特定機能病院の一般病棟で認知症高齢者をケアする3年目以上の看護師の困難感とその背景要因に関する実態調査

Survey on Difficulties Faced by Nurses With 3 or More Years of Experience in Caring for Older Patients With Dementia at General Ward of a Special Functioning Hospital and Its Factors

要旨

　目的：特定機能病院の一般病棟において認知症高齢者をケアする看護師の困難感とその背景要因を明らかにし，認知症対応力を高めるための基礎的資料を得る．

　方法：認知症ケア加算2を取得している特定機能病院の一般病棟に勤務する3年目以上の看護師272名を対象に質問紙調査を行い，困難感の得点を従属変数，認知症者に対する態度等を独立変数として重回帰分析を行った．

　結果：困難感の高さに関連した要因は，認知症者に対する否定的な態度（β＝-.397），経験年数が短いこと（β＝-.213），認知症者の数が多いこと（β＝.182），高齢者イメージがネガティブであること（β＝-.150），認知症に関する知識が多いこと（β＝.129）であった．最も困難感を高めていた要因は，否定的な態度であった．

　結論：看護師の経験年数を鑑み，正しい知識を基に肯定的に認知症を捉えることが求められる．

　Objective: To clarify the perceived difficulty and circumstances of nurses caring for older patients with dementia in general ward of a specialized hospital and to obtain basic data that will enable us to examine countermeasures to improve nurses' ability to cope with dementia.

　Methods: A questionnaire survey was administered to 272 nurses with 3 years or more experience working at general ward of a specialized hospital that had obtained Dementia Care Addition 2. Multiple regression analysis was conducted using the total score for perceived difficulty as the dependent variable and attitude toward people with dementia, years of experience, and job position as independent variables.

　Results: Factors associated with higher levels of perceived difficulty were negative attitudes toward people with dementia (β=-.397), shorter years of experience (β=-.213), a higher number of patients with dementia (β=.182), negative images of older people (β=-.150), and greater knowledge of dementia (β=.129). The factor that increased the sense of difficulty the most was a negative attitude toward people with dementia.

　Conclusion: To improve nurses' ability to cope with dementia, they should be educated to perceive dementia positively based on a correct understanding of dementia, considering their years of experience.