看護師における健康アウトカムに対する職域ストレス要因とジョブ・クラフティングとの交互作用

Interaction Effects of Job Stressors and Job Crafting on Health Outcomes in Nurses

要旨

　目的：看護師における健康アウトカムに対する，職域ストレス要因とジョブ・クラフティング（JC）との交互作用を調べることを目的とした．

　方法：5団体148名の看護師を対象に自記式質問紙調査を行い，健康アウトカム，職域ストレス要因，JCの4つの下位尺度を測定した．線形回帰分析にて交互作用を評価した．

　結果：心理的ストレス反応に対する仕事のストレインと「構造的な資源の向上」，ワーク・エンゲイジメントに対する個人的ないじめと「妨害的な要求度の低減」，疲労に対する個人的ないじめと「対人関係における資源の向上」，心理的ストレス反応に対する個人的ないじめと「挑戦的な要求度の向上」のそれぞれの交互作用が有意（p＜0.05）であった．人口統計学的因子で調整すると，最後の交互作用のみ有意（p＜0.05）であった．

　結論：目的に記した交互作用を認めた．「挑戦的な要求度の向上」は，個人的ないじめによるストレスを緩和することが示唆された．

　Objectives: Job crafting (JC) is defined as “the physical and cognitive change individuals make in the task or relational boundaries of their work.” The purpose of this study was to examine the interaction effects of job stressors and JC on health outcomes of nurses in Japan.

　Methods: In a cross-sectional study with nurses of five organizations, 148 nurses completed a self-administered questionnaire (response rate = 79.7%). JC was assessed using the Job Crafting Questionnaire, which comprises four subscales, increasing structural job resources (JC1), reducing hindering job demands (JC2), increasing social job resources (JC3), and increasing challenging job demands (JC4). Job strain based on the demands-control model, and workplace bullying were assessed as job stressors. Psychological distress (PD), fatigue, and work engagement were assessed as health outcomes. After confirming the validity of the measurements, the interaction effects of job stressors and each subscale of JC on health outcomes were assessed using hierarchical linear regression analyses. We constructed regression lines and predicted values with significant (p < 0.05) interactions.

　Results: The interaction effects of job strain and JC1 on PD, of person-related bullying and JC2 on work engagement, of person-related bullying and JC3 on fatigue, and of person-related bullying and JC4 on PD were significant (p < 0.05). After adjustment for sociodemographic factors, only the last interaction effect was significant (p < 0.05).

　Conclusion: We found the interaction effects of job stressors and JC on health outcomes of nurses. JC4 attenuated the increase in PD accompanying the increase in person-related bullying.