児童・思春期精神科病棟に勤務する看護師の看護実践の卓越性と看護経験

The Relation between Excellence and Experience with Regard to Child and Adolescent Psychiatric Inpatient Care

要旨

　本研究の目的は，児童・思春期精神科病棟に勤務する看護師の看護実践の卓越性とこれまでの看護経験の関連を明らかにすることである．児童・思春期精神科病棟に勤務する看護師を対象に，「看護実践の卓越性自己評価尺度」と看護経験について自記式質問紙調査を実施した．「看護実践の卓越性自己評価尺度」の7下位尺度について，児童・思春期精神科病棟での勤務年数，成人の精神科および一般の小児科での看護経験の有無による差を，分散分析またはt検定を用いて分析した．14病院234名（有効回答率69.6％）を分析対象とした．児童・思春期精神科病棟での勤務年数が長い者は，総得点と6下位尺度で統計的に有意に高い看護実践の卓越性がみられた．成人の精神科での勤務経験を有する看護師は，『医療チームの一員として複数役割の発見と同時進行』のみ統計的に有意に高い卓越性を示した．一般の小児科経験の有無による差は認められなかった．児童・思春期精神科看護は専門性が高く，成人の精神科での臨床経験の一部が活かされるものの，主に当該領域の臨床看護の経験によって看護実践の卓越性が高められると考えられた．

　This study aimed at identifying how the concept of excellence in nursing practice relates to experience of nurses, primarily in child and adolescent psychiatric inpatient care. Quantitative research was conducted with 234 nurses who work in child and adolescent psychiatric wards. The excellence of their nursing practice was evaluated via a “Hospital Nurses' Self-Evaluation of Their Excellence in Nursing Practice” scale. The scores in total and of 7 subscales were compared with the length of the nursing experience of the participants, and whether experience was in pediatric or adult psychiatric nursing, or not. Nurses with more than 6 years' experience in child and adolescent psychiatric inpatient nursing scored higher than those with less experience in 6 subscales. There were no significant differences in the subscales for pediatric nursing, and there were significant differences in the only one subscale for adult psychiatric nursing. In conclusion, the findings show that child and adolescent psychiatric nursing has its own degree of excellence and aspects of know-how which make it difficult to utilize the experience of nurses across specializations.