特定行為研修制度に対する訪問看護師の認識—訪問看護ステーションへの全国調査から

Home-visit Nurses' Awareness of The Specified Medical Acts Training System in Home Care: A National Survey of Home-visit Nursing Stations

要旨

　目的：訪問看護師が特定行為研修制度に対してどのように認識し，それらが研修受講希望に関連するかを明らかにする．

　方法：全国訪問看護事業協会の正会員リストに登録している訪問看護ステーションに従事する看護師を対象に郵送による質問紙調査を行った．質問紙は，訪問看護ステーション1,000カ所に3,000名分を送付した．

　結果：質問紙に回答した459名は，制度に対しある程度の関心はあるが，内容を理解している割合は高いとは言えず，受講希望は低かった．特定行為への期待と制度への関心が高いと必要性の認知が高く，懸念と抵抗感が高いと認知が低かった．また，必要性の認知の高さは受講希望の持ちやすさに関連が見られた．制度を導入する上での課題や受講する上での妨げがあるとする割合は高いが，それらと制度の必要性や受講希望との直接的な関連は認められなかった．

　結論：在宅領域での特定行為研修受講者を増やすためには，本制度に関するさらなる啓蒙活動により制度の関心と必要性の認知を高め，懸念を出来る限り払拭し，同時に多くの訪問看護師が認識している課題に対する対応策を講じる必要性が示された．

　Objectives: This study aimed to elucidate the awareness of home-visit nurses toward the specified medical acts system in home care and relationship with the desire to participate in a training program.

　Methods: Questionnaires were mailed to 3,000 nurses working at 1,000 home-visit nursing stations that were registered as regular members of the National Association for Visiting Nurse Service.

　Results: We collected and analyzed 459 questionnaire responses. Survey participants showed interest in a training system for specific medical acts performed in home care. However, only a small percentage of participants understood the system details. A few participants were interested in participating in a training program. When participants' interest in and expectations for the training system were high, they perceived the system's necessity highly. And when their uneasiness and resistance to the training system were high, their perceptions of the system's necessity were low. Furthermore, their perception for the necessity of the training system was related to their desire to attend the training course.

　A large percentage of participants felt that there were obstacles to participating in a training program and challenges that may arise when introducing the system. The obstacles and challenges identified were not directly related to the need for the system or the interest in participating in a training program.

　Conclusion: To increase the number of participants in the specified medical acts training in home care, it is necessary to raise further awareness of the system, dispel their concerns as much as possible, and deal with the challenges experienced by many visiting nurses.