急性期医療を担う病院における認知症看護実践に関する組織風土尺度の開発と信頼性・妥当性の検討

Development and Verification of the Reliability and Validity of the Organizational Climate Scale for Dementia Nursing Practice in Acute Care Hospitals

要旨

　目的：急性期医療を担う病院における認知症看護実践に関する組織風土尺度を開発し信頼性と妥当性を検討することを目的とした．

　方法：認知症看護認定看護師へのインタビューデータや文献をもとに尺度項目を作成し尺度原案を精選した．その後，急性期医療を担う病院の病棟に勤務するスタッフ看護職2,079名に無記名自記式質問紙調査を実施し，尺度の信頼性・妥当性を検証した．

　結果：863名から回答が得られ，793名を分析対象とした．探索的因子分析を行った結果，4因子14項目が抽出され，Cronbach's α＝.861，GFI＝.956，AGIF＝.934，CFI＝.972，RAMSEA＝.055であった．基準関連妥当性では「急性期病院の認知症高齢者のための看護実践評価尺度」と有意な正の相関を示した．

　結論：本尺度は一定の信頼性と妥当性を有することが確認され，認知症看護実践に関わる組織風土の指標として活用可能である．

　Objectives: The purpose of the study was to develop an organizational climate scale for dementia nursing practice in acute care hospitals and to verify its reliability and validity.

　Methods: The scale was developed based on a literature review and data from interviews conducted with certified nurses in dementia nursing. Draft versions of the scale were carefully evaluated, and an anonymous self-administered questionnaire was administered to 2,079 staff nurses working in hospital wards of acute care hospitals. Lastly, the reliability and validity of the scale were examined.

　Results: Responses were obtained from 863 subjects, and data from 793 subjects were included in the analysis. Exploratory factor analysis was conducted, and 14 items and 4 factors were extracted with Cronbach's alpha = .861, GFI = .956, AGIF = .934, CFI = .972, and RAMSEA = .055. Criterion-related validity showed a significant positive correlation with the "Nursing Practice Rating Scale for Older Adults with Dementia in Acute Care Hospitals".

　Conclusion: The scale was confirmed to have a certain degree of reliability and validity, and can be used as an indicator of organizational climate related to dementia nursing practice.