地域包括ケア病棟の看護職における認知症ケア実践と仕事に向き合う力および職務継続意向との関連

Correlation among Nurses' Dementia Care, Abilities to Tackle Their Jobs, and Intention to Continue Working in Hospitals for Community-based Care

要旨

　目的：本研究は地域包括ケア病棟の看護職における認知症ケア実践と仕事に向き合う力および職務継続意向との関連を明らかにすることを目的とした．

　方法：地域包括ケア病棟の看護職の質問紙調査では570名の回答が得られ，地域包括ケア病棟継続意向なし群320名と，あり群250名を有効回答とした．

　結果：2群では，ソーシャルサポート，ワーク・エンゲイジメントなどに差がみられた．パス図においては，職員間のコミュニケーションおよび学び支えあう環境は互いに関係をし，認知症ケアという仕事に向き合う力となり，職務継続意向につながるというモデルの適合度はGFIは .904，AGFIは .882，CFIは .922，RMSEAは .058，GFI≧AGFIであり，モデルを採用する基準を満たすものであると評価した．

　結論：地域包括ケア病棟における認知症ケア実践は，職務満足および仕事に対するポジティブな思いを高め看護職としての仕事の継続につながると考える．

　Objective: This study aimed to clarify the relationship among dementia care, abilities to tackle their jobs, and intention to continue working in hospitals for community-based care.

　Method: A questionnaire survey was administered to nurses at hospitals for community-based care, and 570 valid responses were obtained. These 570 nurses were divided into two groups: those with and without an intention to continue working in hospitals for community-based care. The former group consisted of 250 nurses, and the latter, 320 nurses.

　Results: The two groups differed in social support and work engagement. The path diagram of the model indicated that was environment in which nurses communicated with, learned from, and supported one another; this relation enabled nurses to tackle their jobs in dementia care. Consequently, nurses had an intention to continue working in hospitals for community-based care. Then, we verified fidelity of the nursing model. The goodness of fit index (GFI) was .904, the adjusted goodness of fit index (AGFI) was .882, the comparative fit index was .922, the root mean square error of approximation was .058, and GFI ≥ AGFI. Therefore, the criteria for adopting the model were satisfied.

　Conclusion: The dementia care at hospitals for community-based care increased nurses' satisfaction with and positive thinking about their jobs, resulting in their intention to continue working in hospitals for community-based care.