精神科看護師の専門的ケア行動に影響を及ぼす組織コミットメントに関する研究

Organizational Commitment on Professional Care Behavior of Psychiatric Nurses in Japan

要旨

　多くの精神科看護師は, さまざまな精神科医療の問題を含んだ病院内で勤務し, さまざまな体験を認知した結果, 職場に対する気持ちを形成し, 病院組織にコミットしている. 本研究ではこの組織コミットメントが, 専門的ケア行動の決定にどのように影響しているのかを明らかにすることを目的とする. 方法は, 関東以西の13カ所の精神科病院に所属する看護師1, 313名を対象に4種類の測定尺度と属性に関する質問票の合計95項目で測定した. データは共分散構造分析を用いて分析した. その結果, 精神科看護師は, 病院組織への愛着の感情を主体とする情動的コミットメントが強いほど患者に対して専門的なケア行動を実施し, 功利的意味合いの強い継続的コミットメントが強いと専門的ケア行動を抑制することが確認された. さらに, 情動的コミットメントの先行因子である職務満足度には職場内の人間関係のよさ, 患者家族との関係の維持, さらに勤務経験の長さが重要な要因になっていた．

Abstract

　A lot of psychiatric nurses in Japan are working in private hospitals. It is safely to say that every kind of problems related to psychiatric nursing can be observed there. In such a situation they necessarily encounter various problematic events to be seriously considered and dealt with, making up their character as psychiatric nurses. Finally, their commitments to the organizations are settled. In this study, we attempted to classify the types of commitment to organizations by psychiatric nurses and investigate how each of them affects their professional care behaviors.

　The subjects were 1,313 nurses working in 13 Japanese psychiatric hospitals located in Kanto and westward, and required to answer a questionnaire. The items surveyed include four measurement scales and questions concerning their attributes, ranging from age, academic career to relationship to the people they work with. The total number of questions was 95. The collected data was analyzed under covariant structure analysis and the following results were obtained:

　1) Affective commitment and continuous commitment are both related to the quality of professional care behavior in a reversal way. Those who have strong affective commitment have a friendly and positive feeling to their organizations, and those who have strong continuous commitment tend to work just for making a living. The former provided professional care behavior to their patients better than the latter.

　2) The level of job satisfaction, which is a prior factor of affective commitment, is strongly related to the degree of relationship to colleagues and patients' families, and how long they have spent working as psychiatric nurses.