患者の死を体験した看護師の成長に関連する要因の検討

The Factors Related to the Personal Development of Nurses Who Have Experienced a Patient's Death

要旨

　目的：悲しみや自責の念等の否定的な感情を伴う強く印象に残る患者の死を体験した看護師の成長に関連する要因を明らかにすることである．

　方法：臨床経験年数3年目～6年目の看護師192名を対象に，《有益性発見尺度》及び《対処行動尺度》を用い，看護師の成長と関連する要因について質問紙調査を実施した．分析には，重回帰分析を用いた．

　結果：大多数の看護師が，否定的な感情を伴う強く印象に残る患者の死を体験していた．患者の死を体験した看護師の成長（有益性発見尺度）と有意に関連がみられたのは，対処行動尺度の下位尺度である「宗教的行動と実存的意味」，「死別の受容と克服」，「考え込み行動」，「援助希求」及び「理想の看取りの確立」であり，分散の51.0％が説明された．

　結論：患者の死を体験した看護師が成長するためには，様々な対処行動をとることが有効であると示唆された．

Abstract

　Purpose：The purpose of this study was to clarify factors that affect the personal development of nurses who have experienced the death of a patient that left them with strong negative emotions, for example, sadness and remorse.

　Method：Subjects were 192 nurses with 3 to 6 years of clinical experience who completed a questionnaire comprised of items from the Finding Benefits Scale and the Scale for Coping with Bereavement, which identifies factors related to the personal development. A multiple regression analysis was used.

　Results：The analysis revealed that most nurses had experienced a patient's death that left them strong negative feelings. The multiple regression analysis revealed that nurses' personal development（evaluated by the Finding Benefits Scale） was significantly affected by the following factors： religious activity and existential meaning, acceptance and overcome, ruminative response, support-seeking behavior（evaluated by the Scale for Coping with Bereavement）, and their beliefs about the ideal death. These factors explained 51.0% of the variance of responses.

　Conclusion：These results suggested that in order to advance nurses' personal development, a various coping behavior was found to be effective.