看護師のクリティカルシンキングと科学的根拠の利用の関連

Relationship between Critical Thinking Disposition and Use of Research-based Information among Nurses in Japan

要旨

　目的：看護師が利用する科学的根拠の利用頻度およびクリティカルシンキング（CT）との関連を明らかにする．

　方法：病院の病棟師長および看護師を対象に自記式質問紙調査を実施した．組織特性，個人特性，CT，情報源の利用頻度等を尋ねた．情報源のうち，ガイドライン・論文データベースを科学的根拠と分類した．

　結果：全国61病院の師長68名，看護師986名分の回答を分析対象とした（有効回答率：師長93.2％，看護師72.1％）．ガイドラインは58.4％，論文データベースは32.8％が1年以内に1度以上利用していた．CTは，ガイドライン（オッズ比［OR］：1.97，95％信頼医区間［CI］：1.30〜2.99）および論文データベース（OR: 2.47, 95％CI: 1.58〜3.85）の利用共に有意に関連していた．その他の要因としてガイドラインの利用には学会参加回数が多いこと，論文データベースには一般病床，統計解析の院内研修がある，年齢が低い，臨床研究実施回数が多い，学会参加回数が多いことが有意に関連した．

　結論：CTの高さは，科学的根拠の利用促進に寄与しうる要因であることが示唆された．

　Aim: To clarify the use of research-based information and its relationship to critical thinking (CT) disposition among nurses.

　Method: This cross-sectional study was conducted using a self-administered questionnaire delivered to unit managers and staff nurses working at various units across Japan. We collected data on the characteristics of the hospital/units and nurses, CT, and the frequencies of use of the information sources. We operationally defined research-based information as clinical practice guidelines and databases of research papers.

　Results: Data from 68 unit managers and 986 nurses from 61 hospitals were analyzed. (valid response rate: managers 93.2%, nurses 72.1%). The percentages of nurses who used clinical practice guidelines and databases of research papers in the year prior to completing our surveys were 58.4% and 32.8%, respectively. Nurses' CT was significantly related to the use of clinical practice guidelines (odds ratio [OR]: 1.97, 95% confidence interval [CI]: 1.30-2.99) and databases of research papers (OR: 2.47, 95% CI: 1.58-3.85). Another factor significantly related to the nurses' use of clinical practice guidelines was higher numbers of participation of academic conferences. Other factors significantly related to database use were unit type (general), having seminars about statistics in the hospitals, nurses' lower age, higher numbers of nursing research conducted, and higher numbers of participation of academic conferences.

　Conclusion: Fostering nurses' CT may promote evidence-based practice implementation in Japan.