看護師長のリフレクションの阻害要因と促進要因に関する質的研究—効果的なリフレクションの方略の検討

Factors Hindering and Facilitating Reflection Among Head Nurses: A Qualitative Study Examining Strategies for Effective Reflection

要旨

　目的：看護師長のリフレクションを阻害・促進する要因を明らかにし，効果的なリフレクションの方略を検討する．

　方法：リフレクション教育を導入している6施設の看護師長16名に半構造化面接を実施し，質的記述的分析を行った．

　結果：阻害要因は，【時間的制約】【心理的抵抗】【リフレクション理解の浅さ】【ファシリテーター機能不全】【行動変容の困難さ】など6カテゴリーを抽出した．促進要因は，〔個人要因〕〔環境・文化的要因〕〔リフレクションプロセスの要因〕の3コアカテゴリーに分類され，特に自己成長意欲と柔軟性といった個人要因は看護師長に特有であり他者の成長を通じて自己を成長させるという学習構造が示唆された．

　結論：効果的な方略は，①心理的状況の確認，②心理的安全性を基盤とした経験共有の場の構築，③継続的実践を可能にする仕組み化であり，看護管理における学習文化の醸成に寄与する可能性が示唆された．

　Purpose: This study aimed to identify factors that hinder or facilitate reflection among head nurses and to explore strategies for promoting effective reflection in nursing management.

　Methods: This study adopted a qualitative descriptive design. Semistructured interviews were conducted with 16 head nurses from six hospitals, and content analysis was used to analyze the transcripts.

　Results: The analysis extracted six categories of factors hindering reflection, including time constraints, psychological resistance, limited understanding of reflection, dysfunction of facilitator roles, and difficulty in behavioral change. Conversely, factors facilitating reflection were classified into three core categories: individual factors, environmental/cultural factors, and process-related factors. In particular, individual factors such as intrinsic motivation for self-growth and flexible attitudes appeared to be unique to head nurses. Furthermore, the findings suggested a learning structure in which head nurses develop themselves through the growth of others.

　Conclusion: Three key strategies were identified for effective reflection among head nurses: (1) assessment of head nurses' psychological readiness, (2) establishment of psychologically safe and open forums for sharing experiences, and (3) development of organizational systems that enable continuous reflection. These strategies are interrelated and provide a foundation for transforming reflection from a superficial exercise into a sustainable learning process that fosters behavioral change and contributes to organizational learning in nursing management.