急性期病院で認知症高齢者をケアする看護師の困難感尺度の開発

Development of a Scale to Measure Difficulties Nurses Experience in Providing Care for Elderly Patients with Dementia in Acute Care Hospitals

要旨

　目的：急性期病院で認知症高齢者をケアする看護師の困難感尺度を開発し，信頼性・妥当性の検証を行うことを目的とした．

　方法：質的先行研究と文献研究に基づき，急性期病院で認知症高齢者をケアする看護師の困難感尺度原案作成した．全国の国公立系医療機関で6つの急性期病院に勤務する認知症高齢者をケアする看護師690名を対象に質問紙調査を実施し，信頼性と妥当性を検証した．

　結果：分析対象は567名（有効回答率82.2％）であった．項目分析と探索的因子分析により16項目3因子が抽出された．さらに，確証的因子分析により探索的因子分析で得られた仮説モデルの適合度が確認された．信頼性では，クロンバックα係数は尺度16項目全体が .93，因子別では .82〜.91の範囲であった．再テスト法の級内相関係数は .69，外的基準としての「仕事ストレッサー尺度」との相関係数は .56であった．

　結論：信頼性，妥当性は概ね良好であった．今後は，この尺度を使用しての実証研究を行うことが望まれる．

　Aim: This study aims to develop a scal (NDDC: Nurses' difficulties in dementia care) to measure difficulties nurses experience in providing care for elderly patients with dementia in acute care hospitals in Japan and evaluate the reliability and validity of the scale.

　Methods: Based on previous qualitative studies and a literature review, we developed an original scale to measure the kinds of difficulties nurses experience in providing care for elderly patients with dementia in acute care hospitals. A questionnaire survey was conducted with 690 nurses in charge of patients with dementia in 6 national/public acute care hospitals nationwide, and the reliability and validity of the scale were evaluated.

　Results: In total 567 responses (82.2%) were determined to be valid and included in the analyses. As a result of item analysis and exploratory factor analysis, 16 items and 3 factors were extracted. With a confirmatory factor analysis, the goodness of fit of the hypothetical model obtained by the exploratory factor analysis was confirmed. For reliability, Cronbach's α coefficient was .93 for all 16 items and from .82 to .91 for each of the factors. The intra-test correlation coefficient in the retest was .69, and the correlation coefficient with the external standard “Job stressors scale” was .56.

　Conclusion: The reliability and validity were considered to be generally good. In the future, it is desirable to conduct empirical research using this scale.