs tailored to the competencies identified in PCUs may be developed, contributing to the support and advancement of mid-career nurses.