感染症患者に対する医療者の倫理的行動の実態

Ethical Behavior of Healthcare Professionals towards People with Infectious Diseases

要旨

　目的：感染症患者の視点で医療者の倫理的行動を探索し，診断時と最近の受診時の体験から医療者に求められる倫理的行動を検討する．

　方法：HBVキャリアを対象に5段階のリッカート法で質問紙調査を実施し，探索的因子分析後，対応のあるt検定で比較した．

　結果：医療者の倫理的行動に関する尺度は4因子18項目で構成され，全項目におけるCronbach's α係数は.902であった．「不安な心に寄り添う看護」の診断時（中央値1990年）と最近の受診時（2018年）の平均±標準偏差は2.0±1.1，2.2±1.1（p＜.05）で，「病気を理解し，受容できる説明」3.0±1.3，3.6±1.2（p＜.01），「公平な対応」4.3±1.0，4.7±0.6（p＜.01），「前を向いて生きていくための支援」2.9±0.9，3.2±1.0（p＜.01）であった．

　結論：感染症患者に対する医療者の倫理的行動に関する質問項目は，信頼性・妥当性が検証された．「第I因子：不安な心に寄り添う看護」に有意差はみられたが，得点数は低かった．

　Purpose: This study aimed to explore the ethical behavior of healthcare professionals towards people with infectious diseases, and examine the ethical behavior required of medical staf based on their experiences at the time of diagnosis and the most recent examination.

　Methods: We conducted a self-administered questionnaire survey with scores recorded on a 5-point Likert scale targeting carriers of hepatitis B virus, and analyzed the results with the paired t-test, after exploratory factor analysis.

　Results: The questionnaire consisted of four factors and 18 items, and the Cronbach's coefficient alpha was .902. The mean ± standard deviation score at the time of initial diagnosis (median year: 1990) and most recent examination (2018), respectively, were 2.0 ± 1.1 and 2.2 ± 1.1 (p < .05) for “Factor I: Sympathetic nursing that soothes feelings of anxiety”; 3.0 ± 1.3 and 3.6 ± 1.2 (p < .01) for “Factor II: Explanation that enables understanding and acceptance of disease”; 4.3 ± 1.0 and 4.7 ± 0.6 (p < .01) for “Factor III: Fair handling”; and 2.9 ± 0.9 and 3.2 ± 1.0 (p < .01) for “Factor IV: Support for positive living.”

　Conclusion: The reliability and validity of the questionnaire on ethical behavior of healthcare professionals towards people with infectious diseases were verifed. Significant difference was observed in “Factor I: Nursing that is close to anxious minds,” although the score was low.