訪問看護師におけるケアリングの相互性と継承性の意識化がもたらす職務継続意向への効果—ランダム化比較試験による検討

Effects of Awareness of Mutuality and Succession in Caring on Job Continuity Intentions among Visiting Nurses: A Randomized Controlled Trial

要旨

　目的：本研究の目的は，心理的困難に直面している訪問看護師に対して，「継承的視点での捉え直し」と「ケアリングの相互性の実感」の意識化を促すことにより職務継続意向への効果を検討することである．

　方法：対象は現職訪問看護師59名を無作為に介入群29名，対照群30名に振り分け，困難事例の想起を促した後に，介入群にのみ「継承的視点での捉え直し」と「その事例から得ているものの意識化」を促す介入を行った．介入評価は「職務継続意向」に関する尺度を使用し，介入時と2週間後の2期に測定した．

　結果：困難事例の想起のみを求めた対照群では職務継続意向が低下したが，介入群では，職務継続意向が維持され，訪問看護経験全般におけるケアリングの相互性の実感が高まっていた．

　結論：困難に直面している訪問看護師に対して「継承的視点での捉え直し」や「その事例から得ているものの意識化」を促すことの有用性が示唆された．

　Purpose: The purpose of this study was to examine the effects of encouragement on the intention to continue work of visiting nurses who faced psychological difficulties to “reconsider the successive reevaluation” and “realize the mutuality of caring.”

　Method: A total of 59 in visiting nurses were randomly assigned to two groups: 29 in the intervention group and 30 in the control group. Nurses were asked to recall difficult cases, only the intervention group underwent an intervention that encouraged them to “reconsider the successive reevaluation” and “become aware of what they had gained from the cases.” Intervention evaluation was conducted at the time of the intervention and two weeks later using a scale related to “intention to continue working.”

　Results: In the control group, who were only asked to recall difficult cases, job continuity intention decreased, but in the intervention group, job continuity intention was maintained and the sense of mutuality of caring in the overall home health care experience increased.

　Conclusion: It was suggested that it is useful to encourage visiting nurses who are facing difficulties in providing support to “reconsider the successive reevaluation” and “become aware of what is gained from the case.”