外来看護師の在宅療養移行支援実践評価尺度の妥当性・信頼性の検証

Verification of Validity and Reliability of the Transitional Care of Outpatient Department Nurses

要旨

　目的：外来看護師の在宅療養移行支援実践評価尺度を開発し，その妥当性と信頼性を検討する．

　方法：文献検討とインタビューより抽出したデータを基に，外来看護師の在宅療養移行支援実践評価尺度原案を作成した．全国805施設の外来看護師を対象に質問紙調査を行い，妥当性・信頼性の検証を行った．

　結果：分析対象は360名で（有効回答率22.3％），探索的因子分析の結果，25項目4下位尺度を作成した．モデルの適合度は，GFI＝.845，AGFI＝.812，CFI＝.904，RMSEA＝.073 であった．収束的妥当性はr＝.741（p＜ .001）で，弁別的妥当性はr＝-.471（p＜.001）であった．尺度全体のクロンバックαが.945で，下位尺度は.771〜.915であった．

　結論：本尺度の妥当性，信頼性は，統計量的に許容範囲であることが確認された．地域包括ケアシステムにおいて，外来看護師が実践する在宅療養移行支援の標準的指標となり，教育研修の効果測定に活用できる．

　Aims: To develop the Transitional Care of Outpatient Department Nurses (TCODN), a self-evaluation instrument for transitional care practices among outpatient department nurses.

　Methods: Based on a literature review and in-depth interviews, we developed a measure for outpatient department nurses to self-evaluate their transitional care practices. A questionnaire survey was conducted with outpatient department nurses in 805 hospitals across Japan, and the validity and reliability of the scale were investigated.

　Results: A total of 360 responses (22.3%) were analyzed. An exploratory factor analysis helped identify four factors (25 items): [Standing with patient's intention and support for continuation of their home care life], [Information sharing between the multidisciplinary and support for the patient's self-care], [Support for planned inpatients and ward cooperation], and [Support for understanding the medical condition]. The goodness of fit of the model was as follows: GFI = .845, AGFI = .812, CFI = .904, and RMSEA = .073. The convergent validity was .741 (p < .001), divergent validity was -.471 (p < .001). Cronbach's α for the overall scale was .945, and the corresponding values for the subscales ranged from .771 to .915.

　Conclusions: The results of this study suggest that the validity and reliability of the scale were within the permissible range. The scale can be used as a quality indicator in transitional care practices by outpatient department nurses and to evaluate the effectiveness of educational training.