助産婦の仕事における承認と仕事の満足度の関係

Relationship Between Recognition of Nurse-midwives' Work and Satisfaction with their Work

要旨

　多くの助産婦は現在の仕事に満足しておらず，その原因の一つとして助産婦が仕事を認められることが少ないのではないかと考えた．助産婦が仕事をする上で他の人から認められ，そして助産婦自身も肯定的に仕事をとらえることを「承認」とし，このことから助産婦が満足できる仕事のあり方を探ることができると考えた．

　本研究の目的は，助産婦の仕事における「承認」という概念を明らかにし，承認に関係する要因を特定することであり，病院で勤務する助産婦460名を対象に調査研究を行った．

　その結果以下のことが明らかとなった．

1）助産婦の仕事における承認は，次の5つの要素から成り立っていた．それには，上司から信頼され権限を委譲され，医師から尊重され，同僚から保証され，患者やその家族と親しい関係がもて，誰からも脅かされないことがあった．特に，上司から信頼され権限を委譲されることは，助産婦にとって大きな承認になることが認められた．

2）承認に関係する変数には，仕事の満足度，自己尊重，看護職の経験年数があった．高い承認を得るためには，仕事に満足し自己尊重が高く，看護職の経験年数が長いことが必要であることが明らかとなった．

3）助産婦の承認を高める仕事のあり方には，プライマリー・ナーシングと助産婦主導の分娩介助があった．プライマリー・ナーシング群は，チーム・ナーシング群に比べ統計学的に有意に高い承認を受けていた．また，助産婦主導の分娩介助群は，医師主導群に比べ統計学的に有意に医師からの尊重を多く受けていた．

Abstract

　As general observations it may be said that most nurse-midwives are not satisfied with their work, and that a significant reason it the generally low level of recognition for this type of work. “Recognition”, as defined here, refers to recognition of the work and services performed by nursemidwives, as well as the affirmative conception of duties by nurse-midwives themselves. From these premises it is possible to explore various ways to raise the satisfaction level of nurse-midwives.

　The purpose of this study is to clarify the concept of recognition as applied to the scope of work of nurse-midwives, and to identify the elements relevant to recognition. With this objective, a survey and study was conducted among 460 nurse-midwives currently working in hospitals. Results of the survey are summarized below.

　1) Recognition of work performed by nurse-midwives is composed of five factors. These are: a) nurse-midwives are trusted by and given authority by their superiors; b) they are respected by medical doctors; c) they have the endorsement and backing of co-workers; d) they maintain close relationships with patients and their families; e) they are not subjected to intimidation in any way. It was clear, in particular, the trust of superiors and transfer of authority contributed greatly to an enhanced level of recognition for nurse-midwives.

　2) Work satisfaction, self-esteem, and number of years of service are all variables related to recognition. It was clear that in order to attain a high degree of satisfaction, it is necessary to have high levels of work satisfaction and self-esteem and sufficiently long experience in maternity nursing.

　3) Primary nursing and supervising of labor and delivery by nurse-midwives are major work factors in elevating recognition. The survey showed the primary nursing group has gained higher recognition in statistical significance than the team nursing group, and the supervision of labor and delivery by nurse-midwives has gained higher appreciation from doctors than for labor supervised by doctors.