特別養護老人ホーム入所者の終末期に関わる多職種チームケア成果尺度の開発—よりよい終末期ケアに焦点を当てて

Developing a Scale to Measure the Outcomes of Inter-Professional Team Care for Terminal-Stage Residents in Special Nursing Homes for the Elderly: Focusing on Better Terminal Care

要旨

目的：多職種チームケアをアウトカムの側面から評価する，「特別養護老人ホーム入所者の終末期に関わる多職種チームケア成果尺度」を開発する．

方法：特養の看護職員，介護職員，介護支援専門員，生活相談員を対象に，無記名自記式質問紙調査を郵送法にて実施した．尺度項目に欠損がない243データを分析対象とし，探索的因子分析および検証的因子分析を行った．再テスト法により，尺度の安定性を検討した．

結果：探索的因子分析の結果，【チームワーク】【本人の「生活と死」への支援】【家族・親しい人への働きかけ】の3因子25項目構造となった．検証的因子分析の結果，モデル適合度指数はGFI＝.839，AGFI＝.807，CFI＝.897，RMSEA＝.067であった．再テストにおける信頼性係数は，尺度全体で.80であった．

結論：開発した尺度は妥当性および信頼性のある尺度であると示唆された．

Objectives: We aimed to develop a scale to measure the outcomes of inter-professional team care for terminal-stage residents in special nursing homes for the elderly.

Methods: We conducted an anonymous, self-administered questionnaire survey by mail on nursing staff, caregiver staff, care managers, and life consultant social workers in special nursing homes for the elderly. We conducted exploratory and confirmatory factor analyses on 243 variables with no missing scale items. We examined the stability of the scale by the retest method.

Results: The results of exploratory factor analysis demonstrated a 25-item, 3-factor structure comprising “teamwork,” “support for residents ‘daily life and death’,” and “support for family members and close friends.” The model showed approximately good fit to the data by confirmatory factor analysis (GFI = .839, AGFI = .807, CFI = .897, RMSEA = .067). The reliability coefficient in the retest method was 0.80 for the scale.

Conclusion: We confirmed the validity and reliability of our developed scale.