特別養護老人ホームに勤務する看護師の看護実践能力に関連する要因

Factors Related to the Competence of Nurses Working in Long-term Care Welfare Facilities for the Elderly

抄録

　本研究の目的は，特別養護老人ホーム（以下，特養）に勤務する看護師の看護実践能力に関連する要因を明らかにすることである．東京都内の特養全550施設に勤務する看護職員1,100人を対象に，個人属性，施設属性，看護実践能力，レジリエンス，キャリアコミットメントに関する内容について，郵送法による無記名自記式質問紙調査を実施した．171人をデータ分析対象とし，記述統計量を算出し，単変量解析，階層的重回帰分析を行った．獲得的レジリエンス要因，現在の施設での勤続年数，入所者平均要介護度が看護実践能力と有意に関連していた（β＝0.181-0.262 ; p＜0.05）．要介護度の高い利用者の課題解決策を探りつつ看護師としての経験を積み重ねることが看護実践能力に影響することが明らかとなり，看護師が施設に定着し，看護実践能力を向上できるようなサポート体制が必要であることが示唆された．

　Introduction: Nurses working in long-term care welfare facilities for the elderly must have medical judgment，knowledge，and skills regarding dementia and multidisciplinary cooperation. However，there is a lack of efforts toward ensuring the systematic evaluation of interventions for improvement.

　Objective: This study aimed to explore the factors related to the competence of nurses working in long-term care welfare facilities for the elderly.

　Methods: Anonymous，self-administered questionnaires were mailed to 1,100 nurses working at 550 nursing homes in Tokyo. IBM SPSS Statistics for Windows，version 27，was used to perform univariate and multiple regression analyses.

　Results: Data from 171 survey responses were analyzed. The mean nursing experience and mean experience in facilities was 21.6 ± 10.5 years and 8.7 ± 6.7 years，respectively. Univariate analysis identified the following factors related to nursing competence: experience in the current facility，the average care levels of residents，employment position，participation in training，innate resilience factors，acquired resilience factors，and career commitment. Multiple regression analysis revealed that the acquired resilience factors，experience in the current facility，and the average care levels of residents were related to nursing competence (β = 0.181-0.262; p< 0.05).

　Conclusion: Experience in developing solutions to various nursing challenges in long-term care welfare facilities for the elderly affected competence. The findings highlight the importance of a support system enabling nurses to adapt to the facility and improve their competence