看護部長が認識する精神科病院入院患者のリカバリーに向けた実践に影響する要因

Nursing Director' Perception of Factors Influencing Inpatient Recovery-Oriented Practice in Psychiatric Hospitals

要旨

　目的：精神科病院の看護部長が認識する入院患者のリカバリーに向けた実践に影響する要因について明らかにする．

　方法：全国の精神科病院の看護部長20名を対象に半構造化面接調査を実施した．面接データは逐語録を作成し，Graneheimのデータ分析方法を参考に質的記述的分析を行った．

　結果：精神科病院の看護部長が認識するリカバリーに向けた実践に影響している要因として325のコードが抽出され，【看護部長のリカバリー志向と伝達】【看護部長を理解する仲間の存在】【退院支援における看護職の充実感】【病院組織の文化と風土】の4つのコアカテゴリに分類された．

　結論：精神科病院においてリカバリーに向けた実践を行っていくためには，看護管理者のリカバリー志向を高める教育と，多職種・他部門を含んだ病院全体に対するリカバリーの教育の必要性，退院後の生活を知るなどリカバリーを目の当たりにする体験の必要性が示唆された．

　Purpose: To clarify the factors that influence recovery-oriented practice for inpatients as recognized by the nursing directors of psychiatric hospitals.

　Methods: A semi-structured interview survey was conducted to 20 nursing directors of psychiatric hospitals in Japan. The interview data were transcribed verbatim, and qualitative descriptive analysis was performed with reference to the data analysis method of Graneheim.

　Results: In terms of the factors influencing the practices facilitating the recovery of inpatients recognized by the nursing directors, 325 codes were extracted and classified into 21 categories and four core categories: nursing director's recovery-orientation and communication to the staff, existence of colleagues who approve the idea of the nursing director, sense of professional fulfillment during discharge support, and culture and climate of the hospital organization.

　Conclusion: The following points were suggested for the introduction of practices facilitating recovery in psychiatric hospitals in the future. There is a need for education that enhances recovery-oriented attitudes of nursing directors, education on patient recovery for the hospital as a whole, including multiple occupations and other departments, and a need for seeing and listening to patients' experience of the recovery process, including understanding of the patients' lives after hospital discharge.