看護専門職における自律性に関する研究—基本的属性・内的特性との関連

The Relationship between Professional Autonomy and Demographic and Psychological Variables in Nursing

はじめに

　看護職の業務内容は，1948年（昭和23年）制定の保健婦助産婦看護婦法に規定されているように，“療養上の世話”と“診療の補助”に大別される。これは，看護の職務内容として看護独自の機能が規定されている一方で，診療の“補助”のように医療介助者としての補助的・従属的な役割についても明記されているために，専門職としてのイニシアチブが取りにくいといら実情を生み出している。また，看護職の専門職性についても，これまで看護職は理論・技術の利用が低く，カンやコツの部分が多いために知識の創造というよりは伝達の側面が強く，必ずしも看護の専門性が充分に確立されてきたとは言いがたい。

　しかしながら，近年の医療の高度化や慢性疾患の増加に伴い，看護実践における看護の判断の技術や対応（治療）の技術など，専門的な能力がよりいっそう求められてくるようになってきた。これら社会的要請や看護職自身の専門職志向の高まりを受けて，看護教育の大学・大学院化による研究者の養成や学問的研究活動の推進などが図られ，看護学自体も次第に体系化されてきている（草刈，1995；杉森，1991；鈴木，1991）。

　The purpose of this study is to investigate the relationships of professional autonomy in nursing with demographic and psychological variables. The measure of professional autonomy in nursing is constructed by five factors, “Cognition”, “Performance”, “Concrete judgment”, “Abstract judgment” and “Independent judgment”, respectively and interpreted to represent the professional work abilities of nursing. Age, years of experience of nursing, arrangement of work place in the hospital, position level and educational background of nursing are selected as demographic variables. Psychological variables used in this study were intention to continue at work as a nurse, work satisfaction and motivation, self confidence and self evaluated aptitude toward nursing.

　Three-hundred and seventy professional nurses in the public hospital were administered a questionnaire including the five-point scale for pro-fessional autonomy in nursing and several demographic and psychological variables.

　The main results were as follows : (1) Each of the sub-scale scores of professional autonomy in nursing had significant and positive correlations with age, years of experience, work satisfaction and motivation, self confidence and aptitude toward nursing. (2) Nurses worked at the intensive care unit and operation room were significantly higher scores of professional autonomy in nursing than the nurses at the ward and the outpatient clinic. (3) Professional autonomy in nursing was totally increasing with the increase of nurse's position and years of experience. (4) Self confidence, position level and the kind of nursing license were the most explicable variables of professional autonomy in nursing.