小児への訪問看護を実施している訪問看護ステーションおよび併設事業所でのレスパイトケアの実施実態とその関連要因

Understanding the Status and Factors of Implementing Respite Care in Visiting Nursing Stations for Children: A Nationwide Survey

要旨

　目的：本研究の目的は，医療的ケア児のレスパイトケア（以下，RC）に焦点をあて，小児の訪問看護を実施している訪問看護ステーションおよびその併設事業所におけるRCの実施実態とその関連要因を明らかにする．

　方法：全国の小児の訪問看護を実施している事業所1,154か所を対象に，郵送法による自記式質問票調査を実施した．分析はχ²検定およびMann-WhitneyのU検定を用いた．

　結果：381名（32.8％）からの有効回答を分析対象とした．RC実施率は57.1％であり，放課後等デイサービスの併設は実施率と関係がみられた（p = .004）．また，RCの実施には，看護職員数，ニーズ，看護の質の統一化，人員確保，事業所スタッフの児とのコミュニケーション能力，家族との信頼関係構築能力が関連していた（p = .00-.036）．

　結論：RCの実施には，人員配置や看護の質の統一化，基本的看護スキルの習得などの整備を行う必要性が示唆された．

　Aim: This study aimed to investigate the status and factors of implementing respite care in a visiting nursing stations and adjoining office for children requiring medical care.

　Method: A survey questionnaire was distributed to 1,154 visiting nursing stations for children between August and September, 2017. Statistical analyses were performed using χ² test and Mann-Whitney U test.

　Results: There were 381 valid responses (response rate: 32.8%). The respite care implementation rate was 57.1% and there was a relationship between the adjoining of After-school day care service including child development support and respite care implementation rate (p = .004). The factors related to the implementation of respite care were the number of nursing staff, needs, standardization of the quality of nursing, recruiting personnel, staff's ability to communicate with children and family caregivers, and staff's ability to build relationships of trust with family caregivers (p = .00-.04).

　Conclusion: As per this study, it was suggested that improvement of respite care implementation was necessary, based on factors such as personnel allocation, unified quality of nursing care, acquisition of basic nursing skills.