ターミナル期の患者に関わる看護師の態度に関連する要因の検討

Factors Related to the Attitudes of Nurses Attending Terminally Ill Patients

要旨

　目的：ターミナル期の患者に関わる看護師の態度に関連する要因を明らかにすることを目的とした．

　方法：関東圏内のがん診療に携わる医療機関に所属する臨床経験3年以上の看護師586名を対象に自記式質問紙調査を実施した．ターミナル期の患者に関わる看護師の態度を測定するために，Frommeltのターミナルケア態度尺度を用い，「個人属性」「ターミナルケアに関する看護師の特性」，及び「看護師を取り巻く環境特性」との関連を分析した．

　結果：ターミナル期の患者に関わる看護師の態度と有意に関連がみられた要因は，「個人属性」の中で年齢や臨床経験であり，「看護師を取り巻く環境特性」の中では，看護組織のチーム力や医師との考えの共有，医療施設におけるターミナルケア提供体制において患者や家族を支援する取り組みに関する項目，インフォームドコンセント時に看護師が同席し，患者に関わる項目などであった．

　結論：看護師が組織のチーム力を高いと認知し，多職種を含めた理念の共有化を目指す組織のあり方がターミナルケアに携わる看護師を支えることにつながることが示唆された．

Abstract

　The purpose of this study was to investigate factors related to the attitudes of nurses attending terminally ill patients. A self-report questionnaire was administered to nurses with three or more years of clinical experience employed at medical institutions providing cancer care in the Kanto region. Answers were obtained from 697 nurses, and 586 (response rate: 50.3%) excluding invalid answers were analyzed to examine the relationships between the attitudes of nurses (as measured using the “Frommelt's Attitudes Toward Care of the Dying Scale”) and “personal attributes,” “characteristics of the nurse in terminal care,” and “characteristics of environment around the nurse.” Analysis of the data revealed that there were significant relationships between the attitudes of nurses and both age and clinical experience, as well as with “characteristics of environment around the nurse” in terms of the strength of the nursing organization as a team, the sharing of opinions with physicians, the condition of care given at the facility to support terminally ill patients and families, and the attendance and involvement of nurses in the process of informed consent. These results suggest the importance of the environment around nurses, including organizational approaches, in promoting positive attitudes of nurses.