精神科看護師の自尊感情の関連要因—患者に対する陰性感情経験を視野に入れた検討

Factors Related to Self-Esteem among Psychiatric Nurses: Including Experience of Developing Negative Feelings Toward Patients

要旨

目的：精神科看護師の自尊感情の関連要因を患者に対する陰性感情経験も視野に入れて明らかにし，看護師支援策を検討する．

方法：9私立精神科病院に勤務する看護師737名を対象に質問紙調査を実施した．有効回答数は365名（49.5％）であった．調査内容は，基本的属性，職場環境要因，心理的健康，自尊感情尺度（Rosenberg, 1965；山本ら，1982）とし，自尊感情尺度合計得点を従属変数とした重回帰分析を行った．

結果：重回帰分析の結果，自由度調整済み決定係数は0.44であった．自尊感情尺度合計得点と有意な関連が認められた要因は，環境制御力，患者に対する陰性感情経験への嫌悪度，既婚，職位が主任，コーピング行動は当事者と話し合う手法をとる，最長勤務領域が外科系病棟，であった．結論：患者に対する陰性感情への嫌悪感が過度にならない支援，患者を取り巻く精神科看護師も含めた人的・物的環境を制御する能力としての患者支援技術修得への支援，問題の当事者と話し合う対処方法修得への支援の重要性が示唆された．

Objectives: This study determines factors related to self-esteem, including experience of developing negative feelings toward patients, as reported by psychiatric nurses and examines ways to assist the nurses.

Method: A self-administered questionnaire survey was distributed to 737 nurses working in nine non-public psychiatric hospitals. We received 365 valid responses (49.5%). The questionnaire included questions about “demographics”, “working environment factors”, “mental health” and Japanese edition (Yamamoto et al, 1982) of “Self-Esteem Scale” by Rosenberg (1965). Using the total score of a self-esteem scale as the dependent variable, a multiple regression analysis was conducted.

Results: The multiple regression analysis showed that the adjusted coefficient of determination was 0.44. Factors that showed statistically significant correlations are “high environmental mastery”, “dislike for the experience of negative feelings toward patients”, “respondent being married”, “presently assistant head nurse”, “coping behavior by discussing with relevant persons when having concerns at the workplace”, and “respondents who had been working longest in surgery wards”.

Conclusions: The findings suggest the importance of providing the following support: (a) to prevent developing excessive feeling of dislike when experiencing negative feelings toward patients, (b) to help acquire skills and understanding to know how to assist patients as a means to control the human and physical environments including psychiatric nurses themselves, and (c) to develop coping strategies for communication with those involved when encountering negative events at the workplace.