移動に対する負担感および管理者のサポートと訪問看護師の就業継続意向との関連—横断研究

Burden and Manager's Support Regarding the Traveling of Home Care Nurses and Their Intention to Remain Employed: A Cross-sectional Study

要旨

　目的：移動に対する負担感および管理者のサポートと訪問看護師の就業継続意向の関連を明らかにする．

　方法：訪問看護管理者と訪問看護師に対し自記式質問紙調査を行い，就業継続意向を従属変数とするマルチレベル二項ロジスティック回帰分析を行った．

　結果：管理者38名，看護師221名から有効回答を得た．就業継続意向がある者は151名（68.3％）であった．負担感は，非効率な訪問スケジュール（OR＝0.41，95％CI：0.22〜0.78），管理者のサポートは，移動しやすい道のりの共有（OR＝2.49，95％CI：1.20〜5.17），訪問間隔の確保（OR＝2.72，95％CI：1.19〜6.21），移動時間の目安の提示（OR＝0.43，95％CI：0.21〜0.92）が就業継続意向と関連した．

　結論：移動に関する直接的な支援が就業継続支援に有用であることが示唆された．

　Purpose: This study aims to examine the relationship between the work-related burden of traveling and the manager's support for home care nurses and home care nurses' intention to remain employed.

　Methods: A self-administered questionnaire survey was conducted with homecare nurses and managers working at 103 home-nursing provider offices. A multilevel binomial logistic regression analysis was conducted with the intention to remain employed as the dependent variable.

　Results: Responses from 38 managers and 221 home care nurses (effective response rate: 32.5%) were analyzed. The mean age of the home care nurses was 46.4 ± 7.9 years, 214 (96.8%) were female, and 151 (68.3%) had the intention to remain employed. The burden of traveling expressed as inefficient visit schedules (Odds Ratio(OR) = 0.41, 95% Confidence Interval(CI): 0.22-0.78), and managers' support, expressed as sharing accessible routes to travel (OR = 2.49, 95% CI: 1.20-5.17), ensuring visit intervals (OR = 2.72, 95% CI: 1.19-6.21), and providing estimated travel time (OR = 0.43, 95% CI: 0.21-0.92), were associated with home care nurses' intention to remain employed.

　Conclusions: These results suggest that developing management support systems regarding the travel itself, such as ensuring intervals between visits, sharing accessible routes to travel, and providing an estimated travel time, may be useful for supporting home care nurses' intention to remain employed.