熊本県内の臨床経験3年以上20歳代の看護職者の自尊感情と抑うつ状態に関連する職業性ストレスの検討

Occupational Stress Associated with Self-Esteem and Depression in Nurses in Their 20s with More than 3 Years' Clinical Experience in Kumamoto Prefecture

要旨

　目的：臨床経験3年以上20歳代の看護職者の自尊感情，抑うつ状態と職業性ストレスとの関連を明らかにする．

　方法：熊本県内の病床数100床以上の施設に勤務する臨床経験3年以上20歳代の看護職者996名を対象に，無記名自記式質問紙調査を実施した．

　結果：臨床経験3年以上20歳代の看護職者の自尊感情を低下させる職業性ストレスは「患者・家族に対する支援困難」「患者・家族との関係困難」「人命に関わる仕事」「患者の死との直面」であり，抑うつ状態を引き起こすのは「対人関係困難」「質的負荷」「患者・家族との関係困難」であった．「患者・家族との関係困難」は，自尊感情の低下と抑うつ状態に影響していた．自尊感情の低下と抑うつ状態を防ぐのは「同僚・上司の支援」「達成感」「裁量度」であった．さらに，自尊感情の低下と抑うつ状態は，相互に影響することが明らかになった．

　結論：臨床経験3年以上20歳代の看護職者の自尊感情の低下と抑うつ状態は，相互に影響していることから，看護職者と患者・家族との関係構築の場面に重点を置き，同僚・上司の支援を充実させ，達成感と裁量度を高めることが重要かつ有効であることが明らかになった．

Abstract

　Purpose: This study aimed to identify relationships among self-esteem, depression, and occupational stress in nurses in their 20s with more than 3 years' clinical experience in Kumamoto Prefecture.

　Methods: An anonymous self-administered questionnaire survey was performed on 996 nurses in their 20s who had more than 3 years' clinical experience in hospitals with 100 beds or more.

　Results: "Difficulties in relationships with patients and families," "job that deals with human lives," and "confronting patient deaths" were extracted as occupational stresses that deteriorated their self-esteem, and "difficulties in interpersonal relationships" and "qualitative workload" as occupational stresses that cause depression. "Difficulties in providing support for patients and families" affected the deterioration of self-esteem and depression. "Support from colleagues and superior nurses," "sense of accomplishment," and "level of discretion" were found to reduce occupational stress, increase self-esteem, and prevent depression. Furthermore, the deterioration of self-esteem and depression affected each other.

　Conclusion: It is important and effective to enhance support from colleagues and superior nurses, and to facilitate a sense of accomplishment and a high level of discretion by focusing on nursing practice in terms of relationships with patients and families.