看護管理実践のための自己評価指標の開発

Toward the Development of a Japanease Nurse-manager's Self Evaluation Index

要旨

　目的：看護管理者のための実践的指標である「看護管理者のための自己評価指標.日本版看護管理ミニマムデータセット第1版（NMMDS-j ver.1）」を開発し，その信頼性・妥当性を検証することを目的とした．

　方法：データ収集は2006年7～10月に行い，全国579病院の看護管理者から得られた1762通の回答をもとに分析を行った（有効回答率43.3％）．6つの大項目に含まれる各7項目について主成分分析を行い，さらに各大項目のα信頼性係数を求めた．妥当性についてはMessickの概念を採用し，内容的側面，構造的側面，外的側面からの証拠を収集した．

　結果：大項目間の相関係数は0.39～0.71であり，各大項目のα信頼性係数は0.37～0.82であった．成分負荷量の低い質問項目を削除したところ，α信頼性係数は0.4～0.82へ上昇した．妥当性は，上記の3側面から複数の証拠が確保された．

　結論：本指標を看護管理実践の指標として利用するため，結果をもとにスケールの見直しを行うとともに，今後も継続的にデータを収集して検討を重ね，より精度を高めていく．

Abstract

　Purpose：This research examined the reliability and validity of the Nursing Management Minimum Data Set in Japan, version1（ NMMDS1）, which was developed for nurse managers as a practical self evaluation index.

　Method：The NMMDS1 questionnaire　mail survey was conducted from July to October, 2006. Analyzed were data based on 1762 responses（43% response rate） obtained from nurse managers of 579 Japanese hospitals. To examine the internal consistency of NMMDS1, alpha coefficients were computed. Principal component analysis was also performed for the 7 items in each of 6 categories. Messick's unified concept of validity was used as a basis to examine the validity aspects of contents, structure, and constructs of the NMMDS1.

　Results：Alpha coefficients of reliability for the categories ranged from 0.37.0.82. When the items with low principal component loadings were deleted, alpha coefficient of reliability rose to 0.4.0.82. Evidence for construct validity were obtained from the three above-mentioned aspects. The proof of content aspect was accomplished by a pool of experts; structural aspect was examined by computing correlation coefficients between categories and they ranged from 0.39.0.71. The external aspect of construct validity gained proof by calculating the relationships between the NMMDS1　score and the years of experience as nurse managers, the size of hospitals, and the experience of taking examination by JCQHC.

　Conclusion：NMMDS1 was developed as an index for nurse managers' self evaluation index. There were items with low factor loading and the categories with low internal consistency. We will continue further examination to raise the accuracy, and it will be considered to be a useful index for nurse managers' professional practice.