指導を守らない患者に対する怒りに起因した看護職の「思考の未統合感」と職場で受けた支援との関連

Relationship between Support in The Workplace and Nurses' “Sense of Unintegration of Thoughts” Derived from Anger toward Patients not Adhering to Nurses' Guidance

要旨

　目的：指導を守らない成人患者に対する怒りを経験した看護職について，思考の未統合感としてその怒りの影響が1週間以上続く状態が，怒りを経験した後に職場で受けた支援と関連するかを明らかにした．

　方法：2018年7〜10月に全国40施設の看護職2,475人に無記名自記式質問紙法で患者に対する怒りの経験の有無や時期，思考の未統合感，職場で受けた支援を尋ね，思考の未統合感スコアを従属変数とした重回帰分析を実施した．

　結果：半数の看護職が指導を守らない患者に対する怒りを経験し，1年以上前の出来事の思考の未統合感を有する看護職もいることがわかった．上司の共感的態度での傾聴や同僚からの助言は思考の未統合感スコアと負の関連が，上司との振り返りは正の関連があった．

　結論：指導を守らない患者に対する怒りを経験した看護職の中には思考の未統合感が長期に続く者も存在するが，職場で受けた支援により思考の未統合感を低減できる可能性が示された．

　Purpose: We aimed to clarify whether nurses' sense of unintegration of thoughts derived from anger toward adult patients who did not to adhere to guidance and lasted for more than one week was related to support received in the workplace after nurses experience this anger.

　Method: A self-administered questionnaire survey was distributed to 2,475 nurses from 40 facilities. Date were collected from July to October 2018. The questionnaire evaluated experiences and timing of anger toward patients, sense of unintegration of thoughts, and support received at the workplace. A multiple regression analysis was conducted to reveal the relationship between the score of the sense of unintegration of thoughts and the support received.

　Results: Fifty percent of the nurses experienced anger toward patients who did not adhere to their guidance. A few nurses had a high score on the sense of unintegration of thoughts resulting from anger experienced over a year ago. The nurses' perception of an empathetic attitude as support from their superiors and colleague's advice negatively correlated with the sense of unintegration of thoughts. Conversely, reflection with their superiors positively correlated with the sense of unintegration of thoughts.

　Conclusion: Nurses may experience anger toward patients who do not adhere to their guidance, and for a few nurses, this could result in extended periods of unintegration of thoughts. However, support in the workplace can help lower nurses' sense of unintegration of thoughts.