エンドオブライフケアに関わる看護師の死生観の構造：看護師の死生観尺度の開発とその検証

Structure of Nurses' Views of Death and Dying Related to End-of-Life Care: Development and Verification of a Scale of Nurses' Views on Death and Dying

要旨

　目的：一般病棟に勤務する看護師の死生観に基づく死生観尺度を開発・検証し，死生観の構成要素を明らかにすること．

　方法：システマティックレビューに基づく質的データを概念分析により得られたデータより，看護師の死生観尺度原案35項目から成る質問紙を作成した．看護師630名を対象に質問紙調査を実施し，尺度の信頼性と妥当性を検証した．

　結果：有効回答率は54.4％であった．主因子解法による因子分析の結果，18項目5因子が抽出された．尺度の信頼性の検討では，Cronbach's α係数.801，再テスト法による信頼性係数は.681であった．妥当性については，基準関連妥当性と構成概念妥当性で確認された．

　結論：【家族が期待するQODD】【死に逝く人の教え】【死に対するネガティブな感情】【死は自然の摂理】【End-of-Lifeの生き方への示唆】などの5つの構成要素が抽出された．

　Objectives: To develop and verify a scale of nurses' views on death and dying based on the views of nurses working in a general hospital, and to clarify the constituent elements of nurses' views on death and dying.

　Methods: The scale of nurses' views on death and dying was developed based on a systematic review of qualitative research into nurses' views on death and dying and evolutionary concept analysis. A draft scale of 35 items was developed, and the questionnaire was distributed to 630 general ward nurses. Subsequently, the reliability and validity of the scale were examined.

　Results: Of the distributed questionnaire forms, valid response rate was 54.4%. Principal factor analysis was conducted to identify constituent elements. The scale was ultimately composed of 18 items and five subscales. The reliability of the scale was confirmed with Cronbach's alpha internal consistency reliability coefficient of .801 and test-retest reliability coefficient of .681. As for the validity of the scale, criterion-related validity and construct validity were confirmed.

　Conclusion: The analysis identified five constituent elements: “The quality of death and dying by the family,” “The teachings of people who are dying,” “Negative feelings about death,” “Death is a law of nature,” and “Suggestions for spending the end-of-life stage.”