中小規模病院に勤務する看護師の職務継続意思につながる看護師長の基本的心理欲求支援行動評価尺度の開発

Developing a Basic Psychological Needs Support Assessment Scale for Head Nurses that Reflects the Intentions of Nurses to Stay at Small and Medium-sized Hospitals

要旨

　目的：中小規模病院に勤務する看護師が看護師長から受ける基本的心理欲求支援行動を評価できる尺度を開発し，妥当性と信頼性を検討する．

　方法：自己決定理論を基盤に59項目を生成し，看護師1,500名に本調査を行い妥当性と信頼性の検証を行った．評価者間および評価者内信頼性に関する調査は看護師40名を対象とした．

　結果：本調査は有効回答率37.9％であった．探索的因子分析の結果，3因子19項目の尺度を作成した．Cronbach's α係数は.963であり，確証的因子分析では適合性が示された．併存的妥当性は.985，弁別的妥当性は-.624，職務継続意思との関連を確認した．評価者間信頼性は有効回答率90％で，Kendallの一致係数W＝.40〜.62を示した．評価者内信頼性は有効回答率100％で，相関係数は.905，重みつきκ係数は.799であった．

　結論：妥当性・信頼性は概ね確保できた．

　Objectives: The study aimed to develop a scale for nurses employed at small- to medium-sized hospitals for evaluating the supportive behaviors of head nurses to meet their basic psychological needs and assess its validity and reliability.

　Methods: By employing the self-determination theory as the theoretical basis of this study, 59 tentative items were generated, and the main survey was conducted with 1,500 nurses to assess the reliability and validity of the developed scale. Subsequently, 40 nurses were reexamined for the assessment of interrater reliability.

　Results: The valid response rate in the main survey was 37.9%. As a result of an exploratory factor analysis, a scale consisting of 3 factors and 19 items was created. With Cronbach's α coefficient being .963, a confirmatory factor analysis showed adequate fit. The concurrent validity and the discriminant validity were r = .985 and r = -.624, and the relationship with the intention to continue working was confirmed. The valid response rate in the reexamination was 100%. Regarding interrater reliability, the valid response rate was 90% and Kendall's coefficient of concordance was W = .40-.62. The correlation coefficient and the weighted κ coefficient were r = .905 and .799, respectively.

　Conclusion: The scale displayed reasonably good reliability and validity.