高齢者ケア施設における学際的チームアプローチ実践評価尺度の開発―信頼性・妥当性の検討

Developing an Assessment Scale of Health Care Professionals' Recognition of a Successful Interdisciplinary Team Approach in Health Care Facilities for the Elderly: Analysis of Reliability and Validity

要旨

　目的：介護保険施設に勤務する医療・福祉職のチームアプローチ実践の自己評価を行うITA評価尺度を開発し，信頼性と妥当性を検討する．

　方法：Interdisciplinary teamの概念分析の結果と医療・福祉職から収集した意見を基に尺度原案（40項目）を作成し，24ヵ所の介護老人保健施設のスタッフ904名を対象に自記式質問紙調査を行った．信頼性，妥当性の検討はCronbach α，再テスト法，因子分析等により行った．

　結果：401票が回収され（有効回答率44.4%），因子分析から本尺度は〈組織構造の柔軟さ〉〈ケアのプロセスと実践度〉〈メンバーの凝集性と能力〉の3因子構造（全32項目），モデルの適合度はGFI等が0.9以上を示した．尺度全体のCronbach αは0.9以上，再テスト法による信頼性係数は全項目で0.4以上であった．

　結論：ITA評価尺度は，介護保険施設スタッフのチームアプローチ実践を把握可能な信頼性と妥当性のある尺度であると示唆された．

Abstract

　Aim：The purpose of this study was to develop an assessment scale of health care professionals' recognition of a successful interdisciplinary team approach in health care facilities for the elderly（HCFE）.

　Methods：We adopted a three-step approach to develop this scale. Firstly, researchers carried out concept analysis of interdisciplinary teams from a literature review. Secondly, 16 health care professionals who cared for the elderly with dementia were interviewed about a successful interdisciplinary team approach. Thirdly, the assessment scale was tested on 904 healthcare professionals who worked in HCFE and re-tested after four weeks. Explanatory component analysis with promax rotation and confirmatory factor analysis were performed.

　Results：A total of 401 responses（valid response rate 44.4%） were acquired from the health care professionals in the test. From the results of the explanatory components analysis with promax rotation and maximum likelihood methods, three prescribing factors of recognition of a successful interdisciplinary team approach were extracted. In brief, the final scale consisted of 32 items and three factors：“flexibility of organization structure（α＝0.93）,” “care process and degree of implementation（α＝0.93）,” and “cohesion and competence of members（α＝0.91）.” Moreover, the hypothesis that was made from the results of the exploratory factor analysis indicated that the three-factor model of successful interdisciplinary team approach provided the best fit for the current sample（GFI＝0.921, AGFI＝0.891, CFI＝0.955, RMSEA＝0.065, AIC＝301.792）.

　Conclusion：The developed scale may have possibilities that can measure health care professionals' recognition of an interdisciplinary team approach in HCFE.