腎臓病患者の行動変容を促す療養援助の検討—腎臓病看護に携わる看護師のコミュニケーションスキルとスピリチュアリティの関連性

Examination of recuperation support to promote behavioral change in kidney disease patients: Relationships between communication skills and personal spirituality of chronic kidney disease nurses

【目的】腎臓病看護に携わる看護師のコミュニケーションスキルとスピリチュアリティの関連性を明らかにすることである．

【方法】日本腎臓病協会の慢性腎臓病対策部会員が所属する全国の腎臓病看護に携わる看護師2,420名に対して質問紙調査を実施した．質問紙の構成は対象者の基本的属性，スピリチュアリティ，コミュニケーションスキルとし，計53項目の質問で所要時間10分程度である．分析は，共分散構造分析により仮説モデルの検証を行った．

【結果】365名より回答を得た（有効回答率15.1％）．「基礎的コミュニケーションスキル」から「援助的コミュニケーションスキル」に関連が認められた（パス係数＝.51，p＜.001）．また，「スピリチュアリティ」から「基礎的コミュニケーションスキル」（パス係数＝.34，p＜.001）および「援助的コミュニケーションスキル」（パス係数＝.27，p＜.001）に関連が認められた．モデルの適合度はおおむね良好であった（AGFI＝.926，CFI＝.956，RMSEA＝.076）．

【結論】本研究の結果より，腎臓病看護に携わる看護師のコミュニケーションスキルとスピリチュアリティの関連が認められた．患者の行動変容を促す援助のために，看護師のスピリチュアリティを高めていくことが重要と示唆された．

【Purpose】The purpose of this study was to clarify the relationships existing between communication skills and personal spirituality of nurses who are involved in chronic kidney disease nursing.

【Methods】We conducted a nationwide questionnaire survey on 2,420 chronic kidney disease nurses working in hospitals where the physicians are members of the Chronic Kidney Disease Countermeasures Department of the Japan Kidney Disease Association. The questionnaire consisted of 53 questions on the subjects' basic attributes, personal spirituality, fundamental communication skills, and therapeutic communication skills and took about 10 minutes to complete. Personal spirituality was measured by Spirituality Rating Scale B, composed of desire, support, evaluation of others, evaluation of self, and view of illness or disease. Fundamental communication skills were measured by ENDCOREs (Encode, Decode, Control, and Regulate) composed of expressivity, self-control, deciphering ability, assertiveness, regulation, and other acceptance. Therapeutic communication skills were measured by the Therapeutic Communication Skills Scale, composed of mental skills, intersectional skills, personal spiritual skills, and nonverbal skills. The hypothetical model was verified by structural equation modeling.

【Results】In total, 365 registered nurses completed the questionnaire survey (response rate 15.1％). A relationship was found between “basic communication skills” and “therapeutic communication skills”(path coefficient＝.51，p＜.001). In addition, relationships were found between “personal spirituality” and “basic communication skills”(path coefficient＝.34，p＜.001), as well as “personal spirituality” and “therapeutic communication skills”(path coefficient＝.27，p＜.001). The structural equation modeling fit was generally good (AGFI＝.926，CFI＝.956，RMSEA＝.076).

【Conclusion】This study clarified the relationships between communication skills and personal spirituality. Results suggest that it is important to enhance the personal spirituality of nurses to help facilitate behavioral changes in patients.