急性期一般病棟における認知症高齢者の家族への看護師のかかわりの因子構造

Factorial Structure of the Interactions of Nurses with Families of Older Adults with Dementia in General Wards of an Acute Care Hospital

抄録

　本研究の目的は，急性期病院の一般病棟において，認知症高齢者の家族に対して積極的・継続的に関係性を築こうとする看護師のかかわり行動について，因子構造を明らかにすることである．1施設の看護師302人を対象として無記名自記式質問紙調査を実施し，155人の看護師から有効回答を得た．探索的因子分析を行った結果，家族へのかかわりは，【家族を患者の重要な支援者として認識したかかわり】【家族を支援の対象として認識したかかわり】【家族の認知症ケアへの理解と感情表出を促すかかわり】【患者の安心・安全のための家族の付き添い依頼と個別事情への柔軟な対応】の4因子18項目の構造となった．【家族の認知症ケアへの理解と感情表出を促すかかわり】や【患者の安心・安全のための家族の付き添い依頼と個別事情への柔軟な対応】の得点は4つのなかで相対的に低く，家族に焦点をあてた内容の認知症ケアの教育や，倫理的取り組みの重要性について示唆を得た．

　This study aimed to clarify the factorial structure of nurses' interactions, specifically their engagement, with family members of older patients with dementia in the general wards of an acute care hospital. A self-administered questionnaire-based survey was conducted with 302 nurses in an acute care hospital, and 155 valid responses were obtained. Exploratory factor analysis revealed that interactions with families comprised a structure of four factors and 18 items: (1) interactions recognizing families as important supporters of patients, (2) interactions recognizing families as recipients of support, (3) interactions promoting families' understanding of dementia care and emotional expression, and (4) requests for family accompaniment for patient safety and security, and for flexible responses to individual circumstances. Scores for interactions promoting family understanding of dementia care and emotional expression, and for requests for family accompaniment for patient safety and flexible responses to individual circumstances, were relatively low among the four factors. These findings suggest the importance of continuing education in dementia care that focuses on families and ethical efforts.