終末期維持血液透析患者の医療・ケア方針の検討に関わる看護実践尺度の開発

Development of a Nursing Practice Scale for Treatment and Care Policies (NPTCP) for Terminal-stage Patients on Maintenance Hemodialysis

要旨

　目的：終末期維持血液透析患者の医療・ケア方針の検討に関わる看護実践尺度の妥当性・信頼性を検証する．

　方法：面接調査と文献検討を基に，終末期維持血液透析患者の医療・ケア方針の検討に関わる看護実践尺度原案を作成した．全国の維持血液透析を実施している250施設の透析部門に勤務する看護師を対象に質問紙調査を実施し，尺度の妥当性・信頼性を検証した．

　結果：分析対象は280部（有効回答率83.3％），探索的因子分析により5因子19項目からなる尺度を作成した．モデルの適合度はRMSEA = .081，CFI = .966であった．併存的妥当性，収束的妥当性と弁別的妥当性も，十分な値を示した．Cronbach's α係数は，下位因子は .793〜.912，尺度全体では .940であった．

　結論：5因子19項目からなる終末期維持血液透析患者の医療・ケア方針の検討に関わる看護実践尺度の妥当性，信頼性が確認された．

　Objective: This study aimed to verify the validity and reliability of a nursing practice scale for treatment and care policies for terminal-stage patients on maintenance hemodialysis.

　Methods: A prototype nursing practice scale for treatment and care policies for terminal-stage patients on maintenance hemodialysis was developed based on interview surveys and literature reviews. To verify the validity and reliability of this scale, a questionnaire survey was used. Nurses working at the dialysis department of 250 different facilities that provided maintenance hemodialysis throughout Japan answered the questionnaire survey.

　Results: The responses of 280 nurses were analyzed (valid response rate: 83.3%). Based on the results of the exploratory factor analysis, we developed a scale consisting of 19 items in five factors. As for the goodness-of-fit indices of the model, the root mean square error of approximation was .081 and the comparative fit index was .966. The concurrent, convergent, and discriminant validities were also sufficient. Cronbach's α coefficients were .793-.912 for the subscale factors and .940 for the entire scale.

　Conclusion: The nursing practice scale, which consisted of 19 items in five factors, for treatment and care policies for terminal-stage patients on maintenance hemodialysis was confirmed to be valid and reliable.