千葉県における訪問看護ステーション看護職の人員規模拡充に関連する要因

Exploring Factors for Expanding Number of Nursing Staff in Home-Visit Nursing Offices in Chiba Prefecture

要旨

目的：千葉県における訪問看護ステーション（ステーション）の人員規模拡充（①看護職常勤換算数，②16か月間の採用から退職を減じた看護職常勤換算数（16か月間人数変動））に関連する要因を明らかにした．

方法：対象は千葉県の全ステーション213件のうち回答のあった78件（回収率36.6％）の管理者である．職員数等の属性，管理者の裁量権，職場環境，管理者および設置主体の人員規模拡大意向，給与状況等を把握するための無記名式質問紙調査を実施し，変数間の関係を分析後，①と②に関連のあった変数を投入した重回帰分析を行った．

結果：①看護職常勤換算数の増加に関連している要因は，管理者の残業時間が多いこと，年間賞与額，人事決定権を管理者がもつこと，減少は人事決定権を設置主体がもつことであった．②16か月間人数変動の増加に関連している要因は年間賞与額，減少は医療法人，スタッフの業務上の困難について相談できる体制が整っていないことであった．

Objectives: This study aims to explore related factors for expanding number of nursing staff (“the present number of nursing staff” and “the number of employed nursing staff minus the nursing staff who quit in the period of 16 months”) in the home-visit nursing offices in Chiba prefecture.

Methods: The participants, who answered the questionnaire, were 78 out of 213 managers in all home-visit nursing offices in Chiba prefecture (the answer rate was 36.6%). The questionnaire investigated the home-visit nursing offices' characteristics, the managers' discretional claim to administer their offices, working environment, managers' and the corporate bodies' expanding views regarding the number of staff, and nurses' salary. After analyzing relationships in each variable, multiple regression analysis was used to clarify the relationships between dependent variables “the present number of nursing staff” and “the number of employed nursing staff minus the nursing staff who quit in the period of 16 months” and the related variables.

Results: The factors that increased “present number of nursing staff” were: the amount of work the managers perform on their overtime, seasonal bonuses in annual income, and the managers' discretional right on personnel matters, while the factor that decreased it was the discretional right on personnel matters by the corporate bodies. The factor that increased numbers of “the number of employed nursing staff minus the nursing staff who quit in the period of 16 months” was seasonal bonuses in annual income, while the factors that decreased it were a medical corporation within the corporate bodies, and a lack of the consultation system dealing with the staff's difficulties to provide home-visit care for their clients.