患者尊厳測定尺度日本版の開発と信頼性・妥当性の検討

Development and evaluation of a Japanese Patient Dignity Scale

　本研究は、入院患者の尊厳を測定する患者尊厳測定尺度日本版（J-PDS）を開発し、信頼性・妥当性を確認することを目的とした。文献検討と患者尊厳測定尺度国際版で用いた調査票の翻訳により尊厳の期待度と満足度を測定する35項目の日本語版調査票を作成し、14施設の入院患者を対象に質問紙調査を行った。307部の回答を得た（回収率47.5％、有効回答率99.7％）。項目分析および探索的因子分析の結果、期待度は5因子21項目、満足度は3因子21項目が抽出された。Cronbach's α係数は期待度で0.92、満足度で0.94であった。ローゼンバーグ自尊感情尺度と一部の因子の間に有意な相関を認めた。確証的因子分析ではCFIが期待度で0.90、満足度で0.91というモデル妥当性を示した。以上よりJ-PDSは一定の信頼性と妥当性を備えた尺度であることが確認された。

　This study aimed to develop the Japanese Patient Dignity Scale (J-PDS), and to evaluate its reliability and validity. The Japanese version of this 35-item questionnaire was prepared by translating its international version. Adult inpatients admitted to 14 hospitals were mailed the self-report J-PDS with demographic questions and the Japanese version of the Rosenberg Self-Esteem Scale (RSES-J). Responses were collected from 307 patients (return rate: 47.5％, valid response rate: 99.7％). Exploratory and confirmatory factor analyses, and examination of the internal reliability and criterion-related validity of the tool were conducted. Expectation of dignity comprised 5 factors: respect for humanity, respect for privacy, politeness and consideration, respect for justice and fairness, and respect for autonomy, with 21 items. Satisfaction with dignified care comprised similar factors for the 21 items, but somewhat integrated 3 factors. The Cronbach's alpha coefficients for expectation and satisfaction were 0.92 and 0.94, respectively. Scores on several factors of both expectation and satisfaction showed significant weak positive correlations (p＜0.05) with the RSES-J scores. The models of expectation and satisfaction indicated relatively high model fit (CFI＝0.90 and 0.91, respectively) on the confirmative factor analysis. These results suggest that the J-PDS has sufficient reliability and validity.