終末期がん患者のケアに携わる看護師のスピリチュアリティとスピリチュアルケアの因果関係に関する研究

Causal Relationship between Spirituality and Spiritual Care of Nurses Involved in Caring for Terminal Cancer Patients

要旨

　【目的】 本研究は終末期がん患者のケアに携わる看護師のスピリチュアリティとスピリチュアルケアの関連性を明らかにすることを目的として実施した．

　【方法】 看護師295名を対象として，無記名自記式質問紙調査を行った．質問紙の主な内容はスピリチュアリティ評定尺度とスピリチュアルケア測定尺度，基本的属性で構成した．

　【結果】 基本的属性は，平均年齢30.6±8.1歳，経験年数8.3±6.7年であった．特定の信仰を有する者は8.3％（仏教2.6％，キリスト教2.2％など）であった．最終的にスピリチュアリティとスピリチュアルケアとの因果関係モデルが示された．スピリチュアリティやスピリチュアルケアについて学ぶこと，臨床経験を積むことによって看護師自身の自己に対する意味感や価値観が高まる．この意味感や価値観は看護師のスピリチュアリティを高め，スピリチュアルケアの実践につながっていた．

　【結論】 スピリチュアルケアに最も強い影響を与えていた要因はスピリチュアリティであり，スピリチュアリティの高い看護師はスピリチュアルケアをより積極的に行っていることが示された．終末期がん患者のケアに携わりながらもスピリチュアリティやスピリチュアルケアを学び続けることによって看護師が自分自身のスピリチュアリティを意識し，スピリチュアルケアをより積極的に実践できるようになると考えられる．

Abstract

　Purpose: The purpose of this study was to investigate the causal relationship of spirituality to spiritual care among nurses.

　Methods: Anonymous, self-describing questionnaires were used for research on 295 nurses who were caring for terminal cancer patients. These questionnaires primarily consisted of a spiritual rating scale, a spiritual care scale, and basic nurse attributes.

　Results: For basic attributes, the average age was 30.6±8.1 years old, the average years of experience was 8.3±6.7 years, and the percentage of those who had a specific religion was 8.3% (Buddhism 2.6%, Christianity 2.2%, etc.).

　Ultimately, indication was made regarding a causal model of the relationship between spirituality and spiritual care. It was found that, by learning about spirituality and spiritual care, and gaining clinical experience, nurses were able to enrich both their values and their own sense of meaning in their work and lives. This leads to an enhanced sense of spirituality, which in turn contributes to performance of spiritual care.

　Discussion: Thus, it was indicated that spirituality is the most influential factor in spiritual care, and that nurses with a high sense of spirituality are more active and positive in their performance of this care. Therefore, it is believed that, by continuing to learn about spirituality and spiritual care while involved with the care of end-stage cancer patients, the nurses themselves find a sense of spirituality awakened within them, which enables them to take a more positive stance in spiritual care and its practice.