訪問看護師を対象とした職場環境測定尺度の開発と信頼性・妥当性の検討

Development, Reliability, and Validity of a Work Environment Scale for Visiting Nurses

要旨

　目的：訪問看護師を対象とした職場環境測定尺度の開発を行うこと．

　方法：全国の訪問看護師2,500名を対象にインターネット調査と質問紙郵送調査を実施し，尺度の信頼性および妥当性の検討をした．

　結果：276名（回収率11.4％）から回答が得られ，5因子35項目（資源の柔軟性と妥当性，管理者のリーダーシップ，看護の質を支える教育・キャリア支援，多職種連携，看護実践に対する支援体制）が抽出された．モデル適合度は，GFI＝0.811，AGFI＝0.779，CFI＝0.901，RMSEA＝0.058で，外的基準との相関係数は，-0.512〜0.677であった．尺度全体のクロンバックα係数は0.95，再テスト法による級内相関係数は0.8以上であった．

　結論：モデル適合度は基準をやや下回ったが，一定の信頼性および妥当性を有することが確認された．訪問看護師が職場環境を評価する指標として活用可能である．

　Objective: To develop a work environment measurement scale for visiting nurses.

　Methods: An Internet survey or a mailed questionnaire survey about the scale was distributed to 2,500 visiting nurses nationwide, and the reliability and validity of the scale were examined.

　Results: Responses were obtained from 276 respondents (response rate: 11.4％) and were included in the analysis. From the analysis results, 35 items from 5 factors (flexibility and adequacy of resources, leadership of managers, educational and career support for nursing quality, multidisciplinary collaboration, and support system for nursing practice) were extracted. The model fit was GFI＝0.811, AGFI＝0.779, CFI＝0.901, and RMSEA＝0.058. Correlation coefficients with external criteria ranged from -0.512 to 0.677. The Cronbach's alpha coefficient for the overall scale was 0.95, and the intraclass correlation coefficient was greater than 0.8 using the retest method.

　Conclusion: Although the model fit was slightly below the criterion (e.g., GFI＜0.9), the scale was confirmed to have a certain degree of reliability and validity. The work environment measurement scale can be used as an indicator for visiting nurses to evaluate good work environments.